Hi Quattrocento, nice to see you again! I think you're referring to the CAGE questionnaire was developed by Dr. John Ewing, founding director of the Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill. CAGE is an internationally used assessment instrument for identifying problems with alcohol. 'CAGE' is an acronym formed from the italicised letters in the questionnaire (cut-annoyed-guilty-eye).
Here's an entry by an NHS doctor, and his trouble with diagnosing an "alcoholic"
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"What is an alcoholic?
It may seem strange for an experienced doctor to say what I am about to say, but here goes anyway.
I do not know what the word ?alcoholic? means.
I used to know before I was a doctor. It meant someone who was addicted to alcohol. Someone who had a physical craving so great that he started drinking as soon as he got out of his bed and continued until he collapsed back into it. It meant a dirty unshaven man lying in the gutter clutching a brown paper bag with a bottle inside it, singing, swearing and vomiting. It meant that sad man who, many years ago when I was a student, grabbed me outside the chemist and asked if I would go in and buy him some methylated spirits.
I suppose all these people are stereotypical alcoholics. I do not see patients like that.
The problem about the word ?alcoholic? is that people assume that if they do not fit into this stereotypical image, there cannot be problem.
?Alcoholic? does not encompass the housewives whom I stand behind in the supermarket. Three bottles of the cheapest white wine and a tin of cat food.
?Alcoholic? does not encompass that eminent QC who drinks two or three bottles of claret every night. Only first growths, don?t you know.
Some years ago a 48 year old police officer, a chief superintendent no less, came to see me.
?When I was shaving this morning, I noticed the whites of my eyes were yellow.?
They were too. He did not feel ill. Going through his history, we came to alcohol. He drank three quarters of a bottle of whiskey every night. He had done that for twenty five years. He never got drunk. He had never had a day off work. He was in liver failure.
?Could you stop drinking?? I asked.
Yes. No problem, doc. And he did. Immediately. Without difficulty. His liver still failed. He had a transplant. He is back at work. He has not drunk since.
Was he an alcoholic? Is the QC an alcoholic? Are all the housewives drinking cheap supermarket wine alcoholics?
I do not think it is a helpful word. I have stopped using it in a medical context. ?Excessive drinking.? ?Alcohol related problem?. Whatever. This is easier. And less pejorative.
How do you know if you have an alcohol problem? If you are asking yourself that question, you probably do have one. But, if in doubt, ask yourself the four CAGE questions.
- Have you ever felt you needed to Cut down on your drinking?
- Have people Annoyed you by criticizing your drinking?
- Have you ever felt Guilty about drinking?
- Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?
Two positives and you are in trouble.
If you cannot face your doctor, have a look at Dryblog, the best and least threatening internet resource for heavy drinkers.
Highly recommended."