You answered four questions about your drinking and got a score between 0 and 4. The CAGE questionnaire is one of the most widely used alcohol screening tools in healthcare. Its name comes from the first letter of each question's key word: Cut down, Annoyed, Guilty, Eye-opener. Here's what your score means.
The quick answer
| Score | What it suggests |
|---|---|
| 0 | Low risk; alcohol problems unlikely |
| 1 | Some concern; worth discussing |
| 2 | Clinically significant; further evaluation recommended |
| 3-4 | High probability of alcohol use disorder |
A score of 2 or more suggests possible alcohol dependence. This doesn't mean you're definitely an "alcoholic"—it means your answers warrant a closer look at your relationship with alcohol.
The four questions explained
Each question gets at a different aspect of problematic drinking:
C: "Have you ever felt you should Cut down on your drinking?"
This question asks about self-awareness. Many people who drink problematically know, at some level, that they should cut back. Feeling this way—even if you haven't acted on it—is itself a warning sign.
A: "Have people Annoyed you by criticizing your drinking?"
This question captures external feedback. When people close to you express concern about your drinking, they're often seeing things you might minimize or deny. Their annoyance or concern matters, even if it feels unfair.
G: "Have you ever felt bad or Guilty about your drinking?"
Guilt indicates internal conflict. If drinking makes you feel bad about yourself—about what you did, how you acted, or how much you drank—that's a sign your drinking is at odds with your values.
E: "Have you ever had a drink first thing in the morning (Eye-opener) to steady your nerves or get rid of a hangover?"
This is the most serious question. Morning drinking to relieve withdrawal symptoms (shakes, anxiety, hangover) indicates physical dependence on alcohol. If you answered yes to this question alone, regardless of your other answers, professional evaluation is strongly recommended.
What to do based on your score
Score 0 (no concerns)
Your answers don't suggest alcohol problems. This screening tool focuses on dependence symptoms and consequences—you may still want to be mindful of how much you drink, but the CAGE doesn't indicate cause for concern.
Score 1 (some concern)
One positive answer suggests alcohol may be worth thinking about. Consider:
- Reflecting honestly on your drinking patterns
- Paying attention to how alcohol affects your life
- Discussing drinking with your doctor at your next visit
This score doesn't indicate dependence, but it's worth noting.
Score 2 (clinically significant)
Two positive answers is the standard threshold for recommending further evaluation. This suggests:
- Your drinking has likely caused some consequences
- A more detailed assessment would be helpful
- Talking to a healthcare provider about alcohol is recommended
Score 3-4 (high probability)
Three or four positive answers strongly suggest an alcohol use disorder:
- Professional evaluation is recommended
- Consider speaking with a doctor, counselor, or addiction specialist
- If you answered "yes" to the eye-opener question, medical supervision may be important (alcohol withdrawal can be dangerous)
Important: The "eye-opener" question
If you drink in the morning to steady your nerves or relieve a hangover, this alone is a significant warning sign. Morning drinking typically indicates:
- Physical dependence on alcohol
- Withdrawal symptoms when alcohol wears off
- A pattern that often escalates
Even if this was your only "yes" answer, consider talking to a healthcare provider. Alcohol withdrawal can be medically serious, and stopping drinking abruptly after physical dependence has developed can be dangerous without medical supervision.
What the CAGE doesn't tell you
It doesn't measure how much you drink. The CAGE focuses on consequences and dependence, not quantity. Someone drinking heavily without yet experiencing consequences might score 0. Someone with one drink daily who feels guilty might score 1.
It doesn't distinguish past from present. The questions ask about lifetime experience. If you had alcohol problems years ago but are now in recovery, you'd still score positive. Clinical context matters.
It might miss early-stage problems. The CAGE is excellent at detecting alcohol dependence but may miss hazardous drinking that hasn't yet progressed to dependence. The AUDIT is better for detecting earlier-stage problems.
Why your doctor might ask these questions
The CAGE is commonly used in:
- Primary care visits — Routine health screening
- Hospital admissions — Identifying patients at risk for alcohol withdrawal
- Pre-surgery evaluations — Alcohol affects surgical risk
- Emergency departments — Assessing trauma patients
- Mental health evaluations — Alcohol often co-occurs with other conditions
If your doctor asks these questions, they're not judging you—they're doing a standard health screening that helps them provide better care.
Common questions
I answered "yes" to feeling I should cut down, but I don't think I have a problem. Is that concerning?
Possibly. Many people minimize their drinking, and the wish to cut down often precedes recognition of a problem. That said, some people feel they should cut down for health or fitness reasons even without true alcohol problems. One positive answer warrants reflection, not panic.
I used to have problems but I'm sober now. Will I still score positive?
Yes. The CAGE asks about lifetime experience. Someone in recovery for 10 years would still answer "yes" to past questions. In clinical settings, providers interpret CAGE scores in context, asking about current drinking patterns.
My spouse criticizes my drinking, but they're overreacting. Does that count as a "yes"?
Yes, for screening purposes. Whether their criticism is fair is a separate question. The CAGE captures the presence of social consequences, not their legitimacy. That said, considering why someone close to you is concerned about your drinking is often worthwhile.
I drink to help me fall asleep, not in the morning. Is that different?
The morning drinking question specifically indicates physical dependence and withdrawal. Drinking to fall asleep is concerning for other reasons (alcohol disrupts sleep quality and can lead to dependence) but isn't what the eye-opener question measures.
If you're concerned about your drinking
Regardless of your CAGE score, if you're worried about your relationship with alcohol, here are some options:
- Talk to your doctor — They can assess your drinking and discuss options
- Call SAMHSA's National Helpline — 1-800-662-4357 (free, confidential, 24/7)
- Try cutting back — See if you can reduce your drinking on your own
- Consider a support group — AA, SMART Recovery, and others are available
- See an addiction specialist — If other approaches haven't worked
You don't need a specific score to deserve help.
The bottom line
Your CAGE score indicates whether your drinking patterns warrant further attention. Scores of 0-1 suggest low concern; scores of 2 or higher suggest possible alcohol use disorder requiring evaluation. The CAGE is a screening tool, not a diagnosis—it identifies who should be looked at more closely. If you scored 2 or higher, or if you answered "yes" to morning drinking, talking to a healthcare provider is recommended. Alcohol problems exist on a spectrum, and earlier intervention typically leads to better outcomes.
Related assessments
- MAST — Michigan Alcohol Screening Test (25 questions, comprehensive)
- PHQ-9 — Depression screening (often co-occurs with alcohol problems)
- GAD-7 — Anxiety screening
- DASS-21 — Combined depression, anxiety, and stress measure