Alcohol withdrawal assessment scale (CIWA-AR)
PDF 44 KB
Management of alcohol withdrawal at home could be considered if the person:
Note 1 the person should be reviewed either by a doctor or a nurse once per day for at least five days. The severity of their withdrawal should be monitored using the CIWA-Ar (PDF 45KB).
Note 2 a contingency plan should be developed in case of deterioration in the person’s condition. This should include who to contact any time of day or night as well as what to do in emergencies.
Worsening withdrawal at 3 to 10 days after the person’s last drink may indicate onset of delirium tremens (a medical emergency). Urgent transfer to hospital is recommended – carers should be urged to call an ambulance on 000.
Note 3 patients should be advised not to drive during withdrawal, due to effects of the withdrawal, as well as the benzodiazepines.
Fixed dosing regime with diazepam (start with QID dosing reducing to TDS, BD then OD) - total daily doses below:
Diazepam needs to be time limited – ie no longer than one week.
100mg PO eight hourly.
[Consider IV or IM thiamine if person is malnourished or has decompensated liver disease. These individuals should be managed in an inpatient setting anyway]
It is recommended that oral thiamine and multivitamins be continued for the first four weeks of abstinence.
If drinking resumes then continue the thiamine and multivitamins.
If the person decides to discontinue the withdrawal,and resumes drinking then the benzodiazepines should be ceased.
ADIS is a confidential telephone information, counselling, and referral service for people dealing with their own or another’s alcohol or drug problem. ADIS operates seven days per week 8.30 am to 10.00 pm. Telephone: 1300 131 340
DACAS provides a telephone and email service for South Australian health professionals seeking clinical information and clarification around clinical procedures, guidelines and evidence-based practice.
Telephone: (08) 7087 1742 from 8:30am - 10pm 7 days/week including public holidays or e-mail your enquiry to: HealthDACASEnquiries@sa.gov.au.
these hours, medically urgent calls from a hospital based Medical
Consultant or country hospital medical officer/GP will always receive a response.
This service does not provide proxy medical
cover and cannot assume responsibility for direct patient care.