Beyond CAGE. A brief clinical approach after detection of substance abuse

Arch Intern Med. 1996 Nov 11;156(20):2287-93. doi: 10.1001/archinte.156.20.2287.


Generalist physicians should incorporate alcohol and drug abuse detection and brief intervention in the care of their patients. A suggestion of alcohol or drug abuse or a positive response to the CAGE questions deserves further assessment such as clarification about adverse consequences, inquiry about loss of control, determination of the patient's perception of the substance use, and an assessment of the patient's readiness to change behavior. Brief intervention with the patient in the clinical setting about alcohol or drug use can be effective. Motivational interviewing, a directive, patient-centered counseling style for enhancing motivation for change, can make brief interventions more effective by incorporating the patient's readiness to address alcohol or drug use. A useful clinical approach is presented that is tailored to the patient's stage of readiness to change alcohol or drug abuse behavior.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Attitude to Health
  • Counseling
  • Family Practice*
  • Health Behavior
  • Humans
  • Medical History Taking
  • Motivation
  • Psychotherapy, Brief
  • Substance Abuse Detection*
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / therapy*
  • Surveys and Questionnaires