The CAGE asks four yes-or-no questions about drinking: whether the person has felt they should cut down, been annoyed by criticism, felt guilty, or needed a morning eye-opener. Two or more yes answers point to a drinking problem worth assessing. See what each letter covers, how to score and read it, where it falls short, and record the result with the free template.
CAGE result template
FreeCAGE SCREEN Date: [Date] Patient: [Name or ID, age] How asked: [In conversation during the history, on a written form, or with an interpreter] Reason: [Routine screening, a positive alcohol screen, or a concern raised by the patient, family, or a test result] CAGE RESULT Yes answers: [0 to 4] Positive letters: [Cut down, annoyed, guilty, eye-opener, or none] When last true: [For each yes: within the past year, or longer ago] Result: [Negative at 0 to 1, or positive at 2 or more; note it if your service counts 1 yes as positive] CURRENT DRINKING Drinking days: [Days a week, or days in the past month] Usual amount: [Standard drinks on a drinking day, and what they drink] Heaviest day: [Most drinks in one day recently, and how often days like that happen] Weekly total: [Standard drinks a week] AUDIT-C: [Total 0 to 12 and the cutoff used, or not done] Other substances: [Tobacco, cannabis, sedatives, opioids, other drugs, or none] WITHDRAWAL HISTORY Past withdrawal: [Shakes, sweats, poor sleep, seizures, hallucinations, or confusion after stopping; or none] Morning drinking: [Drinks soon after waking to settle nerves or a hangover, and how often; or none] Last drink: [Date and time] ASSESSMENT Harms linked to drinking: [Injuries, blood pressure, liver tests, mood, work, family, driving] Impression: [Lower-risk drinking, unhealthy drinking without signs of dependence, or a likely alcohol use disorder needing full assessment] Readiness to change: [The patient's own words, and a 0 to 10 rating if used] BRIEF INTERVENTION Feedback: [What the results show, tied to the patient's own concerns] Advice: [What was advised, including any warning about stopping suddenly] Patient's goal: [Drink less, to a stated amount; stop; or think it over] PLAN Next step: [No further action, follow-up visit, full substance use assessment, or planned withdrawal] Medication: [Naltrexone, acamprosate, or another option offered or started; thiamine; or none] Tests: [Liver tests, blood count, or others ordered] Follow-up: [Date or interval, and when to repeat the screen] Clinician: [Name, credentials]
Use it for
Ask the four questions in conversation, as part of the general health history, of anyone who drinks. It takes under a minute.
Avoid: Opening with questions about amounts. The Bowles Center notes the CAGE works best inside a general history, not straight after questions on quantity and frequency.
Each letter is one yes-or-no question about drinking, at any point in the person’s life.
Avoid: Recording a yes without asking when it last applied. A yes from 20 years ago means something different from a yes this month.
Each yes scores 1. Add them for a total from 0 to 4; 2 or more is the usual positive result.
Avoid: Scoring how strongly the person agrees. Each answer is yes or no.
A total of 2 or more suggests a drinking problem, most often dependence. A total of 0 or 1 makes dependence less likely but says little about risky drinking.
Avoid: Reading a 0 as safe drinking. A heavy weekend drinker can answer no to all four.
Give a brief intervention the same visit, then agree the next step.
Each one follows the recording template. Use them to judge how much to write.
Family practice, follow-up for high blood pressure, CAGE asked during the history
3 of 4: cut down, annoyed, guilty. Eye-opener: no. Positive at the cutoff of 2. All three apply now: he has felt he should cut down several times this year, his wife has raised his drinking more than once, and he feels guilty most mornings.
Drinks every day. About 7 beers each weeknight and 10 or more on Saturdays: roughly 50 standard drinks a week. AUDIT-C 11, positive. Smokes half a pack a day. No cannabis, sedatives, or other drugs.
Stopped for 5 days in January: sweats, poor sleep, and irritability for 2 days. No shakes, seizures, hallucinations, or confusion. No morning drinking. Last drink last night at about 22:00.
54-year-old man, site supervisor. Blood pressure 154/96 on two medicines, up from 138/86 in the spring. GGT 112, ALT 68, MCV 101. Fell on the stairs after drinking in August. Impression: likely alcohol use disorder, at least moderate; a full assessment will confirm it and set the severity. Readiness 6 of 10: “I know it’s too much.”
Linked his blood pressure, liver tests, and the fall to his drinking; he hadn’t connected them. Advised not to stop all at once on his own, given the sweats in January, and to cut down steadily instead. His goal: no more than 3 beers a night, with two alcohol-free days a week, starting this week. He will keep a drink diary.
Full substance use assessment with the practice’s addiction counselor next week. Naltrexone offered; he will decide after the assessment and repeat liver tests. Thiamine 100 mg daily started. If he chooses to stop, plan the withdrawal with the team and score it with the CIWA-Ar. Review in 2 weeks with the diary, and recheck blood pressure then.
Urgent care, wrist injury after a fall on a night out; AUDIT-C on the intake form, CAGE asked by the nurse practitioner
0 of 4. Negative. She has never felt she should cut down; her friends drink the same way and no one has criticized it. No guilt. No drinking in the morning.
