MDCalc

CAGE Questions for Alcohol Use

Screens for excessive drinking and alcoholism.

Have you ever felt you needed to Cut down on your drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt Guilty about drinking?
Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

Result:

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Advice
  • If a clinician suspects that the patient is minimizing his or her alcohol use, more qualitative questions (i.e., about quantity, frequency, pattern of drinking) should be asked to better determine the nature and extent of the problem.
  • Other validated tests for further assessment include:
    • Michigan Alcoholism Screening Test (MAST)
    • Alcohol Use Disorders Identification Test (AUDIT)
  • Data shows that CAGE is less effective in recognizing less severe drinking disorders. In situations where time allows for more in-depth interviewing, incorporating the AUDIT may help to identify a wider spectrum of alcohol problems. (Fiellin DA 2000)
Management

When screening results are positive, the patient should be referred for further evaluation and treatment of an alcohol use problem. This will vary based on available resources, but ideally the patient will be sent to an addiction psychiatrist, psychologist, or addiction treatment program.

Critical Actions

In any hospital setting where access to alcohol may be limited, always monitor for signs/symptoms of alcohol withdrawal, even in patients who have not screened positive for an alcohol problem.

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