CAGE Questionnaire - Positive Change Therapist

The CAGE Questionnaire Adapted to Include Drugs (CAGE-AID)

Source: Reprinted with permission from the Wisconsin Medical Journal. Brown, R.L., and Rounds, L.A. Conjoint screening questionnaires for alcohol and drug abuse. Wisconsin Medical Journal 94:135-140, 1995.

Have you felt you ought to cut down on your drinking or drug use?*

Yes
No

Have people annoyed you by criticizing your drinking or drug use?*

Yes
No

Have you felt bad or guilty about your drinking or drug use?*

Yes
No

Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?*

Yes
No

Name*

First Last

Email Address*

Phone Number*

Name

This field is for validation purposes and should be left unchanged.