Substance Use Screening (CAGE-AID)

The Substance Use Screening form provides a structured approach to screening for alcohol and drug use disorders based on the CAGE-AID (Cut down, Annoyed, Guilty, Eye-opener -- Adapted to Include Drugs) framework. This validated screening tool helps identify patients who may benefit from further evaluation or treatment for substance use disorders.

Beyond the core CAGE-AID questions, this template includes frequency and quantity assessment for common substance categories (alcohol, tobacco, cannabis, prescription misuse, and illicit drugs), impact evaluation on work, relationships, and health, and a readiness-for-change assessment. The frequency questions use standardized intervals that align with AUDIT-C and NIDA screening recommendations.

The form is designed with sensitivity, using non-judgmental language and optional response fields where appropriate. Confidentiality assurances are prominent, noting that substance use information receives additional federal protections under 42 CFR Part 2. This template is used in primary care annual screenings, behavioral health intakes, emergency department SBIRT (Screening, Brief Intervention, Referral to Treatment) programs, and pre-surgical assessments.