About the CAGE Questionnaire
The CAGE Questionnaire is a brief, widely used screening tool for identifying possible alcohol use disorder, developed by Dr. John Ewing and published in JAMA in 1984. It consists of four yes/no questions — each corresponding to one letter of the acronym: Cut down, Annoyed, Guilty, and Eye-opener. Each "Yes" answer scores one point, for a total range of 0 to 4. This calculator totals your answers and applies the standard clinical cutoff so you can see how your responses compare to published screening guidance.
What each question measures
- Cut down: whether you have ever felt a personal need to reduce your drinking, which can signal an early awareness of a problem.
- Annoyed: whether other people's criticism of your drinking has bothered you, reflecting how drinking affects your relationships.
- Guilty: whether you have felt bad or guilty about your drinking, capturing an emotional or moral response to your own behavior.
- Eye-opener: whether you have needed a drink first thing in the morning to steady your nerves or relieve a hangover, a marker associated with physical dependence.
Scoring and interpretation
Add one point for every question you answered "Yes"; the total score ranges from 0 to 4. In the original and most widely cited validation studies, a score of 2 or more is the standard cutoff considered clinically significant, with reported sensitivity around 90% and specificity around 70-80% for detecting alcohol use disorder in general clinical populations (accuracy varies by setting and population). A score of 0-1 suggests a lower likelihood based on this screen alone, though any "Yes" answer can be worth mentioning to a healthcare provider.
Limitations and when to seek help
CAGE is a screening instrument, not a diagnostic test — it flags who may benefit from a fuller clinical assessment, and it does not measure how much or how often someone drinks. It was validated primarily in adult populations and may be less sensitive for early-stage or binge drinking patterns that haven't yet produced guilt, criticism, or morning drinking. If your score is 2 or higher, or if you're concerned about your drinking regardless of your score, talk with a physician, licensed counselor, or contact a resource such as the SAMHSA National Helpline for a confidential assessment.