At a glance
Number of items: 4 questions.
Completion time: ~1 minute.
1. What is the CAGE questionnaire?
The CAGE questionnaire is a brief, four-item screening tool used to identify patients who may have problems with alcohol use. CAGE focuses on behaviours and feelings that commonly occur in people with unhealthy alcohol use:
- Attempts to cut down on drinking.
- Feeling annoyed when others comment on or criticise drinking.
- Feeling guilty about drinking.
- Using alcohol first thing in the morning as an “eye-opener.”
Together, these questions provide a rapid snapshot of whether alcohol use is likely to be problematic and whether a more detailed assessment is needed.
2. How is it scored?
Scoring is simple and designed for quick use in routine care:
- Each “Yes” answer = 1 point.
- Each “No” answer = 0 points.
- Total CAGE score = sum of all items (range 0–4).
Direction of scores: Higher scores indicate a greater likelihood of problematic alcohol use or alcohol use disorder.
Typical interpretation in clinical practice:
0: Low likelihood of alcohol use disorder (continue routine care; consider risk factors and clinical judgement).
1: Possible concern – explore alcohol use further with open questions.
2 or more: Positive screen – increased risk of alcohol use disorder. Further assessment, brief intervention, and/or referral are recommended.
Note: A “Yes” to the ‘eye-opener’ question (needing a drink first thing in the morning) is especially concerning for physiological dependence, even if the total score is below 2.
3. How do I interpret change over time?
CAGE is primarily a screening tool, not a detailed outcome measure, but it can still be used at key time points to track broad changes in risk.
Improvement: A reduction from a positive screen (2–4) to 0–1 over time suggests a shift towards lower risk and may reflect successful treatment or behaviour change.
Persistent high scores: Ongoing scores of 2 or more indicate continuing elevated risk and should prompt further review, safety assessment and treatment planning.