The CAGE screening tool was developed by Dr. Ewing John in 1968 for the purpose of detecting drinking behaviors. The term CAGE is an acronym where the letter C represents cut, A represents annoyed, G represents guilty and E represents eye-opener. The tool was developed following a study of 130 patients who took part in an interview with four questions and successfully identified sixteen alcoholics in the group (Vaughn & Perron, 2013). The tool basically involves asking patients 4 significant questions including: Have you ever felt you should cut down on your drinking? 2. Have people annoyed you by criticizing your drinking? 3. Have you ever felt bad or guilty about your drinking? 4. Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener) (Vaughn & Perron, 2013)? The results are thereafter scored in terms of 1 point for a yes response and 0 points for a no response with the cutoff being two positive responses.

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The parameters of the tool including reliability, sensitivity, specificity, and validity of the tool are equally important. Notably, the tool has been comprehensively evaluated by scholars based on its usability in identifying alcoholism. The tool has been identified as being valid with a reported sensitivity scaling of 93 percent and specificity of 76 percent in identifying excessive alcoholism (Vaughn & Perron, 2013). In the identification of alcoholism, the tool has reported a specificity value of 77 percent and the sensitivity value of 91 percent (Vaughn & Perron, 2013).

Furthermore, CAGE screening tool has shown higher reliability levels ranging from 0.8 to about 0.95 and significant correlations with other alcohol screening instruments at values of 0.48 to 0.70 (Vaughn & Perron, 2013). Therefore, CAGE is a short yet feasible screening tool to use in identifying and detecting alcoholism and the related problems. The tool not only exhibits high levels of reliability but also high levels of specificity, sensitivity, validity, and reliability.

  • Vaughn, M. G., & Perron, B. E. (2013). Social Work Practice in the Addictions. New York, NY: Springer.