CAGE Questions for Alcohol Use

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CAGE Questions for Alcohol Use

Simple screening tool for problem drinking and alcohol dependence

All tools /

CAGE Questions for Alcohol Use

Simple screening tool for problem drinking and alcohol dependence

Have you ever felt you should Cut down on your drinking?

C - Cut down

NoYes

Have people Annoyed you by criticizing your drinking?

A - Annoyed

NoYes

Have you ever felt bad or Guilty about your drinking?

G - Guilty

NoYes

Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?

E - Eye opener

NoYes

CAGE Score 0 — Negative (Low risk, no indication of alcohol problems)

0/4 answered · tap options to update (0–4)

Instructions

The CAGE questionnaire is a brief screening tool used to identify potential alcohol use problems. It consists of four simple yes/no questions. To use it, ask each question clearly and record whether the response is positive. A single “yes” answer may warrant further discussion, while two or more positive responses strongly suggest a potential alcohol use disorder that should be evaluated in more depth. The tool is not diagnostic but serves as a quick screening method in clinical, primary care, and community settings.

Overview

When to use

Why use

Evidences

Interpretation

Score (Yes Responses)	Interpretation
0	No indication of problem
1	Possible concern
2	Clinically significant
3–4	High probability

The CAGE is a 4‑item clinician interview screen introduced in 1984: Cut down, Annoyed by criticism, Guilty, Eye‑opener; each “yes” scores 1, with scores ≥2 historically indicating possible alcohol problems requiring further assessment.
https://pubmed.ncbi.nlm.nih.gov/6471323/

Reviews note wide sensitivity/specificity ranges in primary care (sensitivities 21%–94%, specificities 77%–97%), performing best for detecting alcohol dependence but less so for risky use and in groups like college students and pregnant women.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3339489/

A focused review reported meta‑analytic sensitivities around 0.71 in primary care and 0.87 in inpatients at a ≥2 cutoff, with specificities ~0.91 and 0.77 respectively; performance is generally lower in women and during pregnancy due to under‑reporting and lower prevalence
https://utppublishing.com/doi/pdf/10.25011/cim.v30i1.447

NIAAA and USPSTF‑aligned resources advise against using CAGE as a routine screening tool because it misses many who could benefit from brief intervention, recommending instead AUDIT‑C or single‑question screens to identify unhealthy use earlier.
https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/screen-and-assess-use-quick-effective-methods

Overview

When to use

Why use

Evidences

The CAGE questionnaire is one of the most widely used screening tools for alcohol misuse. Developed in the 1970s, it offers a fast and efficient way to identify individuals who may have unhealthy drinking patterns. The acronym CAGE comes from the four questions asked: Cut down, Annoyed, Guilty, and Eye-opener. Each addresses different aspects of drinking behavior and its effects on the individual’s emotions and relationships.

The tool’s strength lies in its brevity and simplicity. Unlike more comprehensive questionnaires, it can be administered in less than a minute, making it especially valuable in busy healthcare environments. It does not measure quantity or frequency of alcohol intake but focuses on the consequences and behaviors associated with drinking. This makes it useful for uncovering patterns that patients might otherwise minimize or overlook.

Clinicians often use CAGE as an initial step. If the results suggest risk, they may follow up with more detailed assessments such as the AUDIT (Alcohol Use Disorders Identification Test) or clinical interviews. The questionnaire has been validated across various populations, though its sensitivity may be lower in women, young adults, and certain cultural groups. Still, it remains an essential tool in primary care, psychiatry, emergency medicine, and social services.