ciwa_ar_alcohol_withdrawal: Clinical Institute Withdrawal Assessment for Alcohol, Revised...

In cliot: Clinical Indices and Outcomes Tools

Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar)

Description

Calculates the CIWA-Ar score, the gold-standard tool for assessing the severity of alcohol withdrawal syndrome. The scale consists of 10 items: 9 items scored 0-7 and 1 item (Orientation) scored 0-4. The total score guides the administration of benzodiazepines in symptom-triggered protocols.

Usage

ciwa_ar_alcohol_withdrawal(nausea_vomiting, tremor, paroxysmal_sweats, anxiety,
                           agitation, tactile_disturbances, auditory_disturbances,
                           visual_disturbances, headache, orientation)

Arguments

nausea_vomiting	Numeric (0-7). 0=None, 4=Intermittent nausea/dry heaves, 7=Constant nausea/vomiting.
tremor	Numeric (0-7). 0=No tremor, 7=Severe, visible with arms not extended.
paroxysmal_sweats	Numeric (0-7). 0=No sweat visible, 7=Drenching sweats.
anxiety	Numeric (0-7). 0=No anxiety, 7=Acute panic states.
agitation	Numeric (0-7). 0=Normal activity, 7=Pacing constantly/thrashing.
tactile_disturbances	Numeric (0-7). 0=None, 7=Continuous hallucinations.
auditory_disturbances	Numeric (0-7). 0=None, 7=Continuous hallucinations.
visual_disturbances	Numeric (0-7). 0=None, 7=Continuous hallucinations.
headache	Numeric (0-7). 0=None, 7=Very severe.
orientation	Numeric (0-4). 0=Oriented, 4=Disoriented to place and person.

Value

A list containing:

CIWA_Ar_Score	The calculated total score (Range 0-67).
Severity_Category	Classification (Mild <8, Moderate 8-15, Severe >15).
Management_Guideline	General treatment recommendation based on severity.

References

Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM. Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict. 1989;84(11):1353-1357. doi:10.1111/j.1360-0443.1989.tb00737.x

Examples

# Example 1: Severe Withdrawal
# Tremor 7, Sweats 7, Agitation 5, Hallucinations 3
# Score = 22
ciwa_ar_alcohol_withdrawal(0, 7, 7, 0, 5, 0, 0, 3, 0, 0)

# Example 2: Mild Withdrawal
# Tremor 2, Anxiety 2
# Score = 4
ciwa_ar_alcohol_withdrawal(0, 2, 0, 2, 0, 0, 0, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.