Screening for Risk

Substance Use Disorder (SUD) is a disease that affects a person’s brain and leads to an inability to control the use of a legally prescribed medication or the use of illegal substances or medications. This includes alcohol, marijuana, and nicotine as well as stimulants such as Adderall and Ritalin. Although many people see their doctor regularly, the use of substances are often not talked about. “Screening for Risk” is a tool that is helpful in starting a conversation with anyone such as an employee, co-worker or family member if you see signs that they might be using substances.

Screening for risk is asking a few easy questions to assess whether someone is at risk for a disease. Just as doctors ask questions to screen for possible diseases such as diabetes or heart disease, the questions on this CAGE-AID tool can be used to start a conversation about healthier habits.

Like many other diseases, Substance Use Disorder (SUD) is a disease that at certain stages, can be treated and prevented. Asking quick screening questions (such as the questions in the CAGE-AID green bar to the left) provides an easy way to identify someone’s substance use risks and open the door to talking about getting help.

Anyone can Screen for Risk. One simple screening is the “CAGE-AID” tool. It’s a set of 4 simple questions that anyone can use for themselves, their employees, or someone they love. The “CAGE-AID” questions have a scoring process of yes or no answers. You can find the screening tool to the left, and you can download a copy here.

Substance Use Disorders are treatable, and as with most diseases, sooner is better than later. There are many options or pathways that someone can take if they are at risk and it’s important to find the supports that are best for each individual. Often a health care provider is the easiest and most comfortable place to start the discussion. There are many types of treatment programs that can fit anyone’s needs -including women who are pregnant or may be at risk of becoming pregnant. AskPETRA can help you connect to support in Northern NH and throughout the state.

Substance Use Disorder can happen to anyone. Long-term substance use can result in changes to the brain which affect judgement, decision making, and behavior. These changes can last long after the effects of the substance have worn off. The National Institute on Drug Abuse (NIDA) states that people begin taking substances for a variety of reasons: to feel good (to feel “high”); to feel better (to relieve stress or forget problems); to do better (to improve performance or thinking); and because of curiosity or peer pressure. Everyone wants to feel better or to do better. Everyone has felt peer pressure. Everyone deals with these things differently. Substance Use Disorder can happen to anyone, but it is treatable.

CAGE-AID Screening Tool

The CAGE-AID Screening Tool is a set of simple questions that anyone can use for themselves, their employees, or someone they love. There are 4 questions with a scoring process of yes or no answers. The “CAGE-AID” tool asks the 4 following questions:

1. Have you ever felt you should Cut down on your drinking or drug use?

2. Have people Annoyed you by criticizing your drinking or drug use?

3. Have you felt bad or Guilty about your drinking or drug use?

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

Scoring: Each question is scored with a “0”  for each “no” answer, or a “1” for each “yes.” The higher the score, the more likely that there is a substance use risk. A total score of 2 or greater is considered to be a significant risk. Access the CAGE-AID screening tool here:


Lyndsey works in a manufacturing plant. Her daughter Cheryl just started college and lives at home. Lyndsey has noticed that Cheryl is staying up late at night studying and recently seems jittery and irritable much of the time. This is unlike her usual laid-back daughter and she has grown concerned.

Mike is an auto mechanic. He has had chronic back pain for several months following an incident at work where he “pinched” a nerve while lifting a tire. His work performance has not been up to par lately and he often seems sleepy.

Cheryl got a stimulant from a classmate to help her concentrate and stay awake cramming for a test. She liked the drug so much that she began using it regularly and buys it from a guy she met at a party. Mike was given a prescription for OxyContin by his doctor. It helped for a while, but he found himself craving more and more of the drug and, without his doctor’s knowledge, has gone to several other providers for prescriptions.

Neither Cheryl nor Mike considers this misuse of prescription drugs to be a problem, but both are misusing prescription medication.