CAGE Assessment

We are taught a “CAGE Assessment” method when suspecting an alcohol consumption problem in med school. CAGE is one of many mnenomics that med students love so freakin’ much.

C – Consider cutting back?
A – Agitated when asked to cut back?
G – Guilt about amount consumed?
E – Eye-opener
So a positive 2 or more of these means bad news bears.
Now I don’t have a problem with alcohol (at least I don’t think so) but what about other things?
The Science
Alcohol is a substance that is readily absorbed into your blood stream, crosses the blood-brain barrier and has a GABAergic effect leading to depression of your CNS. Chronic use leads to a downregulation of the GABA receptors so that upon withdrawl, the synapses fire uncontrollably and can lead to seizures and other bad stuffs.
Caffeine is a psychostimulant most widely consumed psychostimulant in the world. Caffeine works as a competitive antagonist to adenosine (the exact way it works is unknown) and with increasing use there is an upregulation of adenosine receptors in the brain. What does this mean? Upon withdrawl of caffeine, there will be heightened effect of adenosine (vasodilation of the vessels in the brain) which leads to headache, nausea, fatigue etc. 
Translation
Alcohol —> Bad
Caffeine –> Bad
Since both alcohol and caffeine are bad, I reckon it’d be useful to do a CAGE assessment on myself for caffeine.

I’ve considered cutting back, I DO get agitated when people ask me to cut back, I AM guilty that I 
drink so much dang coffee and obviously I need an eye-opener to get me going in the morning?
Hey that’s a perfect 4/4. 
I guess that’s bad news bears for me!
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