Tuesday, February 19, 2008

Tuesday February 19, 2008
Clinical Institute Withdrawal Assessment for Alcohol—Revised (CIWA-Ar)


The most objective tool to assess the severity of alcohol withdrawal is the Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar). Score consists of 10 items and can be performed in 5 minutes at the bedside. The questions include regarding following 10 items
  1. nausea and vomiting,
  2. anxiety,
  3. tremor,
  4. sweating,
  5. auditory disturbances,
  6. visual disturbances,
  7. tactile disturbances,
  8. headache,
  9. agitation,
  10. clouding of sensorium

0 to 7 points are assigned for each item except for the last item, which is assigned 0-4 points, with a total possible score of 67.

The CIWA-Ar is not copyrighted and may be reproduced freely. Patients scoring less than 10 do not usually need additional medication for withdrawal.

CIWA-Ar has been demonstrated to have high reliability, reproducibility, and validity. Careful and frequent monitoring with the CIWA-Ar is clinically found to be very helpful.

You can view the full survey
here (pdf)