The four coded questions doctors ask to uncover a hidden alcohol problem

Experts today warned of a ‘hidden epidemic’ of alcoholism among a demographic you may not expect to be affected. 

Middle-aged and retired people are drinking harmful levels of booze and putting themselves at risk of a host of diseases, including cancer and depression, as a result.

Latest NHS figures show that 23 per cent of women aged 55-64 drink more than 14 units of alcohol a week — the amount known to dramatically increase cancer risk, and chances of developing dependency.

But many fail to recognise they have a problem because their body hasn’t yet become reliant on alcohol, causing the telltale shakes, warned psychiatrist, Dr Max Pemberton in the Daily Mail this week.

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

Called the CAGE test, the tool involves asking the patient four key questions about their drinking habits. 

Developed by US psychaitrist and addiciton specialist Dr John Ewing in 1984, the questionnaire is thought to be between 76 and 93 per cent accurate for identifying alcoholism, according to a 2014 review published in Occupational Medicine. 

According to Dr Pemberton, the questions include the following: 

Have you ever felt you needed to cut down your drinking? 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 steady your nerves or lessen a hangover?

‘Answering ‘yes’ to two or more of these questions means there could be a problem that can’t simply be explained away as summer fun,’ he said. 

According to studies, people consuming one or two drinks four or more times a week had a 20 per cent higher risk of premature death, compared with those who drank only three times per week or less.

Writing in today’s Daily Mail, Dr Pemberton said: ‘When I ask [patients] about their drinking, they often fail to see they have a problem because things haven’t (yet) reached the stage where they physically depend on it – when the body becomes reliant on alcohol and the shakes kick in if they go without it. ‘

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. 

While there were more alcohol-related deaths in men than women overall, the biggest leap was in women aged 50-54. 

The number of Brits in this category dying a booze-related death rose from 17.8 per 100,000 people, to 26.3. 

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

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