CAGE-AID: CAGE Adapted to Include Drugs
4-item yes/no screener for alcohol and drug use disorders. Adapts the CAGE scale to cover all substances. Score ≥2 is a positive screen requiring further evaluation.
CAGE-AID Score Interpreter
Score ≥2 warrants further clinical evaluation for a substance use disorder. This is a screen, not a diagnosis.
4 yes/no items scored 0 (No) or 1 (Yes); total ranges from 0–4. Higher scores indicate greater likelihood of a substance use disorder.
| Total score | Interpretation |
|---|---|
| 2+ | Positive screenScore ≥2 warrants further clinical evaluation for a substance use disorder. This is a screen, not a diagnosis. |
| 0–1 | Negative screenScore of 0–1 suggests lower likelihood of a substance use disorder; clinical context should still guide decision-making. |
Brown RL, Rounds LA. Wis Med J. 1995;94(3):135-140. Positive screen threshold (≥2) per original criterion validity study. Educational reference only — not a diagnostic tool.
What is the CAGE-AID?
The CAGE-AID (CAGE Adapted to Include Drugs) is a brief 4-item screening questionnaire that extends the original CAGE alcohol screener to cover all substance use, including illicit drugs and misused prescription medications. It was developed by Brown and Rounds in 1995 and is widely used in primary care, addiction medicine, and emergency settings.
Like the original CAGE, each item is answered Yes (1) or No (0). A score of 2 or higher is a positive screen for a possible substance use disorder and warrants a more full evaluation. The CAGE-AID takes less than 2 minutes to administer and requires no special training.
The CAGE-AID is particularly useful when a clinician suspects poly-substance use or when the original CAGE (alcohol only) may miss drug-related problems. For alcohol-specific screening, AUDIT or CAGE are more sensitive. For adolescent populations, the CRAFFT is preferred.
CAGE-AID Screener
For clinical use and educational reference only. A positive screen does not constitute a clinical evaluation. Clinical judgment is required.
CAGE vs CAGE-AID
The only difference is the scope, CAGE-AID adds drugs to each question.
You specifically need an alcohol use disorder screen and suspect no other substance involvement.
You need a combined alcohol and drug screen, the most efficient option for general substance use screening.
You need granular alcohol consumption data, hazardous vs harmful drinking distinction, or World Health Organization-standardized scoring.
Administer CAGE-AID in HiBoop
Substance use screening built into your clinical workflow, automated scoring, SBIRT integration, and longitudinal tracking.
References
- 1.Brown RL, Rounds LA. Conjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice. Wis Med J. 1995;94(3):135-140.View source
- 2.Couwenbergh C, Van Der Gaag RJ, Koeter M, De Ruiter C, Van den Brink W. Screening for substance abuse among adolescents: validity of the CAGE-AID in youth mental health care. Subst Use Misuse. 2009;44(6):823-834.View source
- 3.Leonardson GR, Kemper E, Ness FK, Koplin BA, Daniels MC, Leonardson GA. Validity and reliability of the AUDIT and CAGE-AID in Northern Plains American Indians. Psychol Rep. 2005;97(1):161-166.View source
Frequently Asked Questions
How is the CAGE-AID scored?
Each of the 4 items is answered Yes (1) or No (0), giving a total score from 0 to 4. A score of 2 or higher is considered a positive screen and indicates that further clinical evaluation for a substance use disorder is warranted. Scores of 0 or 1 are considered a negative screen.
What does a positive CAGE-AID score mean?
A score of ≥2 is a positive screen, not a diagnosis. It signals that the patient is at elevated risk for an alcohol or drug use disorder and should receive a more comprehensive assessment. Clinical judgment is required before drawing any conclusions.
Is the CAGE-AID self-report or clinician-administered?
The CAGE-AID can be administered in either format. It is short enough to be self-completed by patients during intake or used as part of a structured clinical interview. The original validation by Brown and Rounds (1995) used a clinician-administered format, while subsequent studies have examined both.
Can the CAGE-AID be used with adolescents?
Research has examined its use with adolescents, including a validation study by Couwenbergh et al. (2009) that found good diagnostic accuracy in youth mental health settings. However, for adolescent populations, screeners such as the CRAFFT are more specifically developed and widely recommended for that age group.
Related Assessments
Explore complementary clinical tools and screeners