CIWA-AR Withdrawal Severity Calculator

The CIWA-AR Withdrawal Severity Calculator estimates withdrawal severity based on ten key symptom categories. This tool helps healthcare professionals and addiction specialists guide treatment plans safely. Whether you are determining medication dosing, monitoring patient progression, or deciding on inpatient care, this calculator offers a quick, standardized assessment.

Rate the severity of nausea and vomiting
Rate the severity of tremor
Rate the severity of sweating episodes
Rate the severity of anxiety
Rate the severity of agitation
Rate the severity of tactile disturbances
Rate the severity of auditory disturbances
Rate the severity of visual disturbances
Rate the severity of headache or fullness in head
Rate the level of orientation and clouding of sensorium

How CIWA-AR Score Is Calculated

CIWA-AR Score = Sum of 10 Symptom Ratings

Where:

  • Each symptom is rated on a scale from 0 to 7
  • Higher numbers indicate more severe symptoms

The CIWA-AR score measures the physical and mental impact of stopping alcohol use. To calculate it, a clinician rates ten specific symptoms based on observation and patient report. First, assess each item, such as nausea or anxiety, using the provided scale. Next, add all these individual ratings together to reach the final total. This sum, ranging from 0 to 67, provides a clear picture of withdrawal intensity. This validated method helps medical teams make safe, consistent choices for patient care.

What Your CIWA-AR Score Means

The total score tells you how serious the withdrawal is and what kind of medical help is needed. Scores range from 0 to 67, with higher numbers meaning greater risk to the patient.

Mild Withdrawal (0-9)

Patients in this range often do not need medication. Focus on providing supportive care, hydration, and monitoring to ensure the condition does not get worse.

Moderate to Moderately Severe (10-20)

This range typically requires medication, such as benzodiazepines, to prevent complications like seizures. Regular checks are vital to ensure the score stabilizes or drops.

Severe Withdrawal (Over 20)

High scores indicate a critical situation. These patients need intensive monitoring, often in an inpatient setting, and aggressive medication dosing to ensure safety.

Important: Always treat the patient's whole condition, not just the number. Watch for signs not captured in the list, such as seizures or heart issues.

This tool is for educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Reassess the score every 1 to 4 hours to track improvement or decline.