Exploration of the use of clinical institute withdrawal assessment, alcohol scale-revised (ciwa-ar) in a local context

Clinical Institute Withdrawal Assessment Alcohol Scale-revised (CIWA-Ar) is currently the "gold standard" in the assessment of alcohol withdrawal in patients. The initial CIWA-A validation study was based on patients with moderate to severe alcohol withdrawal. The patients in the validation study were treated conservatively, without using benzodiazepines if possible. The validation study excluded patients with dual diagnosis or polydrug use. In contrast, most inpatients in Victorian withdrawal units have mild to moderate alcohol withdrawal and they are all aggressively treated with medications. In practice CIWA-Ar is used in all patients in alcohol withdrawal with or without dual diagnosis or polydrug use. This is despite the fact that CIWA-Ar has not been validated for patients with dual diagnosis or poly drug use. This study explored some of the potential problems and difficulties in the use of CIWA-Ar in a local context.