When I am working with people affected by someone’s use of alcohol, I make a variety of suggestions, but almost always recommend Al‑Anon. People referred to Al‑Anon show significant improvement in their health, well-being, and total daily functioning. They tell me they find a degree of support, acceptance, and understanding in Al‑Anon that they can find nowhere else.

In health care settings, there are many people who could potentially benefit from Al‑Anon, but their need is never identified. Health care providers often struggle to find time to screen for patients who have been affected by someone else’s drinking, which conservative estimates show to be at least 20 percent of the population. This statistic is unfortunate because, as in other health conditions, early identification is important.

There is a screening tool—the “Family CAGE”—that can help identify people who have been affected by someone else’s drinking. The screening involves four short questions:

  • C Have you ever felt that anyone in your family should cut down on their drinking?
  • A Has anyone in your family felt annoyed by complaints about their drinking?
  • G Has anyone in your family ever felt bad or guilty about their drinking?
  • E  “Eye opener” Has anyone in your family ever had a drink first thing in the morning to steady nerves or get rid of a hangover?

One or more positive answers should be followed by a more thorough diagnostic assessment.

I have found the “Family CAGE” to be a helpful tool in my work. I try to encourage other health care providers to use it.

Once a health care provider has identified an individual impacted by another’s drinking, I advise them to strongly consider making a referral to Al‑Anon. I believe that once they see the benefits of Al‑Anon, they will do more frequent screenings and make more referrals to Al-Anon.

By Neil A. Capretto, D.O., F.A.S.A.M.

Medical Director, Gateway Rehabilitation Center, Aliquippa, PA

© Al-Anon Family Group Headquarters, Inc., Virginia Beach, VA,

Al-Anon Faces Alcoholism 2009 magazine.

Note: Al-Anon cooperates with therapists, counselors, and other professionals but does not affiliate with or endorse any organization. Articles written by professionals are their personal perspective on how Al-Anon Family Groups can help patients, clients, or consumers affected by someone else’s drinking.