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The CAGE-AID is the shortest substance-use screen in Rivet. Four yes/no items covering alcohol AND drug use in a single form. Brown and Rounds adapted the original alcohol-only CAGE (Ewing 1984) to include drugs in 1995, validated in primary-care practice. CAGE is an acronym: Cut down, Annoyed, Guilty, Eye-opener.

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What it measures

Four items about lifetime alcohol or drug use:
  • Ever felt you should Cut down
  • People Annoyed you by criticizing your use
  • Felt Guilty about your use
  • Used first thing in the morning to steady nerves or get rid of a hangover (Eye-opener)
Each item is rephrased to cover “drinking or drug use” rather than alcohol alone — that’s the AID adaptation.

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When to send it

  • Rapid intake screen when you want a substance-use signal in a single question block
  • When the AUDIT or DAST-10 is too long for the workflow (intake panels with many measures, ED-style triage)
  • As an initial flag for whether to send the fuller AUDIT or DAST-10
  • Primary-care embedded mental-health practice
The four items take under a minute.

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Scoring and severity cutoffs

Sum of yes-scored items, range 0–4. Cutoff ≥1 is the standard threshold for the CAGE-AID — lower than the original alcohol-only CAGE’s ≥2 cutoff. The CAGE-AID adaptation lowered the threshold because (a) it covers a broader behaviour set (alcohol AND drugs) and (b) Brown demonstrated higher sensitivity at ≥1 in primary-care populations.

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Trade-off

The CAGE-AID is fast but less sensitive than the AUDIT or DAST-10. It’s a flag, not a severity gradient. A positive CAGE-AID earns a fuller follow-up — the AUDIT for alcohol, DAST-10 for drugs, or a clinical interview.

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CAGE-AID vs AUDIT and DAST-10

The CAGE-AID’s advantage is that four yes/no questions cover alcohol and drugs at once. Nothing else here is that fast or that broad. The cost is sensitivity. It is less sensitive than either the AUDIT or the DAST-10, and it does not measure severity — a positive CAGE-AID tells you to look further, not how serious the problem is. That’s a reasonable trade when intake time is genuinely short, and a poor one when substance use is already part of the formulation. Worth knowing about the threshold: the older alcohol-only CAGE used a cutoff of 2. The CAGE-AID lowered it to 1, because it covers a wider range of behaviour and because the lower threshold performed better. One “yes” warrants follow-up.

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Is it free to use?

Yes. Free clinical use, and widely reprinted.

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Citation

Brown, R. L., & Rounds, L. A. (1995). Conjoint screening questionnaires for alcohol and other drug abuse: Criterion validity in a primary care practice. Wisconsin Medical Journal, 94(3), 135–140. Adapted from: Ewing, J. A. (1984). Detecting alcoholism: The CAGE questionnaire. JAMA, 252(14), 1905–1907. Free clinical use.

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When not to use it

The CAGE-AID is lifetime-framed and gives no severity bands beyond the flag — for treatment monitoring or pre/post measurement, use the AUDIT (which has a 12-month frame and a 0–40 severity scale) or DAST-10. For adolescents, the CRAFFT is the validated alternative and is the same length.

AUDIT-C

The 3-item alcohol-specific brief screen.

DAST-10

The 10-item drug-use screen with severity bands.