Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar)
Assessment tool
A total does not establish individual item responses.
Complete the clinician interview and observation for every item. Record pulse/heart rate and blood pressure separately in the clinical record; they are not components of the ten-item total. Ratings without source verbal anchors are identified as intermediate ratings.
CIWA-Ar: Sullivan and colleagues (1989). COWS: Wesson and Ling (2003). Preserve selected-source attribution.
Responses stay in this page’s memory. Reset or leave the page to clear them. No patient identifiers are collected.
About this scale and references
Reference information · Questionnaire
- Last content update
- 2026-10-26
- Clinical review
- Not independently reviewed
- Source jurisdiction
- See individual sources
- Coverage
- Questionnaire
| Field | Instrument context |
|---|---|
| Version | Original English Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar); source-specific item anchors |
| Population | Adults in a supervised clinical assessment setting |
| Respondent | Trained clinician examination and interview |
| Recall period | Current examination; item-specific recent observation periods as stated |
| Purpose | Quantify withdrawal signs and symptoms for clinician assessment |
Interpretation & limitations
- Maximum score is 67. ASAM mild, moderate and severe example bands are retained from the existing verified scoring guide.
- The score depends on reliable interview and observation. It is not a standalone predictor of seizures, delirium or the level of care needed.
- Do not infer a medication regimen from the total.
- Use a trained clinician and the complete examination. Assess competing causes of signs and symptoms.
- Missing responses are not zero. A score does not establish diagnosis, determine medication or establish safety.
References · 3
- Exact English form, questions and response anchors
- Government public-domain statement · Alaska Department of Health and Social Services identifies CIWA-Ar and COWS as public domain. CIWA-Ar source also explicitly states it is not copyrighted and may be used freely.
- Primary scoring / instrument reference