# CAGE Questionnaire Calculator

> CAGE is a quick 4-question screen for alcohol problems. Two or more yes answers suggest further evaluation.

**Last updated:** September 2026
**URL:** https://bodyhealthcalculator.com/cage-questionnaire-calculator
**Category:** Addiction & Recovery

## How it works

Score 0 to 4. ≥2 positive answers has ~70 to 85% sensitivity for alcohol use disorder.

## What is the CAGE questionnaire?

CAGE is a four-question screen for alcohol problems, named for Cut down, Annoyed, Guilty, and Eye-opener. John Ewing published it in 1984; primary care clinics still use it because it fits into a one-minute visit. Two or more yes answers suggest probable alcohol use disorder and should trigger fuller assessment with the AUDIT or a structured clinical interview.

Questions ask about lifetime experience rather than only the last month. A yes on the eye-opener item often signals morning withdrawal relief drinking.

The US Preventive Services Task Force recommends screening adults for unhealthy alcohol use in primary care and offering brief counseling when appropriate. Primary care teams often pair CAGE with questions about quantity and frequency because brief screens miss non-dependent binge patterns. Emergency departments sometimes use CAGE during trauma evaluations when alcohol may have contributed to injury.

Sources: [1] [2]

## The four CAGE questions

Have you ever felt you should cut down on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt guilty about your drinking? Have you ever had a drink first thing in the morning to steady nerves or get rid of a hangover?

Answer yes or no for each item based on your lifetime experience. The calculator counts positive responses. Include past decades even if you currently drink less than in years when problems occurred. CAGE is designed to detect lifetime patterns.

Meta-analyses at a cutoff of two positives report sensitivity around 70 to 85% for alcohol use disorder in general medical settings, with specificity near 80 to 90%. Clinicians may ask CAGE verbally; self-administration on paper or phone reduces embarrassment and improves disclosure in some studies.

Sources: [1] [3]

## Interpreting CAGE results

Zero or one positive answer suggests low probability of alcohol use disorder, though any yes answer deserves discussion when clinical suspicion is high. Two to four positives indicate high probability; proceed to AUDIT or diagnostic evaluation.

CAGE misses some binge drinkers who do not drink daily. Women and older adults may underreport compared with men.

A positive screen is not a diagnosis. DSM-5 alcohol use disorder requires at least two of eleven criteria within 12 months, including tolerance, withdrawal, and unsuccessful efforts to cut down. A single yes on the eye-opener question warrants urgent assessment for withdrawal risk if the person still drinks daily.

*CAGE questionnaire scoring for alcohol use disorder screening.*

| Score | Interpretation | Sensitivity for AUD |
| --- | --- | --- |
| 0 to 1 | Negative screen | Low probability of alcohol use disorder |
| 2 | Positive screen | About 70 to 85% sensitivity for AUD |
| 3 to 4 | Strongly positive | High likelihood; clinical assessment needed |

Sources: [2] [4]

## CAGE scoring reference

The usual positive threshold is 2 or more, but accuracy changes by setting and population. A diagnostic meta-analysis found pooled sensitivity of 0.87 in inpatients, 0.71 in primary care, and 0.60 in ambulatory populations at that cutoff, with an overall area under the receiver operating curve of 0.87. Sensitivity and specificity do not give one universal personal probability because that probability also depends on how common the disorder is in the tested population.

*CAGE questions and scoring*

| Letter | Lifetime question focus | Yes | No |
| --- | --- | --- | --- |
| C | Felt a need to cut down | 1 | 0 |
| A | Felt annoyed by criticism | 1 | 0 |
| G | Felt guilty about drinking | 1 | 0 |
| E | Used a morning eye-opener | 1 | 0 |
| Total | Add all positive answers | 0 to 4 |  |

Sources: [1] [3] [6]

## Worked examples

| Answers | Score | Interpretation |
| --- | --- | --- |
| No, no, no, no | 0 | CAGE does not identify a lifetime problem, but current binge risk may still exist |
| Yes, no, yes, no | 2 | Positive screen; complete a current alcohol assessment |
| No, no, no, yes | 1 | Below the usual cutoff, but morning drinking needs prompt withdrawal-risk review |
| Yes to all four | 4 | Strong positive screen; assess diagnosis, withdrawal, and immediate safety |

Count each yes once. Do not weight the eye-opener item more heavily in the arithmetic, although it can carry urgent clinical meaning. Answering about lifetime experience can keep the score positive after years without alcohol. If the goal is current-risk screening, a clinician may use a tool with a defined recent period and quantity questions instead of changing CAGE wording or scoring.

Sources: [1] [4] [7]

## Screening is not diagnosis

CAGE was designed as a brief case-finding screen. It does not measure current drinks, binge frequency, withdrawal severity, or all DSM criteria. A positive result calls for a fuller interview; it does not establish alcohol use disorder. A negative result does not rule out hazardous weekend drinking, especially among younger adults, pregnant people, and populations in which validation has been weaker.

