The CAGE Questionnaire was developed in 1970 by Dr. John A. Ewing.
It is a combination of four simple questions that can be used for the screening of patients for alcoholism. A total of two or more positive answers indicates a positive history of alcoholism.
A history of alcoholism may indicate maladaptive behavior and poor coping strategies when faced with life stresses. These same maladaptive mechanisms may interfere with the adequate management of pain and other symptoms.
This questionnaire has to be completed as part of the medical history; if it is completed as part of the baseline assessment of the patient it becomes much more natural and the patient is less likely to feel defensive.
All the questions pertain to the whole life of the patient.
1. Have you ever felt you should cut down on your drinking?
2. Have people annoyed you by criticizing your drinking?
3. Have you ever felt bad or guilty about your drinking?
4. Have you ever had a drink first thing in the morning or to get rid of a hangover (eye-opener)?
Two or more affirmatives = probable diagnosis of alcoholism 2/4 = a positive CAGE
The validity of the questionnaire decreases if it is asked after asking about the amount of alcohol or drugs ingested; therefore it is necessary to ask first the CAGE questions, and then the volume of alcohol.
- 1 shot of liquor = ½ oz = 1 drink
- 1 glass of wine = 5 oz = 1 drink
- 1 bottle of beer = 12 oz = 1 drink
Ewing, J.A. Detecting alcoholism: the CAGE questionnaire. JAMA: Journal of the American Medical Association 1984: 252(14);1905-1907.