Alcohol and Drug Abuse Assessment
| 
   
CAGE-AID Questionnaire  
 | 
  
   
Yes 
 | 
  
   
No 
 | 
 
| 
   
Cut down: Have you ever felt that
  you should 
cut down on your drinking or use of drugs? 
 | 
  
   
1 
 | 
  
   
0 
 | 
 
| 
   
Annoyed: Have you ever felt annoyed by being 
criticized about your drinking or use of drugs? 
 | 
  
   
1 
 | 
  
   
0 
 | 
 
| 
   
Guilty: Have you ever felt guilty about 
drinking or using drugs? 
 | 
  
   
1 
 | 
  
   
0 
 | 
 
| 
   
Eye-opener: Have you ever
  needed an eye-opener 
(alcohol or drugs) after waking up in order to get 
rid of a hangover or calm your nerves? 
 | 
  
   
1 
 | 
  
   
0 
 | 
 
| 
   
Note: A total score of 2 or
  greater is considered 
clinically significant and indicates a high 
likelihood for alcoholism. 
 | 
  
   
Total 
 | 
  
   | 
 
| 
   
RAFFT Questionnaire 
 | 
  
   
Yes 
 | 
  
   
No 
 | 
 
| 
   
Relaxation: Do you ever
  use drugs or drink alcohol 
in order to relax or improve your self-esteem? 
 | 
  
   
1 
 | 
  
   
0 
 | 
 
| 
   
Alone: Do you ever use drugs or
  drink alcohol 
while you are alone? 
 | 
  
   
1 
 | 
  
   
0 
 | 
 
| 
   
Friends: Do you have any friends
  who use drugs or 
have a problem with alcohol? 
 | 
  
   
1 
 | 
  
   
0 
 | 
 
| 
   
Family: Does any of your close
  family use drugs or 
have a problem with alcohol? 
 | 
  
   
1 
 | 
  
   
0 
 | 
 
| 
   
Trouble: Have you ever gotten into
  trouble because 
of alcohol or drugs? 
 | 
  
   
1 
 | 
  
   
0 
 | 
 
| 
   
Note: Any positive answer
  warrants further 
investigation. 
 | 
  
   
Total 
 | 
  
   | 
 
| 
   
Definition  
of Pain 
 | 
  
   
■ Whatever
  the Pt says it is, existing whenever 
the Pt says it exists. 
■ Pain
  is the “fifth vital sign.” Always include it 
with every
  assessment! 
 | 
 
| 
   
Cultural 
Factors 
 | 
  
   
■ Beliefs
  about pain and how to respond to it 
differ between cultures. 
■ Must be considered to effectively manage pain. 
 | 
 



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