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Alcoholism may be determined by a physician during a physical examination that includes a medical history and list of medications. It is sometimes difficult to diagnose because many people with alcoholism also experience denial (the refusal to recognize truth or reality). This may cause people to hide aspects of drinking or to fail to recognize that physical symptoms (such as digestive problems) may be related to drinking.

Patients suspected of having alcoholism may be asked to fill out a questionnaire, such as the CAGE questionnaire. The questionnaires include questions aimed at identifying drinking patterns and emotions that indicate alcoholism.

For example, the CAGE questionnaire includes four questions. An affirmative answer to two or more questions indicates a high likelihood of alcoholism. The questions are:

• Have you felt you should Cut down on your drinking?
• Have people Annoyed you by criticizing your drinking?
• Have you felt bad or Guilty about your drinking?
• Have you ever had to drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?

Blood alcohol tests are not usually performed because they only identify levels of alcohol ingested at a particular point in time, not long-term use. However, patients may be given other tests, such as liver function tests and other blood tests. People with alcoholism may have elevated liver function tests (which indicates liver damage) and anemia (low red blood cell count).

Patients suspected of having alcoholism may be referred to a substance abuse counselor or other health professional that specializes in treating addiction.