By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

“CAGE” TEST CAN HELP DETERMINE IF COUPLE HAS A DRINKING PROBLEM

Question: My husband and I have a glass or two of wine every night and sometime a bit more on weekends. We were talking about this and began to wonder if we were drinking too much. How much is it OK to drink? How do we know if we have a problem? We don’t get drunk or feel bad in the morning.

Answer: For many adults, drinking socially is a daily occurrence. The current standard for what is considered to be moderate drinking is having no more than one drink per day for a woman and no more than two drinks a day for a man. This is not to be saved up or averaged out over time. In other words, you can’t say, “I didn’t have any liquor yesterday so I can have twice as much today.”

Another misconception is that beer doesn’t count. Truth is that it does. One drink is defined as 12 ounces of beer, eight ounces of malt liquor, five ounces of wine or a “shot” (1.5 ounces) of 80 proof liquor. Interestingly, all of these drinks have about the same amount of alcohol with varying amounts of water.

According to the Centers for Disease Control, heavy drinking is defined rather rigidly. For men, heavy drinking is consuming an average of more than two drinks per day. For women, heavy drinking is consuming an average of more than one drink per day. By this definition, it’s a rather steep slope from moderate to heavy drinking.

Is drinking a problem for you or your husband? That is something only you can answer. With alcohol abuse, a person has developed a pattern of drinking that is harmful to one’s health, interpersonal relationships or ability to work. Alcohol abuse can lead to alcohol dependence.

Alcohol dependence has several key characteristics. These include one or more of the following: having a craving for alcohol, continuing to use alcohol when you know you shouldn’t (like being pregnant), not being able to limit your drinking, becoming ill when you stop drinking, or needing to increase the amount you drink to feel a buzz.

A simple four question test can help you evaluate your drinking. It’s called the CAGE questionnaire. The name derives from the first letter of the four key words -- Cut, Annoyed, Guilty and Eye-opener. Here is each key word again, with its corresponding question:
• Cut -- Have you ever felt you needed to cut down on your drinking?
• Annoyed -- Have people annoyed you by criticizing your drinking?
• Guilty -- Have you ever felt guilty about drinking?
• Eye-opener -- Have you ever felt you needed a drink first thing in the morning (an eye-opener) to steady your nerves or to get rid of a hangover?

If you answered “Yes” to two questions that is a strong indication that you have a serious alcohol problem. In that case, it would be a good idea you and your spouse to evaluate the amount of alcohol you are consuming and to cut down. If you answered “Yes” to three questions, that confirms a diagnosis of alcoholism. You need to take immediate action. Please call today to make an appointment with your primary care physician for further direction about your drinking issues.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.