🍷 CIWA-Ar (Alcohol Withdrawal)
Grade alcohol withdrawal severity with the CIWA-Ar to drive symptom-triggered therapy.
Clinical takeaway
≥ 8–10 typically triggers benzodiazepine dosing.
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When to use
Titrate benzodiazepines and monitor alcohol withdrawal.
How it works
Ten items (nine scored 0–7, orientation 0–4); total 0–67. < 8 minimal, 8–15 mild–moderate, > 15 severe.
Key points
- ≥ 8–10 typically triggers benzodiazepine dosing.
- Unreliable in delirium, intubation or communication barriers.
- Use fixed-dose/phenobarbital protocols where CIWA-Ar can't be applied.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Nausea/vomiting (0–7) | 0 |
|---|---|
| Tremor (0–7) | 0 |
| Paroxysmal sweats (0–7) | 0 |
| Anxiety (0–7) | 0 |
| Agitation (0–7) | 0 |
| Tactile disturbances (0–7) | 0 |
| Auditory disturbances (0–7) | 0 |
| Visual disturbances (0–7) | 0 |
| Headache/fullness in head (0–7) | 0 |
| Orientation/clouding of sensorium (0–4) | 0 |
→CIWA-Ar0/67
- Interpretation：Minimal/absent withdrawal
- Note：≥ 8–10 usually triggers benzodiazepine dosing; reassess on a schedule.
| Nausea/vomiting (0–7) | 7 |
|---|---|
| Tremor (0–7) | 7 |
| Paroxysmal sweats (0–7) | 7 |
| Anxiety (0–7) | 7 |
| Agitation (0–7) | 7 |
| Tactile disturbances (0–7) | 7 |
| Auditory disturbances (0–7) | 7 |
| Visual disturbances (0–7) | 7 |
| Headache/fullness in head (0–7) | 7 |
| Orientation/clouding of sensorium (0–4) | 4 |
→CIWA-Ar67/67
- Interpretation：Severe — high risk of seizures/DTs
- Note：≥ 8–10 usually triggers benzodiazepine dosing; reassess on a schedule.
Frequently asked questions
- What is CIWA-Ar (Alcohol Withdrawal)?
- Grade alcohol withdrawal severity with the CIWA-Ar to drive symptom-triggered therapy.
- How is CIWA-Ar (Alcohol Withdrawal) calculated? What is the core formula?
- Ten items (nine scored 0–7, orientation 0–4); total 0–67. < 8 minimal, 8–15 mild–moderate, > 15 severe.
- When is CIWA-Ar (Alcohol Withdrawal) used?
- Titrate benzodiazepines and monitor alcohol withdrawal.
- What are the key clinical points for CIWA-Ar (Alcohol Withdrawal)?
- ≥ 8–10 typically triggers benzodiazepine dosing. Unreliable in delirium, intubation or communication barriers. Use fixed-dose/phenobarbital protocols where CIWA-Ar can't be applied.
- What are the limits and cautions when using CIWA-Ar (Alcohol Withdrawal)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is CIWA-Ar (Alcohol Withdrawal) calculated in practice? Can you show a worked example?
- Inputs: Nausea/vomiting (0–7) 0, Tremor (0–7) 0, Paroxysmal sweats (0–7) 0, Anxiety (0–7) 0, Agitation (0–7) 0, Tactile disturbances (0–7) 0, Auditory disturbances (0–7) 0, Visual disturbances (0–7) 0… → Result: CIWA-Ar 0 /67（Interpretation: Minimal/absent withdrawal, Note: ≥ 8–10 usually triggers benzodiazepine dosing; reassess on a schedule.） Inputs: Nausea/vomiting (0–7) 7, Tremor (0–7) 7, Paroxysmal sweats (0–7) 7, Anxiety (0–7) 7, Agitation (0–7) 7, Tactile disturbances (0–7) 7, Auditory disturbances (0–7) 7, Visual disturbances (0–7) 7… → Result: CIWA-Ar 67 /67（Interpretation: Severe — high risk of seizures/DTs, Note: ≥ 8–10 usually triggers benzodiazepine dosing; reassess on a schedule.）