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Frequency of CIWA-Ar monitoring depends upon treatment setting and clinical condition of the patient. Patients with CIWA-Ar scores of more than 10 need frequent monitoring (at least 4 hourly), and patients with severe withdrawal (CIWA-Ar score of more than 20) should be monitored every 1-2 hours.
How is the CIWA-AR Scored? The CIWA-AR scores on a scale from 0-7 for each symptom and takes less than 2 minutes to complete. By adding up the scores of each 10 symptoms into a total, physicians can determine a severity range for patients withdrawal syndrome.
The Catholic Institute of West Africa (CIWA) is a tertiary educational institution in Port Harcourt, Rivers State, Nigeria. It is a higher ecclesiastical institute of the Catholic Church and remains the leading theological facility in West Africa.
The COWS opioid withdrawal scale is derived from an older tool called the Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA). The main difference between these two instruments is that COWS is used to assess symptoms of opioid withdrawal, while CIWA is used to assess symptoms of alcohol withdrawal.
Assessment of alcohol withdrawal: The revised Clinical Institute Withdrawal Assessment for Alcohol scale (CIWA-Ar).
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Clinicians use the CIWA-Ar tool to rate 10 signs/symptoms on numeric scales to determine the severity of signs and symptoms. The total score can range from 0 (no symptoms) to a maximum of 67. Any score over 18 indicates severe withdrawal. The tool takes approximately 5 minutes to administer.

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