The Four Coded Questions Doctors Ask to Reveal a Hidden Alcohol Problem

Experts today warned of a “hidden epidemic” of alcoholism among a population group you would not expect to suffer from it.

Middle-aged and retired people drink a lot of alcohol and are therefore at risk of all kinds of diseases, including cancer and depression.

Latest NHS figures show that 23 per cent of women aged 55 to 64 drink more than 14 units of alcohol a week, a level that significantly increases the risk of cancer and the likelihood of dependence.

But many people don’t realise they have a problem because their bodies aren’t yet dependent on alcohol, which causes the telltale tremors, psychiatrist Dr Max Pemberton warned in the Daily Mail this week.

But experts have revealed a simple test doctors use to spot a hidden, ‘functioning’ alcoholic.

Since the late 1980s, doctors have used the CAGE test (which stands for Cut, Annoyed, Guilty, and Eye, related to each question) to identify alcoholism.

In this test, the CAGE test, the patient is asked four important questions about his or her drinking habits.

According to a 2014 review published in Occupational Medicine, the questionnaire was developed in 1984 by American psychiatrist and addiction expert Dr. John Ewing. The questionnaire is estimated to be between 76 and 93 percent accurate for identifying alcoholism.

According to Dr. Pemberton, the questions include:

Have you ever felt like you should drink less? Have people annoyed you by criticizing your drinking? Have you ever felt guilty about drinking? Do you need to drink first thing in the morning to calm your nerves or to lessen a hangover?

“If you answer yes to two or more of these questions, you may have a problem that cannot simply be dismissed as summer fun,” he said.

Research has shown that people who drink one or two drinks four or more times a week have a 20 percent higher risk of premature death, compared to people who drink only three times a week or less.

Dr Pemberton wrote in the Daily Mail today: ‘When I ask (patients) about their alcohol use, they often don’t recognise that they have a problem because it hasn’t progressed to the point where they become physically dependent on it. Then the body becomes dependent on alcohol and they start shaking when they stop drinking.’

Earlier this year, official figures showed that alcohol-related deaths hit a record high in December 2022, rising to over 10,000, 32.8 percent higher than before the pandemic.

By comparison, ten years ago, fewer than 6,800 alcohol-related deaths were recorded.

Although there were more alcohol-related deaths overall among men than among women, the greatest increase occurred among women aged 50 to 54 years.

The number of Britons in this category who died from an alcohol-related death rose from 17.8 per 100,000 people to 26.3.

People who are concerned about an alcohol problem should visit their GP, who can diagnose them and refer them to specialist clinics for support and help with withdrawal.

According to the NHS, withdrawal symptoms, which include anxiety, shaking, vomiting and a fast heart rate, usually go away within a week.