CIWA Protocol for Alcohol Withdrawal

What the CIWA-Ar alcohol withdrawal scale measures, why hospitals use it, and how it connects to medically supervised detox - not a DIY scorecard.

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Key takeaway

CIWA-Ar is a clinical scoring tool clinicians use to gauge alcohol withdrawal severity and guide benzodiazepine or other protocol dosing. It is not a home checklist. Call 911 for seizures or severe confusion, or call or text (800) 653-9376 for detox matching.

Last updated: Wed Oct 07 2026 00:00:00 GMT+0000 (Coordinated Universal Time)

CIWA-Ar is how many hospitals and detox units decide how hard alcohol withdrawal is hitting - and how aggressively to treat it.

Call 911 for seizures, severe confusion, or an unresponsive person. Call or text 988 for a crisis.

What CIWA measures

Trained staff score items such as nausea, tremor, sweating, anxiety, agitation, tactile/auditory/visual disturbances, headache, and orientation. Higher scores usually mean more frequent reassessment and medication under a written protocol.

Why it is not a home tool

Withdrawal can escalate between scores. Benzodiazepine dosing and other protocol meds belong with a clinician who can also watch for DTs, Wernicke risk, and cardiac issues.

Broker filter

A call center that promises "CIWA detox at home" without a licensed clinician is selling risk, not care.

Next step

If you need medically supervised alcohol detox, call or text (800) 653-9376.

Additional Resources

Sources cited on this page:

Common Questions

What does CIWA stand for?

CIWA-Ar means Clinical Institute Withdrawal Assessment for Alcohol, revised. Nurses and clinicians score symptoms such as tremor, sweating, anxiety, agitation, and orientation to guide treatment.

Can I score myself at home?

No. CIWA is designed for trained staff in a clinical setting. Self-scoring can miss life-threatening withdrawal and delay care.

Does a high CIWA score mean I need inpatient detox?

Often a rising or high score supports closer monitoring and medication, which may mean inpatient or hospital-level care. The clinician decides level of care.

Is CIWA the same as PAWS?

No. CIWA tracks acute alcohol withdrawal over hours to days. Post-acute withdrawal (PAWS) refers to longer lingering symptoms after detox.

Where can I start detox tonight?

Call 911 for seizures, hallucinations, or unresponsiveness. Otherwise call or text (800) 653-9376 or search FindTreatment.gov for detox programs.