Are Cage Questions Reliable in Testing Alcoholism?

Are Cage Questions Reliable in Testing Alcoholism?

There are a lot of ways to determine potential alcoholism in adults, and using Cage questions is one of the most frequently used.The CAGE test is a straightforward alcoholism screening test, used by many professionals in the alcohol addiction field. It can be self-administered or be provided by a family doctor or other health care providers.

The CAGE questionnaire is utilized to test for AUD or alcohol use disorder in adults. It isn’t used to actually diagnose the disorder, but just to show if a problem might be present.

It is the most commonly used screening tool for signs of alcoholism and is a widely respected alcoholism test due to its reliability. It has been translated into many languages and has been used around the world.

While this is a short tool, it has it has been found to be very effective in identifying individuals who have alcoholism characteristics. Research has shown that it has an accuracy rating of 93%.

According to a study, “The CAGE test was more sensitive for patients diagnosed as alcohol-dependent than for alcohol abusers (61% vs. 84%) with the same specificity (94%). These values are close to those for the English-language CAGE. The first three items (CAG) were very similar, with sensitivity 70% and specificity 94%. The eye-opening question (E) differentiated sharply between abuse and dependency, with sensitivities of 18% and 46%, respectively. A questionnaire comprising only the CAG questions of the CAGE had properties similar to the full questionnaire.”

It is best used as part of a general screening, and does not include questions regarding how much a person drinks and the quantity they drink. For this reason, it is not meant to be used as a diagnostic tool. For a proper diagnosis of substance abuse, a person would need to have a full assessment by mental health or general health provider.

This assessment would investigate how much a person is drinking, how much they are drinking, if they have developed a tolerance as well as any negative consequences that they have experienced that were the result of their drinking.

Nevertheless, several studies have shown that the CAGE questionnaire isn’t a precise alcoholism detector, provided that a 4-item positive response is the measure. On the other hand, if at least 2- or 3-item criterion is taken into consideration, the questionnaire serves a feasible quick alcoholism detection technique for big groups.

Thus, it is important to note that a diagnosis can only be provided by a licensed health professional.

Still, CAGE should be widely circulated so it could be utilized systematically in hospital wards as matter of public health policy. A “brief CAGE” with just three items with a cut-off at 1 may be utilized for broad screening where high sensitivity is primarily sought.

A questionnaire having only the CAG items of the CAGE questionnaire exhibited similar properties to the whole questionnaire. We consider the CAGE questionnaire to be a good tool of choice (even for healthcare providers who might have little interest in alcohol-related issues), among the short routine-use questionnaires, to determine alcohol use disorder patients (dependency or abuse) who might need special care.

“If you’re unsure whether alcohol may be a problem, speak with one of our supportive counselors. With many having first-hand experience they understand the struggle. The free chat is confidential & they are available 24/7.”

Alcoholism Screening Test
The CAGE Questionnaire

Below you will find the CAGE Questionnaire. You will notice its length and simplicity to use.

All you have to do is answer yes or no to the questions.

It is important to note that when answering the questions you should take into account your behavior and feelings over your whole lifetime NOT just in the present moment. Be sure to answer all the questions.

Please answer ALL the questions:

1. Have you ever felt you needed to Cut down on your drinking?
 Yes  No

2. Have people Annoyed you by criticizing your drinking?
 Yes  No

3. Have you ever felt Guilty about drinking?
 Yes  No

4. Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?
 Yes  No


As you can see the CAGE questionnaire gets its name from the acronym formed by the letters in red; Cut, annoyed, guilt and eye.

Answering yes to two questions is considered clinically significant. However, just because you may have answered yes to two or more questions does not mean you are alcoholic.

It simply means that you should take a through look at your drinking behaviors and any negative consequences you have experienced from drinking. If you answer the questions and find yourself uncertain regarding your drinking, take a step back and look at how your drinking impacts your behaviors, your mood, your thoughts, and your relationships.

If any of those are ringing a bell for you, it wouldn’t hurt to have a conversation with a health professional and see what their impression is. Hearing a variety of perspectives can be quite helpful.

If you think you need a more in-depth screening test than the CAGE questionnaire, then you can try some of the other alcoholism screening questionnaires on the alcoholism tests page. Again, if you have an interest in other screenings, it may be worthwhile to talk to your primary physician about your concerns

What do my Answers mean?

-If you have answered yes to 1 question.

Then the probability of you having an alcohol problem is about 25%

– If you have answered yes to 2 questions.

Then the probability of you having an alcohol problem is about 50%

– If you have answered yes to 3 questions.

Then the probability of you having an alcohol problem is about 75%

– If you have answered yes to 4 questions.

