The 4 coded questions your doctor might ask to work out if you’re a functioning alcoholic

WHEN we think of alcoholics, it tends to bring to mind images of people slumped by a wall with a bottle in a brown paper bag.

And heavy drinking might conjure up images of hooligans brawling the street, lager can in hand, football shirt waving in the other.

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Doctors have been using the CAGE test to identify functioning alcoholicsCredit: Getty

But there is another group that has a serious issue with alcohol, a problem that may well shorten their lives: middle-aged women.

Latest NHS figures show that 23 per cent of women aged 55-64 drink more than 14 units of alcohol a week – which is equivalent to around six medium-sized glasses of wine.

This is the amount known to increase cancer risk dramatically, and the chances of getting addicted.

But many fail to recognise they have a problem because their body hasn’t yet become reliant on alcohol, causing the telltale shakes.

Doctors often use a simple test to help spot a ‘functioning’ alcoholic, which is someone who’s dependent on alcohol but is still able to function relatively effectively in their daily life.

It’s called the CAGE test and involves asking the patient four key questions about their drinking habits. 

The test, developed by US psychiatrist Dr John Ewing in 1984, is thought to be up to 93 per cent accurate for identifying an alcohol addiction,

The questions are as follows:

1. Have you felt the need to Cut down on your drinking?
2. Do you feel Annoyed by people complaining about your drinking?
3. Do you ever feel Guilty about your drinking?
4. Do you ever drink an Eye-opener in the morning to relive the shakes?

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Typically, answering “yes” to two or more questions suggests you may be dependent on booze.

Drinking more than 14 units per week is also known to increase the risk of a range of other deadly illnesses, including fatty liver disease and heart disease.

Earlier this year, official figures revealed that deaths from alcohol reached an all-time high in December 2022, rising to more than 10,000 and 32.8 per cent higher than pre-pandemic levels. 

For comparison, just under 6,800 total alcohol-related deaths were logged a decade ago. 

Scotland and Northern Ireland had higher rates — 22.6 and 19.5 per 100,000 respectively — than Wales and England.

Those concerned they may have a problem with alcohol should visit their GP, who can make an assessment and refer them to specialist clinics for counselling and help with withdrawal.

Withdrawal symptoms, including anxiety, shakiness, vomiting and fast heart rate, usually resolve within a week, according to the NHS. 

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How to cut back on drinking

If you’re concerned about your drinking, a good first step is to see a GP

They’ll be able to give advice and support on how to manage your drinking habits and cut back safely.

This might involve counselling, medicines or detox services.

There are many charities and support groups you can join or speak to, as well as helplines: