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What
are the symptoms of withdrawal from alcohol?
Signs and symptoms of withdrawal from alcohol include two or more
of the following, developing within several hours to a few days after
cessation or reduction in heavy and prolonged use:
- Autonomic
hyperactivity (e.g., diaphoresis, tachycardia, and elevated blood
pressure)
- Increased
hand tremor
- Insomnia
- Nausea
and vomiting
- Transient
visual, tactile, or auditory hallucinations or illusions
- Delirium
tremens (DTs)
- Psychomotor
agitation
- Anxiety
- Irritability
- Grand
mal seizures
Using the CIWA-Ar to assess the need for detoxification
The potential for an alcohol withdrawal syndrome can be gauged
only imprecisely by asking the patient the pattern, type, and quantity
of recent and past alcohol use. Therefore, we need to consider standardized
measures such as the CIWA-Ar to assess the severity of withdrawal
symptoms.
CIWA-Ar
Resources
How
do I interpret the CIWA-Ar score? (View a presentation
of the CIWA-Ar)
The
maximum score of CIWA-AR is 67. The higher the score, the greater
the risk.
Scores
of less than 8 to 10 indicate minimal to mild risk of withdrawal
symptoms. Patients that score less than 8 to 10 normally do not
need to use additional medication for the management of withdrawal.
Scores of 8 to 15 indicate moderate withdrawal.
Scores of 15 or more indicate that a patient is at increased
risk for severe alcohol withdrawal (RR 3.72; 95% confidence interval
2.85-4.85).
NOTE: Some patients (6.4%) still suffered complications
despite low scores, when symptoms were left untreated. (Foy, et
al, 1988).
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