Your CAGE score ranges from 0 to 4 based on the number of affirmative responses. A score of 0 suggests no current evidence of an alcohol problem based on these questions. A score of 1 is borderline and warrants further questioning about drinking patterns. A score of 2 or higher is considered a positive screen with a sensitivity of 93% and specificity of 76% for identifying alcohol problems, and should prompt a more detailed assessment of alcohol use.

The CAGE questions probe for behavioral and psychological indicators of problem drinking rather than measuring consumption directly. Feeling the need to cut down, being annoyed by criticism about drinking, experiencing guilt, and needing a morning eye-opener are all markers of a problematic relationship with alcohol that may indicate abuse or dependence. A score of 3 or 4 is highly suggestive of alcohol dependence.

The CAGE is best suited for settings where an extremely brief alcohol screen is needed and the primary goal is detecting alcohol abuse or dependence rather than hazardous drinking. Its four yes/no questions can be asked verbally in under a minute, making it practical for busy emergency departments, inpatient admissions, and brief clinical encounters.

It is particularly useful when incorporated into a clinical interview as part of the social history. The questions can be asked conversationally, which some clinicians find less awkward than administering a formal 10-item questionnaire. The CAGE is also commonly used in surgical pre-assessments to identify patients at risk for alcohol withdrawal during hospitalization.

The CAGE asks about lifetime experiences, not current drinking behavior. A patient who had alcohol problems in the past but has been sober for years may still score positive. This makes it less useful for detecting current hazardous drinking and more useful for identifying a history of alcohol problems that may be relevant to clinical care.

The CAGE does not assess drinking quantity or frequency, which means it may miss heavy drinkers who have not yet developed the behavioral markers captured by the four questions. It is less sensitive than the AUDIT for detecting hazardous or harmful drinking before dependence develops. For comprehensive alcohol screening, the AUDIT is generally preferred.

The CAGE has reduced sensitivity in certain populations, including women, younger adults, and college students, who may engage in hazardous drinking without endorsing the CAGE items. Cultural factors and stigma around alcohol use may also lead to underreporting, particularly for the guilt and criticism questions.