CIWA-Ar calculator: 10-item alcohol withdrawal severity scale
Assess alcohol withdrawal severity with the 10-item CIWA-Ar: 0–67 points with thresholds at 10 and 20.
Updated · Methodology
Nine items scored 0–7 (none to maximum), orientation 0–4. Total range: 0–67.
About this calculator
CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol, revised) is the Sullivan 1989 scale that quantifies alcohol withdrawal severity. Ten items: nausea, tremor, sweats, anxiety, agitation, tactile, auditory and visual disturbances, headache (each 0–7), and orientation with clouding of sensorium (0–4). Total range 0–67. Categories: <10 mild (supportive care), 10–19 moderate (symptom-triggered benzodiazepine PRN), ≥20 severe (fixed-dose benzodiazepine, risk of delirium and seizures). SEPB (Sociedad Española de Patología Dual) endorses CIWA-Ar as the standard for symptom-triggered therapy: medication is given only when the score crosses the threshold, which lowers the cumulative benzodiazepine dose and overdose risk versus a fixed schedule.
Source
Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM. Br J Addict 1989;84(11):1353-7
Formula version: sullivan-1989-v1