McMaster University

Michael G. DeGroote
National Pain Centre

Scope of Search

Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain

Appendix B-1: Examples of Tools for Assessing Alcohol and other Substance Use

  • Interview Guide for
    Alcohol Consumption
  • Interview Guide for
    Substance Use
  • CAGE Questionnaire

Appendix B-1.1: Interview Guide for Alcohol Consumption

  1. Maximum number of drinks* consumed on any one day in past 1–3 months
  2. Number of drinks per week
  3. Previous alcohol problem
  4. Attendance at treatment program for alcohol
  5. Family history of alcohol or drug problem

* Standard drink = 1 bottle beer (12 oz, 5%)
     = 5 oz glass wine (5 standard drinks in 750 ml wine bottle)
     = 1.5 oz liquor (vodka, scotch) (18 standard drinks in 26 oz bottle 40% alcohol)

Low-Risk Drinking Guidelines

— Source: Centre for Addiction and Mental Health (CAMH) 2004

(No more than 2 standard drinks on any one day)

Women: up to 9 standard drinks a week.

Men: up to 14 standard drinks a week.

Patients who exceed the Low-Risk Drinking Guidelines are considered at-risk for acute problems such as trauma, and/or chronic problems such as depression and hypertension.

Appendix B-1.2: Interview Guide for Substance Use

  1. Cannabis: number of joints per day, week
  2. Cocaine: any use in the past year
  3. Over the counter drugs: especially sedating antihistamines
  4. Opioids:
    • In past year, use of opioids from any source: e.g., OTC (Tylenol® No. 1), prescriptions from other physicians, borrowed from friends/family, buying from the street
    • How much, how often
    • Crushing or injecting oral tablets
    • Opioid withdrawal symptoms: myalgias, GI symptoms, insomnia, dysphoria
    • Previous opioid problem
    • Attendance at treatment program for opioid addiction (e.g., methadone)
  5. Benzodiazepines: Amount, frequency, source

Appendix B-1.3: CAGE Questionnaire

"CAGE" is an acronym formed from the italicized words in the questionnaire (cut-annoyed-guilty-eye).

The CAGE is a simple screening questionnaire to id potential problems with alcohol.

Two “yes” responses is considered positive for males; one “yes” is considered positive for females.

CAGE Questionnaire

Please note: This test will only be scored correctly if you answer each one of the questions.

Please check the one response to each item that best describes how you have felt and behaved over your whole life.

  1. Have you ever felt you should cut down on your drinking?

  2. Have people annoyed you by criticising your drinking?

  3. Have you ever felt bad or guilty about your drinking?

  4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?


Substance Use Screening & Assessment Instruments Database
Alcohol And Drug Abuse Institute
University of Washington