Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly

CAGE + CAGE-AID

Alcohol and Substance Abuse Screening Tool

Purpose : The CAGE questionnaire is used to test for alcohol abuse and dependence in adults. The CAGE-AID version of the tool has been adapted to include drug use

 

Admin time : 1-3 min


User Friendly :  High


Administered by : GP or nurse 

 

Content : Questions pertaining to alcohol use (CAGE). , Questions pertaining to alcohol and other drug use (CAGE-AID).

 

Author :

CAGE : Ewing J, 1984  

CAGE-AID : Brown RL, 1995  

Copyright : Brown RL, 1995

The original 1995 article bearing the CAGE and CAGE-AID questions appeared in the Wisconsin Medical Journal.

It is now archived in the Open Access Medical Heritage Library and thus free to use, with attribution, for non-commercial purposes.

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CAGE + CAGE-AID

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CAGE - online

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CAGE-AID - online

CAGE and CAGE-AID

 

Advantages:

  • free to use

  • quick

  • relatively non-confrontational

Disadvantages: 

  • ​questions do not discriminate well between active and inactive drinkers or drug users, so following positive scores on the CAGE with questions regarding usual consumption patterns (e.g., frequency/quantity/heaviest consumption) will help make this distinction

 

Accuracy : (Brown RL, 1995)

CAGE : sensitivity 85.1% and specificity 88.9%

CAGE-AID : sensitivity 85.1% and specificity 88.9%

Note :

CAGE and CAGE-AID are not used to diagnose diseases, but only to indicate whether a problem might exist.

The questions are most effective when used as part of a general health history and should NOT be preceded by questions about how much or how frequently the patient drinks or uses drugs.

The reason for this is that denial is very common among persons abusing alcohol or other drugs; and therefore, the CAGE/CAGE-AID questions focus the discussion toward the behavioral effects of the drinking or drug use rather than toward the number of drinks or drugs used per day (Steinweg DL, 1993).

 

However, because questions do not discriminate well between active and inactive drinkers or drug users, FOLLOWING positive scores with questions regarding usual consumption patterns (e.g., frequency/quantity/heaviest consumption) will help make this distinction.

Note :

By far the most important question in the questionnaires is the use of a drink as an Eye Opener, so much so that some clinicians use a "yes" to this question alone as a positive to the questionnaire.

Tthis is because the use of an alcoholic drink or drug as an Eye Opener connotes dependence since the patient is going through possible withdrawal in the morning, hence the need for a drink or drug as an Eye Opener.

This Tool is used in the assessment of Alcohol Problems

Back To : Alcohol Problems

Alcohol Problems
Thorny Issues

Back To : Thorny Issues

This is one of several topics presented in the Thorny Issues sector of this toolkit