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Cage: A Screening Technique To Detect Alcohol Dependence

1846 words - 8 pages

The CAGE is a screening technique that was developed in the 1970s to detect alcohol dependence. The four questions asked are: “Have you ever felt the need to cut down on your drinking? Have you ever felt annoyed by someone criticizing your drinking? Have you ever felt bad or guilty about your drinking? Have you ever had a drink first thing in the morning to steady your nerves and get rid of a hangover? (eye-opener)” (Hester & Miller, 2003). If a person responds “yes” to at least two of the questions, their test is considered positive. A positive test indicates the need for further assessment and/or reference to an alcohol treatment specialist. Although the CAGE has been proven effective in determining whether or not an individual is alcohol dependent, it has several major deficiencies: “it does not assess current problems, levels of alcohol consumption, or binge drinking” (Hester & Miller, 2003). It is recommended that when using the CAGE, accompany it with questions regarding quantity, frequency, and binge drinking in order to make up for its weaknesses.
The CAGE has been modified before with the intention of better fitting specialized groups of people. For instance, the TWEAK was created for pregnant women. It differs from the CAGE by exchanging a question on tolerance for the question that previously asked about guilt, editing the question concerning annoyance, and adding a question that asks about amnesia. The questions asked in the TWEAK are: “How many drinks can you hold? (three or more suggests tolerance) Have close friends or relatives worried or complained about your drinking in the past year? Do you sometimes take a drink in the morning when you first get up? (eye-opener) Has a friend or family member ever told you about things you said or did while you were drinking that you could not remember? (amnesia) Do you sometimes feel the need to k/cut down on your drinking?” (Hester & Miler, 2003). The TWEAK is a prime example of how the CAGE can be adjusted to help different population groups.
In 2001, a study was designed to examine the use of alcohol, as well as drugs, among elderly citizens. Drug and alcohol abuse among the elderly tends to pass under the radar because clinicians do not routinely ask older patients about substance use behaviors. Also, non-specific symptoms of abuse or dependence, such as self-neglect, cognitive deficits, and sleep disturbance, may be misdiagnosed as dementia or depression. Contrary to popular belief, the rates of drug and alcohol abuse among elderly people are gradually increasing. Estimates suggest that “at least 5-10% of Americans over age 65 have a drinking problem, and as many as 50% of older psychiatric patients are alcohol abusers” (Hinkin et al., 2001). Because there were no drug abuse screening tools made for the elderly at the time, a group of researchers decided to modify the CAGE yet again to assess drug use as well as alcohol consumption. Drug use was added to the list of questions by changing...

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