CAGE questionnaire: brief screening tool for problematic alcohol use

Core questions and scoring

The name "CAGE" is an acronym formed from key words in the four items. The usual items ask whether a person has ever:

• Felt they should Cut down on their drinking,
• Been Annoyed by criticism of their drinking,
• Felt Guilty about drinking,
• Needed a drink first thing in the morning as an Eye-opener.

Each affirmative answer scores one point. A total score of two or more is commonly considered a threshold indicating a possible alcohol problem that warrants further evaluation; a lower score does not rule out harmful drinking.

Administration and uses

The questionnaire can be delivered verbally by a clinician, self-completed on paper, or administered electronically. Its brevity makes it useful as an initial screen in time-limited encounters. Patients and clinicians often use it to open a discussion about drinking patterns, risk, and readiness to change. For screening of other substances, an adapted version (CAGE-AID) is available.

History and context

The tool was developed and popularized in the mid‑20th century and remains widely cited for its simplicity. Research has examined its performance across settings and populations; it performs well as a quick screen but is less sensitive for some patterns of risky drinking, such as binge use or substance use in younger people.

Limitations and alternatives

CAGE is not diagnostic. It focuses on long‑standing problems and may miss recent or situational heavy drinking. Cultural factors and patient willingness to answer honestly can affect results. When more detailed measurement is needed, longer instruments such as the AUDIT are preferred. For further information on screening and clinical guidelines, see resources on drinking habits (drinking habits), approaches to alcoholism (alcoholism), and the origin of the acronym (acronym).

When a screen is positive, recommended next steps include a structured clinical interview, assessment of medical and psychiatric comorbidities, brief intervention or counseling, and referral to addiction services when appropriate.