Drinks on Friday and Saturday nights, sometimes Thursday. 5 or 6 drinks on a usual night out, 8 or more at parties about twice a month: about 12 standard drinks a week, none on other weeknights. AUDIT-C 8, positive at the cutoff of 3 for women. No tobacco. Cannabis edibles a few times a year.
None. No shakes, sweats, or poor sleep after weekends, and no morning drinking. Last drink at about 1 a.m., 9 hours before this visit: 7 drinks before the fall.
33-year-old woman, accountant. Right wrist sprain; X-ray shows no fracture. A cut chin after a night out in March. Fewer than 2 DSM-5 criteria on questioning: no cravings, she keeps to her limits on weeknights, and work is unaffected. Impression: unhealthy drinking, a weekend binge pattern with injuries, without signs of dependence. The CAGE was negative because it looks for dependence; the AUDIT-C caught the pattern. Readiness 4 of 10: “Everyone I know drinks like this.”
Showed her where her AUDIT-C sits, and linked both injuries to nights of more than 5 drinks. Advised fewer drinks on each night out. Her goal: no more than 3 drinks on a night out, water between drinks, and a ride home booked ahead. She declined further support for now.
Wrist splint, ice, and rest; return in 1 week if not improving. Visit summary with the AUDIT-C result sent to her family doctor. Repeat the AUDIT-C at her next primary care visit. She has the clinic’s number if she wants help to cut down.
The CAGE asks about problems, not amounts. Someone who has 6 drinks every Saturday can answer no to all four. Ask about quantity, or use the AUDIT-C.
The questions ask about ever. A yes from someone sober for 15 years needs a different plan from a yes this month. Record when each yes last applied.
Starting with how much someone drinks can put them on guard. Ask the CAGE as part of the general history, then ask about quantity.
A CAGE of 3 suggests a problem. It doesn’t set the diagnosis or its severity; the interview, against the DSM-5 criteria, does.
Someone who drinks heavily every day can go into withdrawal when they stop. Ask about past withdrawal first, and plan the stop with them.
Vero Scribe records the CAGE result in your template from the visit, with the patient’s consent, or from your dictation: the yes answers, the drinking pattern, any withdrawal history, the brief intervention, and the plan. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
Each of the four questions is answered yes or no. Each yes scores 1, so the total runs from 0 to 4. Record which letters were yes as well as the total, and ask when each yes last applied, since the questions ask about ever.
Two or more yes answers is the usual cutoff, and the Bowles Center calls it clinically significant. A total of 0 or 1 makes a drinking problem less likely. Some services count a single yes as positive to miss fewer people, and many follow up a yes to the eye-opener question on its own.
Each letter is one question. C is for cutting down: feeling you ought to drink less. A is for annoyed: being annoyed when people criticize your drinking. G is for guilty: feeling bad or guilty about drinking. E is for eye-opener: needing a drink soon after waking to settle your nerves or a hangover.
For routine screening, the AUDIT-C. Its three questions ask how often and how much someone drinks, scored 0 to 12, so it picks up risky drinking as well as dependence. The CAGE asks about problems at any point in life and is best at finding dependence; it misses many heavy weekend drinkers. The two can be used together: the AUDIT-C for the pattern, the CAGE for signs of dependence.
The CAGE screens for a drinking problem, in four questions anyone can answer in a minute. The CIWA-Ar measures how severe alcohol withdrawal is right now, in someone who has stopped or cut down, and guides treatment. A positive CAGE with heavy daily drinking means asking about withdrawal; if withdrawal starts, the CIWA-Ar scores it.
No, the original CAGE asks only about alcohol. The CAGE-AID adapts the four questions to cover drug use as well. For a full picture of alcohol and drug use, follow a positive screen with a substance use assessment.
It depends on the setting. A 2004 meta-analysis found a cutoff of 2 picked up 87% of people with alcohol abuse or dependence among hospital inpatients, 71% in primary care, and 60% in outpatient clinics. It does less well in women, young adults, and pregnancy, and misses risky drinking without dependence.
Any trained member of the care team: physicians, nurse practitioners, physician assistants, nurses, counselors, and social workers. It takes under a minute, asked in conversation or on a written form. A clinician reads the result and decides on the next step.
For clinical care and research, yes. The Bowles Center for Alcohol Studies asks that published work cite Ewing’s 1984 paper in JAMA, and needs no other permission unless the CAGE is used for profit, when it negotiates a fee. The exact wording is in that paper. The recording template on this page is free to copy or download.
Three questions on how often and how much someone drinks, scored 0 to 12: positive at 4 or more for men, 3 or more for women.
The WHO’s 10 questions on drinking, dependence, and harm, scored 0 to 40 into four zones that each come with an intervention.
Ten signs rated at the bedside: how severe alcohol withdrawal is now, scored 0 to 67.
Eleven withdrawal signs, from pulse to gooseflesh, rated by a clinician: opioid withdrawal severity from 0 to 48.
A teen alcohol and drug screen for ages 12 to 21: days of use, then six yes-or-no questions scored 0 to 6, high risk at 2 or more.
After a positive CAGE: each substance, withdrawal risk, the diagnosis, and the level of care.
Screens, assessments, and follow-up notes, drafted from the visit for your review.
Every tool, by area, with what its scores mean.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
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