12. CAGE-AID Questionnaire

CAGE-AID Questionnaire

Screening tool to help identify problematic alcohol or drug use.
Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate of birth
Email
example@example.com
Select your therapist
CAGE-AID Questionnaire: Substance use screening tool

When thinking about drug use, include illegal drug use and the use of prescription drug use other than as prescribed.

Rows	NO (0) points each	YES (1) point each
C. Have you ever felt that you ought to Cut down on your drinking or drug use?
A. Have people Annoyed you by criticizing your drinking or drug use?
G. Have you ever felt bad or Guilty about your drinking or drug use?
E. 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)?

CAGE-AID Questionnaire