Score each item from clinical assessment: 0–7 for every item except orientation, which is 0–4.
Nausea and vomiting (0–7)
Tremor (0–7)
Paroxysmal sweats (0–7)
Anxiety (0–7)
Agitation (0–7)
Tactile disturbances (0–7)
Auditory disturbances (0–7)
Visual disturbances (0–7)
Headache / fullness in head (0–7)
Orientation and clouding of sensorium (0–4)
Enter a score for all ten items to calculate
Evidence
Original publication
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). Ten-item scale (nine items 0–7, orientation 0–4); total 0–67.
British Journal of Addiction, 1989
Open source
Guideline
Widely used for symptom-triggered benzodiazepine dosing in alcohol withdrawal. It requires a cooperative patient and is unreliable when confusion, delirium, or another acute illness confounds the items; it does not by itself diagnose or exclude severe withdrawal.
Last reviewed: 2026-09
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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.