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The CAGE questionnaire as a screen for alcohol problems

Nov. 23, 2008

An article in one of this month's editions of the Journal of the American Medical Association celebrates the publication of the CAGE alcohol screening questionnaire by Charles Ewing 25 years ago.  CAGE is a mnemonic to help remember the four simple questions.  "Have you ever ...

1.) felt the need to cut down your drinking?
2.) felt annoyed by criticism of your drinking?
3.) had guilty feelings about drinking?
4.) taken a morning eye opener?

An affirmative answer to 2 or 3 of these questions makes an alcohol problem likely, while a score of 4 suggests a diagnosis of alcoholism is almost certain. 

The questions can be used in most clinical settings to identify people who need to be checked out more fully.  In the United States, 30% of primary care physicians report  regularly screening for substance abuse.  Of these physicians 55% use the CAGE.  See too the January blog posting on The demon drink. 

O'Brien, C. P. (2008). "The CAGE Questionnaire for Detection of Alcoholism: A Remarkably Useful but Simple Tool." JAMA 300(17): 2054-2056.  [Free Full Text]