The CAGE Questionnaire

Some of the cases on the USMLE Step 2 CS have a component that may relate to alcohol or drug problems. The CAGE questionnaire is a helpful, brief tool designed to screen for alcoholism. The CAGE questionnaire has been updated to also be used as a screening tool for drug abuse, in which case it is called the CAGE-AID.

Before beginning a CAGE questionnaire, ask the patient two questions:
1. Do you drink alcohol?
2. Have you ever experimented with drugs?

If the answer to either of these questions is "yes," then a CAGE questionnaire should be considered. Below, the parts of the questions in parentheses is the part used to screen for drug abuse.

The mnemonic "CAGE" stands for the following:
C-ut down
A-nnoyed
G-uilty
E-ye opener

The cage questionnaire is as follows:

Have you every felt you should cut down on your drinking (or drug use)?

Have people every annoyed you by criticizing your drinking (or drug use)?

Have you ever felt bad or guilty about your drinking (or drug use)?

Have you ever had an eye-opener to steady your nerves or get in the morning or get rid of a hangover? (An eye-opener is a drink or drug use in the morning).

An affirmative answer to one of the questions indicates a possible alcohol or drug problem.
An affirmative answer to two of the questions indicates a probable alcohol or drug problem.
An affirmative answer to three or more of the questions confirms alcoholism or drug abuse.


All rights reserved worldwide. Copyright 2005, Theodore X. O'Connell, M.D.