Substance Use

CAGE Questionnaire: How to Know If You Have an Alcohol Problem

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If you find yourself grappling with the urge to consume alcohol or believe that its effects are detrimentally influencing your life, you might ponder, “Am I battling an Alcohol Use Disorder?” The CAGE questionnaire, endorsed by clinicians and highlighted in JAMA publications, serves as an effective screening tool to gauge your alcohol dependence.

Especially relevant in primary care settings, this assessment can guide you in understanding the severity of your condition and determining the appropriate course of action for treatment. Keep reading to delve deeper into the CAGE Assessment, its criteria, and how it can be a pivotal step in your journey toward recovery and well-being.

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What Is the CAGE Assessment?

The CAGE Assessment also referred to as the CAGE questionnaire, is a screening tool that treatment providers use to diagnose alcoholism. CAGE stands for:

  • Cutting Down: Have you ever felt you should reduce your drinking?
  • Annoyance by Criticism: Does it annoy you when someone criticizes your drinking?
  • Guilty Feeling: Have you ever felt guilty about your drinking?
  • Eye Openers: Do you ever drink first thing in the morning?

Although commonly used to diagnose alcoholism, the assessment can also be used for drug and substance abuse. 

Each question you answer “no” to is scored as a 0, and each “yes” is scored as a 1. A total score of 2 or higher is considered clinically significant. (1)

Warning Signs of Alcoholism

In addition to the CAGE Assessment, there are warning signs that you may have an alcohol problem.

Know these signs and watch out for them. If you are struggling to quit drinking and these warning signs pertain to you, it might be time to seek help.

1. Consistently Drinking More Than You Had Planned

From time to time, you may end up drinking more than you intended for several reasons: your favorite team might have gone into overtime during a big game, or you stayed out later than normal celebrating a milestone or holiday.

But, if you find yourself consistently drinking more than you had planned or are unable to stop drinking after you start, it may be a sign of a bigger problem.

2. You Crave Alcohol

You might look forward to a glass of wine after a long day or a drink during a fun dinner with friends. But, if you are experiencing alcohol cravings that make it hard to concentrate or think about anything else, or you start having cravings as soon as you wake up, this could be a warning sign of excessive drinking.

A strong urge to drink may be triggered by certain places, people, events, or even emotions. People with drinking problems react to these triggers differently and with more urgency than social drinkers do. (2)

3. It’s Causing Tension in Your Relationships

If your loved ones have begged you to stop drinking but you can’t, or you find yourself hiding your drinking only for them to find out (which inevitably starts an argument), it’s likely time to get help to stop drinking.

Alcohol is never worth risking close relationships with your family and friends, and therapy and support groups can help you overcome the urge to drink while restoring your relationships.

Learn more about therapy at Zinnia Health.

4. You’re Experiencing Symptoms of Alcohol Withdrawal

When you’re a heavy drinker, your body becomes reliant on alcohol to function.

Therefore, when it does not get the substance it has grown used to, the body goes into shock and presents several unpleasant withdrawal symptoms, including:

  • Anxiety
  • Mood changes
  • Headaches
  • Shakes and tremors
  • Insomnia and trouble sleeping
  • Fatigue
  • Heart palpitations
  • Increased blood pressure
  • Increased heart rate
  • Hallucinations
  • Seizures

5. Alcohol Is Destroying Your Life

If your drinking habits are starting to spiral out of control and impact other areas of your life, including work, school, home, health, and legal issues, but you still can’t stop drinking, it’s time to seek help.

When a Diagnostic Test for Alcoholism Returns Positive Results

When a screening tool, such as the CAGE questionnaire, suggests the presence of an Alcohol Use Disorder (AUD), it’s a call to action for both clinicians and patients. Especially in primary care settings, early detection is crucial. (3)

Tools like the CAGE-AID, adapted to include drugs, broaden the scope to encompass both alcohol and drug use disorders. They can also be used for alcohol use disorder identification tests. Recognized by the American Medical Association and highlighted in JAMA publications, these tools serve as the first line of defense against the rising prevalence of substance abuse. (4)

Whether it’s alcoholism, drug addiction, or the challenges of the opioid crisis, timely intervention can pave the way for effective treatment and recovery. Adolescents, given their vulnerability, especially benefit from early detection, ensuring they receive the necessary care and support.

