CAGE Questionnaire Calculator
The CAGE questionnaire is a four-question alcohol use screening tool used by clinicians worldwide. Answer each question honestly based on your lifetime experience with alcohol. Each "Yes" scores 1 point. A total score of 2 or higher is considered clinically significant and warrants further evaluation by a healthcare provider.
Formula
Worked example
A patient answers Yes to Cut down and Guilty, and No to Annoyed and Eye-opener. Score = 1 + 0 + 1 + 0 = 2. This equals the clinical threshold (>= 2), so further evaluation with the AUDIT questionnaire is recommended.
What is the CAGE questionnaire?
The CAGE questionnaire is a four-item validated screening instrument developed by Dr. John Ewing at the University of North Carolina in 1968 and published in JAMA in 1984. The name is an acronym formed from the key word in each question: Cut down, Annoyed, Guilty, and Eye-opener. The tool was designed to be brief enough to administer in under one minute during a routine clinical visit while still identifying patients with alcohol use disorder reliably. It has since become one of the most widely used and studied alcohol screens in primary care and emergency medicine. The CAGE assesses lifetime alcohol use rather than recent use, which is an important distinction: a single positive response at any point in a person's history still counts.
How to interpret your score
Each "Yes" answer adds one point to your total, giving a range of 0 to 4. A score of 0 suggests no current indicators of problem drinking, though the tool is most informative when answered honestly and in the context of a full medical history. A score of 1 is considered a mild red flag and worth monitoring; some guidelines treat even a single "Yes" as a prompt for a brief counselling conversation. A score of 2 or higher is the widely accepted clinical threshold for identifying likely alcohol use disorder. At this cutoff, research shows the CAGE has approximately 93% sensitivity (it catches most true cases) and 76% specificity (three in four people it flags actually have the condition). Scores of 3 or 4 indicate a high or very high likelihood of alcohol dependence and warrant prompt clinical evaluation.
The CAGE-AID extension for drug use
The CAGE-AID (CAGE Adapted to Include Drugs) modifies each question to cover illicit drug use and the misuse of prescription medications alongside alcohol. The wording shifts from "your drinking" to "your drinking or drug use." The scoring and thresholds remain the same. CAGE-AID is useful in settings where poly-substance use is a concern, such as primary care, emergency departments, and addiction medicine practices. Selecting the CAGE-AID mode in this calculator adapts the interpretation guidance accordingly.
Limitations and complementary tools
The CAGE is a lifetime screen, so it can flag a past problem that has since resolved. It performs less well for detecting milder alcohol use disorders or hazardous drinking that has not yet crossed into dependence. It also does not quantify how much someone drinks, which is why a positive CAGE result is typically followed by the AUDIT (Alcohol Use Disorders Identification Test), a ten-item instrument that assesses both quantity and patterns. Other related tools include AUDIT-C (a three-item abbreviation of the AUDIT), MAST (Michigan Alcoholism Screening Test), and CRAFFT (designed for adolescents). None of these are substitutes for a full clinical assessment by a qualified healthcare provider.
CAGE Score Interpretation
| Score | Risk Level | Clinical Action |
|---|---|---|
| 0 | Low Risk | No action required; re-screen if circumstances change |
| 1 | Mild Concern | Monitor drinking patterns; discuss with provider if concerned |
| 2 | Clinically Significant | Seek evaluation; AUDIT recommended for fuller picture |
| 3 | High Concern | Prompt clinical evaluation advised; do not stop abruptly |
| 4 | Very High Concern | Immediate evaluation; supervised withdrawal may be needed |
Standard clinical interpretation of CAGE scores. The >= 2 threshold has 93% sensitivity and 76% specificity for alcohol use disorder.
Frequently asked questions
What does a CAGE score of 2 mean?
A score of 2 is the standard clinical cut-off for a positive CAGE screen. It means you have answered "Yes" to two of the four questions, which research shows has a sensitivity of about 93% for identifying alcohol use disorder. A positive screen does not diagnose you with a condition - it flags that further evaluation by a healthcare provider is warranted. They will typically follow up with a more detailed questionnaire such as the AUDIT or a clinical interview.
Is the CAGE questionnaire used for drugs too?
Yes. The CAGE-AID (Adapted to Include Drugs) version modifies each question to cover illicit drugs and prescription drug misuse alongside alcohol. The questions ask about cutting down on "drinking or drug use," being annoyed by criticism of "drinking or drug use," and so on. The scoring and threshold remain the same: a score of 2 or more is considered clinically significant.
Can I pass the CAGE even if I drink a lot?
The CAGE does not measure how much you drink - it measures four specific behavioural and emotional signals that tend to appear when alcohol use has become problematic. A heavy drinker who has never felt the need to cut down, faced criticism, felt guilty, or used a morning drink could score 0. That is why the CAGE is a screening tool rather than a measure of alcohol quantity. If you are concerned about the amount you drink, the AUDIT questionnaire is designed to assess consumption levels.
What is the eye-opener question and why does it matter?
The eye-opener question asks whether you have ever needed a drink first thing in the morning to steady your nerves or get rid of a hangover. This pattern, sometimes called a "morning drink," is a strong clinical marker of physical alcohol dependence. Among the four CAGE items, the eye-opener has been found in several studies to be the single best individual predictor of alcohol use disorder.
Should I be worried if I score 1?
A score of 1 is below the formal clinical threshold but is still worth taking seriously. Some guidelines treat even a single "Yes" as a prompt for a brief counselling conversation, particularly if the positive response was the eye-opener question. If you are concerned, talking with your doctor is always the right step. The CAGE is a lifetime screen, so even past drinking patterns count.
Is it safe to stop drinking if I score high?
Do not stop drinking abruptly without medical guidance if you are a heavy or daily drinker. Alcohol withdrawal can cause serious complications including seizures and delirium tremens, which can be life-threatening. A healthcare provider can assess your situation and recommend a safe tapering plan or medically supervised detoxification if needed.