CIWA-Ar (alcohol withdrawal)
CIWA-Ar alcohol-withdrawal scale (Sullivan 1989): nine symptoms graded 0-7 (nausea, tremor, sweats, anxiety, agitation, tactile / auditory / visual disturbances, headache) plus orientation 0-4.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Nausea / vomiting
- 2
- Tremor
- 2
- Paroxysmal sweats
- 2
- Anxiety
- 2
- Agitation
- 1
- Tactile disturbances
- 0
- Auditory disturbances
- 0
- Visual disturbances
- 0
- Headache
- 1
- Orientation / clouding of sensorium
- 0
Result: CIWA-Ar 10 (moderate withdrawal, 8-15 band; symptom-triggered protocol typically considers active treatment).
The tool opens with these values already filled in. Replace them with your own.
What the result means
- 0-9
- Minimal-to-mild alcohol withdrawal per source.
- 10-15
- Moderate alcohol withdrawal per source.
- 16-19
- Moderate-to-severe alcohol withdrawal per source.
- >=20
- Severe alcohol withdrawal per source.
What you enter
- Nausea / vomiting (0-7)
- Tremor (0-7)
- Paroxysmal sweats (0-7)
- Anxiety (0-7)
- Agitation (0-7)
- Tactile disturbances (0-7)
- Auditory disturbances (0-7)
- Visual disturbances (0-7)
- Headache (0-7)
- Orientation / clouding of sensorium (0-4)
What this is
Score the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar, Sullivan 1989) across its ten items - nausea, tremor, sweating, anxiety, agitation, tactile/auditory/visual disturbances, headache, and orientation. Sophie Well sums to a 0-67 total and returns the conventional severity band so the bedside nurse and prescriber can drive a symptom-triggered protocol.
When to use it
Use this at scheduled intervals (typically q1-2h) for an inpatient at risk of alcohol withdrawal so benzodiazepine dosing can be triggered by score thresholds rather than fixed schedules. CIWA assumes the patient can communicate; for intubated, sedated, or non-verbal patients, an observation-only scale such as the Minnesota Detoxification Scale (MINDS) or RASS-driven protocol is more appropriate.
How this is calculated
Sullivan JT, et al. Assessment of alcohol withdrawal: the revised CIWA-Ar. Br J Addict. 1989;84(11):1353-1357. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.
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