Loading...
Printed on 7/20/2026
For informational purposes only. This is not medical advice.
CAGE-AID adapts CAGE wording to include drug use in addition to alcohol. It is commonly used as a quick behavioral risk screen in medical and mental-health settings.
Formula: Total score = sum of 4 yes/no items (0-4). Common positive threshold: >=2.
Save your results with a free account
Keep a history of calculations, favorite tools, and access your dashboard anytime.
The clinician asks four yes/no questions covering: feeling a need to Cut down on alcohol or drug use, being Annoyed by criticism about use, feeling Guilty about use, and using alcohol or drugs as an Eye-opener first thing in the morning — each adapted to include both alcohol and drugs.
Each 'Yes' answer scores 1 point. Total score ranges from 0 (no indicators) to 4 (all four indicators present).
A score of ≥1 is used when sensitivity is paramount (79% sensitivity for substance use disorder). A score of ≥2 increases specificity (82%) while reducing sensitivity to 67%. Positive results require detailed substance history and clinical follow-up.
Primary Care Physicians
CAGE-AID provides a fast, non-threatening way to screen for both alcohol and drug use problems during routine primary care visits, extending the original CAGE's reach to all substances.
Addiction Medicine Specialists
At addiction medicine intake, CAGE-AID rapidly identifies patients with indicators of problematic substance use involving both alcohol and drugs, supporting comprehensive assessment planning.
Emergency Medicine Clinicians
In the ED, CAGE-AID enables quick behavioral screening for substance problems in patients presenting with injuries, altered mental status, or other presentations potentially related to substance use.
Pain Management Physicians
Before initiating opioid therapy, CAGE-AID identifies patients with a history of problematic alcohol or drug use — a key risk factor for opioid misuse — supporting pre-prescription risk stratification.
Surgeons & Anesthesiologists
Identifying substance use disorders preoperatively allows planning for potential withdrawal, medication interactions, and post-operative pain management needs in patients with substance use histories.
The original CAGE questionnaire was alcohol-only. CAGE-AID adapts all four questions to include 'or drugs' — making it a dual-substance screener. Ensure all four questions specifically reference both alcohol AND drugs when administered.
Use ≥1 when sensitivity matters most (e.g., general screening to avoid missing cases). Use ≥2 when specificity is needed (e.g., pre-referral screening where false positives have significant consequences). Most guidelines recommend ≥1 for initial screening.
A positive CAGE-AID indicates problematic substance use behavior but does not identify which substance(s) are involved. Follow up with a detailed substance history, asking specifically about alcohol, opioids, stimulants, cannabis, benzodiazepines, and other drugs.
For patients with positive CAGE-AID screens, brief motivational interviewing (MI) techniques — reflective listening, exploring ambivalence, eliciting change talk — improve engagement with further assessment and treatment compared to direct advice-giving.
CAGE-AID is validated for adults. For adolescent substance use screening, CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) is the preferred and validated tool, with evidence in the 12-21 age group.
When CAGE-AID is positive and drug use is suspected as the primary concern, DAST-10 (Drug Abuse Screening Test) provides a more detailed 10-item assessment of drug-related problems, helping quantify severity and guide intervention intensity.
Approximately 50-60% of people with substance use disorders have co-occurring mental health conditions (depression, anxiety, PTSD, bipolar disorder). A positive CAGE-AID should trigger mental health screening alongside substance assessment.
Frame CAGE-AID questions neutrally: 'Some of my patients tell me they sometimes use substances to cope — does that feel relevant to you?' rather than judgmental framing. Non-judgmental language significantly increases honest disclosure rates.
The eye-opener question (using alcohol or drugs first thing in the morning) is the most specific indicator of physiological dependence in the CAGE-AID. A 'Yes' to this item alone should prompt immediate comprehensive substance use assessment.
CAGE questionnaire: Ewing (JAMA 1984). CAGE-AID adaptation to include drugs: Brown & Rounds (Wis Med J 1995). Sensitivity 79% at threshold ≥1 for substance use disorders (Buchsbaum et al., Arch Fam Med 1993). NIDA Quick Reference Guide to Screening for Drug Use recommends CAGE-AID alongside AUDIT for primary care. SBIRT implementation guides (SAMHSA 2018) recommend brief screening tools including CAGE-AID.
Scores >=2 suggest elevated risk for problematic alcohol/drug use patterns and support expanded substance-use assessment.
Use for rapid behavioral substance-use screening in general medical and behavioral health intake.
CAGE-AID does not quantify amount/frequency, substance type details, or current withdrawal/intoxication severity without additional tools.
Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.
April 21, 2026 · trust-baseline
Clinical trust metadata enabled for this tool page with structured review/version fields.
Quick four-question alcohol screening using the CAGE questionnaire. A score of 2 or more suggests possible alcohol problems. For comprehensive screening, use [AUDIT](/tools/audit).
OpenMental HealthRapid 3-question alcohol-use screen to identify hazardous drinking patterns.
OpenMental HealthScreen for hazardous and harmful alcohol use with the 10-question AUDIT. Scores range from 0 to 40 across four risk zones. For quick screening use [CAGE](/tools/cage).
OpenMental HealthScreen risk of opioid misuse with the Opioid Risk Tool before initiating long-term opioid therapy.
Open