Then the probability of you having an alcohol problem is about 95%

“If you’re unsure whether alcohol may be a problem, speak with one of our supportive counselors. With many having first-hand experience they understand the struggle. The free chat is confidential & they are available 24/7.”

If you have answered yes to any of the questions in the CAGE questionnaire, or you are worried about your alcohol consumption, it is strongly advisable to consult an alcohol specialist.

Common concerns associated with drinking are financial impacts from drinking, increased family tension, legal concerns, problems at work and a loss of control over your drinking.

Usually this means making an appointment with an alcohol/addiction counselor and discussing your alcohol consumption with him/her. Other options would be to speak with your family doctor.

To find providers, one recommendation is to call your insurance company and ask for providers in network. A simple google search could also provide you with a list, however this would likely not include insurance companies they are in network with.

If you feel more comfortable with your family doctor then go to them by all means. Most doctors have a good knowledge of alcoholism and its signs so they would be able to help you better understand what you’re experiencing.

If they think you are abusing alcohol or have developed a physical dependence to alcohol,  they can talk to you about different treatment options and refer you to a counselor/treatment center.

Whichever route you take, know that it takes courage to ask for help. There is never a time where it is “too late” for a person to begin their recovery from drinking alcohol. Everyone’s recovery will look different, so try to be patient and kind to yourself.

Cage Questionaire

Do you want to do something about your drinking? If so, there are a number of options open to you.

Cage Test

1. Attend Alcoholics Anonymous Meetings. This is seen by many as the one and only way to get sober. It is effective, however many individuals are unable to stay sober by going to meetings alone.

It is estimated that only 5% of alcoholics are able to remain sober for three years or more using the 12 steps (the main philosophy behind Alcoholics Anonymous’ approach). However do not discount it until you have tried it. For more on their approach read Stop Drinking Alcohol With AA.

cage alcohol

2. The Sinclair Method. The Sinclair Method, using the medication Natlrexone, has a far better success rate than AA. It has been shown to be effective in over 78% of cases (Read Results with Naltrexone and Nalmefene: Clinical Trials and Reviews for more on research into Naltrexone and its effectiveness when used to combat alcohol dependency). The use of Naltrexone has grown significantly over the years and is offered in two forms.

One options is a onetime per day pill that is taken orally. A down side to the oral route is that it can easily be manipulated by not taking the pill. The other option is an injection once per month provided by a health care professional. This not as simple to manipulate as the health care professional would administer the medication.

This medication blocks the opiate receptors in a person’s brain which will decrease the euphoric effects of alcohol. A person will still experience the physical impacts of alcohol such as poor coordination, blackouts and poor judgement. Go to The Sinclair Method to learn more about this breakthrough.

cage questions

3. Treatment Centers. A treatment center is a great place to get sober. There are, however, a couple of downsides to this form of getting sober. The first is that a stay in a treatment center is that it can be expensive.

If you have insurance then this is not a problem, if you don’t then the cost may well be too much (some centers can cost up to 40,000 dollars for an eight week stay).

The second difficulty that some find that most treatment centers follow the 12 step method of alcohol treatment. If you find it hard to follow the 12 step program, then a treatment center may not be for you.

Inpatient treatment centers are also a safe place for a person to detox from alcohol in. Alcohol withdrawal should not be taken lightly, as a person can die from it.

Most inpatient programs strongly recommend that individuals engage in an outpatient addiction program after completing an inpatient program. The hope is that by continuing treatment a person is able to have additional support throughout the beginning stages of their recovery.

Life can be hard, and some difficulties are unexpected. It can also provide an opportunity for a person to engage in mental health treatment. It is quite common for mental health concerns to accompany addiction. Examples of this would be PTSD, traumatic experiences, mood disorders, depression and anxiety.

You can read Alcohol Addiction Recovery for more on alcohol treatment centers.

4. Baclofen. There are many who have managed to defeat their drinking problems by taking the drug Baclofen. Although not licensed for the treatment of alcohol dependency, those who have tried it swear by it. Baclofen has been found to reduce alcohol cravings as well as can help manage some symptoms of alcohol withdrawal.

This medication is also metabolized in the kidney, compared to the liver which can be an attractive factor for individuals who have liver damage that resulted from their drinking use. You can read Baclofen And Alcohol for more on this form of alcoholism treatment.

5. Other Treatments. There are countless ways of treating problem drinking. We have gathered what we consider the best and put them on one page, for more you can read Alcohol Treatment Programs.

“If you’re unsure whether alcohol may be a problem, speak with one of our supportive counselors. With many having first-hand experience they understand the struggle. The free chat is confidential & they are available 24/7.”

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