Treatment for Alcohol Use Disorder

There are several alcohol addiction treatment options for people struggling to get their drinking behaviors under control.

Some of the most common and effective methods are:

  • Detox: Undergoing a clinically assisted alcohol detox program is an excellent first step to rid your body of alcohol in a controlled environment. Health professionals are concerned about the detection of alcoholism and often provide medication to counter the nastiest effects of alcohol withdrawal so that you can successfully detox without being pushed back into the grips of alcohol addiction.
  • Therapy: There are several drug and alcohol therapy options for people who are rethinking their drinking, including DBT and CBT therapy, group therapy, family therapy, and support groups like Alcoholics Anonymous. Therapy aims to teach you new coping skills while connecting you with people who are going through similar situations so you have people to rely on while you create new habits and friendships.
  • Medication: Medication-assisted therapy, or MAT, provides patients with medications to treat alcohol withdrawal symptoms. If you drink alcohol while taking these medications, the drug will produce a physical reaction that includes flushing, nausea, vomiting, and headaches. Other medications block the “feel good” effects of alcohol and can prevent heavy drinking while reducing the urge to drink.
  • Mental health treatment: Alcohol use disorder commonly occurs with other mental health disorders, known as co-occurring disorders. Sometimes, depression and anxiety can push people to drink. This is why it’s so important to seek treatment for these conditions and learn healthier ways to cope with unpleasant feelings.

Clinicians in Primary Care Settings

In the realm of healthcare, primary care clinicians often stand at the forefront of detecting and addressing substance use disorders. These professionals, operating in primary care settings, are uniquely positioned to identify early signs of alcohol and drug addiction.

Tools like the CAGE questionnaire, adapted to include drugs, are invaluable in their diagnostic arsenal. By utilizing such screening questionnaires, clinicians can swiftly assess the severity of alcohol or drug use, guiding their subsequent medical interventions.

The American Medical Association (AMA) and publications in the Journal of the American Medical Association (JAMA) have consistently emphasized the pivotal role of early detection. With the rising prevalence of substance use disorders, especially among adolescents, primary care settings are becoming increasingly crucial in the fight against alcoholism and drug addiction. (5)

Ewing’s Contribution to Alcohol Abuse Detection

Dr. John A. Ewing’s dedication to the field of alcohol abuse detection has left an indelible mark on healthcare practices. His pioneering work led to the development of the CAGE questionnaire, a tool that has since become synonymous with the diagnosis of alcoholism. (2)

The acronym is a testament to its concise yet effective nature, with each letter representing a criterion-based question aimed at gauging alcohol dependence. Ewing’s contribution has been widely recognized and endorsed by institutions like the American Medical Association, with numerous articles in JAMA underscoring the questionnaire’s significance. 

In a landscape where timely detection can mean the difference between timely intervention and prolonged suffering, Ewing’s legacy continues to impact countless lives.

Opioid Crisis and Screening

The opioid crisis has cast a long shadow over the healthcare landscape, bringing to light the dire need for effective screening tools. While the CAGE questionnaire was initially conceptualized for alcohol use, its principles have found relevance in the broader context of substance use, including opioids.

The adapted version, known as CAGE-AID (Adapted to Include Drugs), offers clinicians a more comprehensive assessment tool, encompassing both alcohol and drug use disorders. With opioids presenting a unique set of challenges, from their addictive nature to their prevalence, the importance of tools like CAGE-AID cannot be overstated.

As the crisis continues to evolve, so does the approach to detection, with primary care settings and psychiatry playing pivotal roles in addressing the multifaceted nature of opioid addiction.

Zinnia Health Can Help

If you’re ready to take back control of your life and quit drinking, Zinnia Health is here to help you. Zinnia Health has a number of alcohol rehab facilities around the country, and its team of experienced and compassionate staff is trained to help clients recover from alcohol addiction and other forms of substance abuse.

If you are concerned about your alcohol consumption and getting the treatment you need, contact Zinnia Health today to take the CAGE questionnaire and start your journey to your best self. You can also call the National Drug Abuse Hotline for further assistance and resources.

Zinnia Health is here to help. Contact us today at (855) 430-9439 to learn more about our substance use treatment options.


Call us
Ready to get help?
(855) 430-9439
Why call us? Why call us