What is Clinical Institute Withdrawal Assessment for Alcohol?
The '''Clinical Institute Withdrawal Assessment for Alcohol''' (often called '''CIWA''' or '''CIWA-Ar''' (an updated version)), is a scale used to measure [[alcohol withdrawal]] [[symptom]]s.<ref>Assessment of alcohol withdrawal: the revised Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar). Br J Addict 1989;84:1353–7</ref> The scale lists ten common symptoms of alcohol withdrawal. Based on how bad a person's symptoms are, each of these is assigned a number. All ten numbers are added up to make one final score. The highest possible score is 67. Higher scores are a sign of more severe alcohol withdrawal: * Scores of 15 or less usually mean a person is having mild alcohol withdrawal; * Scores of 16-20 usually mean moderate alcohol withdrawal; and * Scores over 20 usually mean severe alcohol withdrawal. The CIWA is used not just to measure how bad withdrawal symptoms are, but also to guide decisions about what treatments to give, like when to give [[benzodiazepines]]. ==The CIWA Scale== The CIWA measures ten of the most common signs and symptoms of alcohol withdrawal: *[[Nausea]] and [[vomit]]ing *[[Tremor]] *[[Paroxysmal]] [[sweat]]s (sweats that come and go) *[[Anxiety]] *Agitation (like not being able to stay still) *[[Tactile]] disturbances (like feeling [[burn]]ing, itching, or bugs crawling on the skin) *[[Hearing|Auditory]] disturbances (like hearing things louder than usual, hearing scary things, or [[Hallucination|hearing things that are not there]]) *[[Vision|Visual]] disturbances (like lights being too bright, seeing different colors, or [[Hallucination|seeing things that are not there]]) *[[Headache]] *Orientation and clouded [[sensory system|sensorium]] (for example, if a person does not know who he is, where he is, or what is happening) ==Uses== The CIWA scale is validated, which means it is proven to measure what it means to measure - alcohol withdrawal symptoms. It also has high inter-rater reliability. This means that if more than one medical professional used the CIWA o