CAGE-AID

Purpose & Evidence:

  • Purpose: The CAGE-AID (Adapted to Include Drugs) is a version of the CAGE alcohol screening questionnaire, adapted to include drug use. It assesses likelihood and severity of alcohol and drug abuse.
  • Target population: Adults and adolescents
  • Evidence:
    • Easy to administer, with good sensitivity and specificity (Leonardson et al. 2005).
    • More sensitive than original CAGE questionnaire for substance abuse (Brown & Rounds 1995)
    • Less biased in term of education, income, and sex then the original CAGE questionnaire (Brown & Rounds 1995).
  • Advantages/Limitations

    Advantages

    • Well suited for use in a primary care facility
    • Quick and easy to administer
    • Screening for alcohol and drug usage conjointly rather than separately
    • Easily incorporated into a medical history protocol or intake procedure

    Limitations

    • Not created for pain patients (Butler 2008)
    • Be cautious in prescribing to a patient who answers yes to any one question. Individuals who answer yes to 2 or more questions should be subject to a psychosocial assessment prior to prescription (Fine and Portenoy 2004).


Test features:

  • Estimated time: brief, approximately 1 minute to administer and score
  • Length: 4 items
  • Administered by: Patient Interview or Self-Report
  • Intended settings:
    Primary care
  • Scoring and Interpretation: Of the 4 items, one or more positive responses (a "yes" answer) is considered a positive screen, and substance use should be further addressed with the patient.


Available Formats & Links:

The CAGE or CAGE-AID should be preceded by these two questions:

1. Do you drink alcohol?

2. Have you ever experimented with drugs?

If the patient only drinks alcohol, then ask the CAGE questions. If the patient has experimented with drugs, ask the CAGE-AID questions.

CAGE-AID questions:

Cut Down

Have you ever felt you ought to cut down on your drinking or drug use?

Annoyed

Have people annoyed you by criticizing your drinking or drug use?

Guilty

Have you ever felt bad or guilty about your drinking or drug use?

Eye Opener

Have you ever had a drink or used drugs first thing in the morning to steady your nerves or get rid of a hangover?

View ReferencesHide References
Brown RL, Rounds LA. Conjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice. Wis Med J. 1995; 94: 135-40. Available at: http://www.ncbi.nlm.nih.gov/pubmed/7778330 Accessed on: 2013-09-12.
Butler SF. Evidence of Co-occuring Alcohol and Prescription Opioid Abuse in Clinical Populations: Implications for Screening. Tufts Health Care Institute, Program on Opioid Risk Management: Conference on Co-Ingestion of Alcohol with Prescription Opioids. 2008.
Fine P, Portenoy RK. Opioid analgesia. New York: McGraw Hill. 2004. Available at: http://www.amazon.com/dp/B000FJVU6O Accessed on: 2013-10-23.
Leonardson GR, Kemper E, Ness FK, Koplin BA, Daniels MC, Leonardson GA. Validity and reliability of the AUDIT and CAGE-AID in Northern Plains American Indians. Psychol Rep. 2005; 97: 161-166. Available at: http://www.amsciepub.com/doi/abs/10.2466/pr0.97.1.161-166?journalCode=pr0 Accessed on: 2013-10-23.