This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.
Four questions that take a minute
The CAGE questionnaire is one of the oldest and best-known screening tools for alcohol problems. John Ewing, a psychiatrist at the University of North Carolina, developed it in the 1970s and published it in 1984. Its name comes from the key word of each question:
- Have you ever felt you should Cut down on your drinking?
- Have people Annoyed you by criticizing your drinking?
- Have you ever felt bad or Guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?
Scoring
Each yes counts 1 point, for a total of 0 to 4.
- 0: no sign of an alcohol problem on this screen
- 1: a possible concern, especially if the yes is to the eye-opener question, which suggests physical dependence
- 2 or more: clinically significant; an alcohol use disorder is likely and deserves a fuller assessment
Example
A person answers yes to feeling they should cut down and to feeling guilty, and no to the other two: score 2, a positive screen.
Strengths and limits
The CAGE questions are quick and easy to remember, and studies found good accuracy for alcohol dependence in primary care and hospital patients. But they ask about lifetime experience, not the past year, and do not measure how much someone drinks. They miss many people with risky or binge drinking who do not yet feel dependent, and they are less accurate in women, young people and some cultural groups.
For that reason, the AUDIT (10 questions) or its short form, the AUDIT-C (3 questions on amount and frequency), are now preferred for routine screening. The CAGE is still useful as a quick conversation opener, and some versions add two questions on other drugs (CAGE-AID).
Getting help
A positive result is a reason to talk with a doctor, not a diagnosis. Effective help ranges from brief advice to counseling, medications that reduce cravings and support groups. The SAMHSA National Helpline (1-800-662-4357) is free, confidential and open 24 hours a day. People who drink heavily every day should not stop suddenly without medical advice, because withdrawal can cause seizures.