The USPSTF recommends screening adults in primary care with instruments that have adequate accuracy and providing brief counseling for unhealthy use. Current quantity-frequency questions and the Alcohol Use Disorders Identification Test often fit that purpose better than lifetime CAGE alone. Diagnosis requires at least two qualifying symptoms within twelve months and a severity assessment. Withdrawal risk requires separate questions about daily intake, prior seizures or delirium, morning symptoms, and sedative use.

Sources: [2] [6] [8]

## How to use your CAGE result

Save the four answers and discuss them with a primary care or addiction clinician. Also bring a seven-day standard-drink log, the largest amount consumed in one day, medication list, and any history of withdrawal. A positive screen can lead to brief counseling, diagnostic assessment, behavioral treatment, medication, or specialty care according to severity and goals. If privacy is a concern, ask how the health system records and shares substance-use information.

Do not stop abruptly without medical advice if you drink heavily every day, need a morning drink, or have had withdrawal seizures, hallucinations, or delirium. If drinking continues, avoid driving and alcohol mixed with opioids, benzodiazepines, or sleep medicines. Call emergency services for a seizure, severe confusion, hallucinations with agitation, inability to wake, or slow breathing. SAMHSA treatment referral is available in the United States at 1-800-662-4357.

Before an appointment, write when each positive experience occurred and whether it remains current. Add concrete details without trying to reinterpret the score: approximate drinks, frequency, injuries, missed obligations, blackouts, morning symptoms, and prior attempts to stop. Bring the names of medicines and other substances because sedative combinations change immediate risk. Ask what follow-up instrument or interview will be used and how withdrawal safety will be assessed. If the result is negative but quantity, memory loss, driving, pregnancy, or family concern remains an issue, request a current alcohol screen. The four-item total should not close the conversation.

Sources: [4] [5] [9]

## Next steps after a positive screen

Primary care brief interventions using feedback, responsibility, advice, a menu of options, empathy, and self-efficacy reduce consumption in hazardous drinkers. Moderate to severe disorder warrants specialty referral. Heavy daily drinkers may need medically supervised detox before outpatient treatment because withdrawal can progress to seizures or delirium tremens.

NIAAA recommends combining mutual support, therapy, and medications such as naltrexone or acamprosate for many patients with alcohol use disorder.

SAMHSA can locate detox, outpatient, and mutual-support resources by ZIP code when you call the national helpline. Document your CAGE answers before the visit if anxiety makes it hard to discuss alcohol openly with a new clinician. If CAGE is positive and you drive or operate machinery, give an accurate account of impairment risk so your clinician can plan safer transportation and work adjustments.

Sources: [4] [5]

## Limitations

CAGE does not measure drinks per week or binge frequency. Pair it with standard drink tracking for a fuller picture.

CAGE-AID adds drug questions but needs separate interpretation. This calculator applies the original alcohol CAGE only. Screening identifies risk; diagnosis and treatment planning require a licensed clinician. Translated versions require validated language-specific cutoffs; English thresholds may not apply globally.

College students and young adults may score low on CAGE while still engaging in dangerous binge drinking on weekends. Save or print your CAGE result to discuss at your next primary care visit. Wording and reference period must remain consistent with the validated version. Changing "ever" to "this month," converting yes or no into frequency options, or combining alcohol and drug use changes what the score means. Translation requires more than literal wording because criticism, guilt, and morning drinking can carry different meanings across cultures. CAGE also performs differently as prevalence changes, so an online result cannot supply a reliable personal probability without setting-specific data. Repeat or confirm the screen when answers were given during intoxication, acute illness, or pressure from another person. Clinical judgment should address any concerning history even when the total is below two.

Sources: [1]

## FAQ

### Is CAGE a diagnosis?

No. CAGE is a screening tool. Positive screens need clinical assessment.

## References

1. Ewing, 1984. [Detecting alcoholism: the CAGE questionnaire](https://pubmed.ncbi.nlm.nih.gov/6471320/)
2. USPSTF. [Screening for alcohol use disorders](https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions)
3. Aertgeerts et al.. [CAGE questionnaire validation meta-analysis](https://pubmed.ncbi.nlm.nih.gov/11025741/)
4. NIAAA. [AUDIT and brief intervention guidelines](https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help)
5. Jonas et al.. [Pharmacotherapy for alcohol use disorder](https://pubmed.ncbi.nlm.nih.gov/26813377/)
6. Aertgeerts et al.. [Diagnostic meta-analysis of CAGE in general clinical populations](https://pubmed.ncbi.nlm.nih.gov/15019008/)
7. Dhalla & Kopec. [CAGE questionnaire review](https://pubmed.ncbi.nlm.nih.gov/17716538/)
8. NIAAA. [Alcohol Use Disorder: DSM-5 criteria](https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-use-disorder-comparison-between-dsm)
9. SAMHSA. [Find Support for Alcohol Use](https://www.samhsa.gov/find-support/health-care-or-support)

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