> ## Documentation Index > Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt > Use this file to discover all available pages before exploring further. # CAGE-AID — Brief combined alcohol-and-drug screen > The 4-item yes/no screen that covers alcohol and drugs together — the fastest substance-use measure in the library. 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: **C**ut down, **A**nnoyed, **G**uilty, **E**ye-opener. ## What it measures Four items about lifetime alcohol or drug use: * Ever felt you should **C**ut down * People **A**nnoyed you by criticizing your use * Felt **G**uilty about your use * Used first thing in the morning to steady nerves or get rid of a hangover (**E**ye-opener) Each item is rephrased to cover "drinking or drug use" rather than alcohol alone — that's the AID adaptation. ## 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. ## Scoring and severity cutoffs Sum of yes-scored items, range 0–4. | Total | Band | | ----- | ------------------------------------------------------------ | | 0 | Negative screen | | 1 | Positive screen — further substance-use assessment indicated | | 2–4 | Strong positive screen — substance-use disorder likely | **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. ## 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. ## 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](/clinical-templates/substance/audit) or the [DAST-10](/clinical-templates/substance/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. ## Is it free to use? **Yes.** Free clinical use, and widely reprinted. ## 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. ## 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](/clinical-templates/substance/crafft) is the validated alternative and is the same length. ## Related articles The 3-item alcohol-specific brief screen. The 10-item drug-use screen with severity bands.