CAGE and DAST-10 substance use screening questionnaires. Scores, interprets severity, and provides recommended actions for alcohol and drug use assessment.
The Addiction Screening Calculator implements two validated clinical questionnaires — the CAGE Questionnaire for alcohol use and the Drug Abuse Screening Test (DAST-10) for drug use — providing scored results with severity classification and recommended clinical actions.
The CAGE questionnaire (Cut down, Annoyed, Guilty, Eye-opener) is one of the most widely used brief screening instruments for problematic alcohol use. Consisting of just four yes/no questions, it has a sensitivity of approximately 93% and specificity of 76% for detecting alcohol use disorders when a cutoff score of 2 or more is used. Its simplicity makes it ideal for primary care, emergency department, and preoperative settings.
The DAST-10 is a 10-item self-report instrument that screens for drug use problems (excluding alcohol and tobacco). It quantifies the degree of drug-related problems across multiple life domains. Scores range from 0-10, with higher scores indicating greater severity and more intensive treatment recommendations. Both tools are integral components of the SBIRT (Screening, Brief Intervention, Referral to Treatment) model endorsed by SAMHSA.
Substance use disorders affect over 20 million Americans and are vastly underdiagnosed. Brief validated screening tools like CAGE and DAST-10 enable early identification in any healthcare encounter, facilitating intervention before severe consequences develop. Keep these notes focused on your operational context. Tie the context to the calculator’s intended domain. Use this clarification to avoid ambiguous interpretation.
CAGE Score = Number of "Yes" responses (0-4); ≥2 = clinically significant DAST-10 Score = Sum of scored items (0-10); items 4 & 5 are reverse-scored Severity levels map to recommended intervention intensity
Result: CAGE Score: 2/4 — Clinically significant, further evaluation recommended
A CAGE score of 2 or more has high sensitivity for alcohol use disorder. Two positive responses warrant a more comprehensive assessment such as the full AUDIT questionnaire.
The CAGE questionnaire screens for lifetime alcohol problems and dependence, making it ideal for detecting chronic patterns. The AUDIT (Alcohol Use Disorders Identification Test) screens for hazardous drinking over the past year and is better for detecting risky drinking before dependence develops. Use CAGE for quick screening in time-limited encounters; use AUDIT when a more detailed assessment is feasible.
Substance use disorders are chronic, relapsing brain disorders with well-characterized neurobiological mechanisms involving reward circuitry, stress systems, and executive function. They are not moral failings. Treatment works — evidence-based approaches including medications (naltrexone, buprenorphine, acamprosate) combined with behavioral therapies achieve outcomes comparable to other chronic diseases.
When screening reveals moderate-risk substance use, a brief intervention (5-15 minutes) using motivational interviewing techniques can reduce consumption by 15-30%. The FRAMES framework — Feedback, Responsibility, Advice, Menu of options, Empathy, Self-efficacy — provides a structured approach to these conversations.
Cut down (felt the need to reduce drinking), Annoyed (by criticism of drinking), Guilty (about drinking), Eye-opener (morning drink to steady nerves). Each letter represents one screening question.
A score of 2 or more (out of 4) is considered clinically significant and warrants further evaluation. Even a score of 1 should prompt discussion about alcohol use patterns.
The Drug Abuse Screening Test (DAST-10) is a 10-question tool that screens for the degree of drug-related problems in the past 12 months. It covers prescription drug misuse and illicit drug use but not alcohol or tobacco.
These tools are validated for self-administration but may underestimate severity due to denial or minimization. Clinical administration with follow-up questions improves accuracy.
SBIRT stands for Screening, Brief Intervention, and Referral to Treatment. It is an evidence-based approach using tools like CAGE and DAST to identify and address substance use in healthcare settings.
No. These are screening instruments that identify individuals who may have a substance use disorder. A positive screen should lead to comprehensive clinical assessment for formal diagnosis using DSM-5 criteria.