For those working to withdraw from alcohol misuse, the effects of withdrawing can be overpowering and unpleasant, often leading them to quit the process. In some cases, medications can be prescribed to help with those symptoms, however these drugs can be very strong on one’s body, can have side-effects of their own to be concerned with, and can sometimes lead to addiction themselves.
To help health care professionals objectify the severity of alcohol withdrawal symptoms when considering if medications are needed to ease or alleviate symptoms, a standardized tool called the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) was created. Over time, this alcohol withdrawal scale has also been used for assessing patients in various situations other than those being considered for prescription drug administration to alleviate symptoms. These include assessment of those in general outpatient, emergency, surgical, or psychiatric care. Because patients sometimes under-report alcohol consumption, misuse can be overlooked by physicians. Potentially life-threatening consequences, such as delirium tremens or seizures, can be missed if alcohol withdrawal symptoms go unrecognized.
The CIWA-Ar Alcohol Withdrawal Scale
The CIWA-Ar scale consists of ten checkpoints (or conditions) for an attending health care provider to review towards an assessment of alcohol withdrawal. Each is evaluated separately, then an aggregated score is obtained to indicate the severity of alcohol withdrawal. It should be noted that any sign indicating a pattern, or the side-effects, of excessive alcohol consumption should raise a concern for the possibility of alcohol withdrawal being present.
The ten checkpoints of the scale are as follows. Some checkpoints give the provider instructions on what to say to the patient or what the patient should be asked to do. Once each is done, there are seven qualifiers for the health care provider to use for the assessment - some based on observation of the patient, while others are based on answers to questions they ask of the patient.
Upon completion of the assessment, the points are tallied, and the level of alcohol withdrawal is calculated. A score of less than or equal to eight shows that withdrawal is absent or minimal; nine through nineteen indicates mild to moderate alcohol withdrawal; twenty and above is considered severe alcohol withdrawal.
Once the severity has been calculated, the health care provider can further reference a part of the tool that provides information on drugs that can be used to manage alcohol withdrawal symptoms when needed.
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I'm April Bailey, a freelance writer and editor for hire who has been writing about various topics for many years. Most of my early print work was destroyed in a major house fire. Luckily, I was able to pull some copies from an old PC and have posted them here. Other items on this blog reflect my current articles and blog posts written for online publications and copied here so I never lose my work again!