Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) | University of Maryland School of Medicine

description of resource

The Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA‑Ar), is a 10‑item clinician‑administered tool used to measure the severity of alcohol withdrawal symptoms. It provides a structured way to assess symptoms such as nausea, tremor, agitation, hallucinations, and orientation, with a maximum score of 67.

who might use it

Clinicians, nurses, and medical staff in inpatient or outpatient settings use the CIWA‑Ar to monitor alcohol withdrawal, guide medication decisions, and track symptom progression. It is especially valuable in hospitals, detox programs, and emergency departments where timely assessment supports safe withdrawal management.

how to use it

A clinician rates each of the 10 symptom categories based on patient report and direct observation, then sums the scores to determine overall withdrawal severity. Patients scoring under 10 typically do not require medication, while higher scores help guide treatment intensity and monitoring frequency.