Am I in alcohol withdrawal? And if so, how serious are my symptoms…Do I need to go to the hospital or not?

Any serious drinker has felt the mild effects of alcohol withdrawal – after all, acute alcohol withdrawal is a large part of what makes up a hangover. But when a regular heavy drinker stops completely for long enough (Time measured in hours) that person may be at risk for harmful or life-threatening alcohol withdrawal symptoms.

To put it simply – if you are physically addicted to alcohol, and you stop drinking, you will feel some degree of alcohol withdrawal symptoms.

If you have been drinking heavily enough, and you are very physically addicted, the severity of these withdrawal symptoms can put your life at risk. If you are in severe withdrawal – you NEED to get medical care.

Do you need to go to the hospital?

But how do you know if what you are feeling is serious enough to warrant going to the hospital?

The answer is probably yes. If you are feeling the effects of withdrawal, and you are wondering if you need medical care, then you probably do – and even if you are in no danger of life-threatening symptoms, alcohol withdrawal symptoms are very unpleasant. Doctors have medications that will make you feel much much better.

Secondly, since the dangers of alcohol withdrawal are real (it can kill you) then you don’t want to play around either – and safe is always better than sorry.

But if you want to get a sense of the severity of your symptoms, you can attempt a quick self diagnosis using a clinical scale that your doctor is very likely going to use to assess you when you go in for help.

This test is called the CIWA-AR and though it should not be used as a substitute for medical advice and care, if you score highly on the test it should definitely compel you to go and get some immediate help.

CIWA-AR Diagnostic Test of Withdrawal

This test is a series of questions you will ask yourself, in order to rate your symptoms on a scale 1-7. The test is written for use by a clinician, and so is slightly adapted here from the original for use as a self test. This should not be used in any way as a substitute for medical advice or care.

Nausea/Vomiting

Are you feeling sick to your stomach, or have you vomited? How bad is it?

• 0 not feeling sick
• 1 Mild feelings of nausea
• 2
• 3
• 4 some nausea and dry heaving
• 5
• 6
• 7 continual nausea, dry heaving and vomiting

Tremor

Do you have a tremor? Stand with your arms extended to the side, and your fingers spread out straight.

• 0 no tremor
• 1 no visible tremor, but you can feel it a bit in the fingertips
• 2
• 3
• 4 moderate tremor, only when arms and fingers are extended
• 5
• 6
• 7 severe tremors even when arms are not extended

Sweating

Are you sweating?

• 0 no sweat
• 1 a very little bit, palms are a little moist
• 2
• 3
• 4 sweat is beading on forehead
• 5
• 6
• 7 Heavy and profuse, drenching sweat

Anxiety

How anxious do you feel?

• 0 no anxiety
• 1 mild anxiety
• 2
• 3
• 4 moderately anxious
• 5
• 6
• 7 in a panic

Tactile Disturbances (feelings on skin)

Do you feel any unusual sensations (pins and needles, itching, bugs on skin, burning, numbness) on or under skin?

• 0 no
• 1 very mild
• 2 mild
• 3 moderate
• 4 moderately severe
• 5 severe hallucinations
• 6 very severe hallucinations
• 7 continual hallucinations

Auditory Disturbances

Do things sound different; are you more aware of sounds around you than normal? Do things sound harsher, or do you hear things that are not present? Do sounds frighten you?

• 0 no difference
• 1 sounds are very mildly harsh or frightening
• 2 sounds are mildly harsh or frightening
• 3 sounds are moderately harsh or frightening
• 4 sounds are moderately severe in harshness, some auditory hallucinations
• 5 severe hallucinations
• 6 very severe auditory hallucinations
• 7 continual severe auditory hallucinations

Visual Disturbances

Are you noticing anything different visually? Is the light too bright or does the light hurt your eyes? Is the light disturbing? Are you seeing things that you know are not there (hallucinations)?

• 0 no change
• 1 very mild
• 2 mild
• 3 moderate
• 4 moderate with hallucinations
• 5 severe hallucinations
• 6 very severe hallucinations
• 7 continual visual hallucinations

Headache

Do you have a headache? Does it feel like a tight band around the head? Rate the severity of your headache (Do not rate dizziness)

• 0 none
• 1 very mild
• 2 mild
• 3 moderate
• 4 moderately severe
• 5 severe
• 6 very severe
• 7 extremely severe

Agitation

Do you feel agitated or fidgety?

• 0 no
• 1 a very little bit
• 2
• 3
• 4 moderately fidgety and agitated
• 5
• 6
• 7 can't stop pacing or moving (thrashing)

Orientation

• 0 you know where you are, the date, and can do serial additions (Add 2 + 2 + 2)
• 1 Not sure of date or can't so serial additions
• 2 Don’t know date (Off by less than 2 calendar days)
• 3 Don't know date (off by more than 2 calendar days)
• 4 Don't know where/when you are

Scoring

If you score less than 8, you are in mild withdrawal, and probably do not need any medication at this time. If you score between 10 and 20, you are in moderate withdrawal, and would benefit from medication and medical management. If you score 20 or more, you are in a more serious withdrawal, and need medical care.

Withdrawal symptoms will change over time, and although you may not demonstrate severe symptoms now, you may feel more serious symptoms as time passes. If you decide not to get medical help, you should re-evaluate your condition regularly, to ensure that you are not putting yourself in any danger. Remember too, that symptoms are more easily controlled if you receive appropriate medication before you allow withdrawal symptoms to grow too severe.

This test is not designed to diagnose withdrawal, but used only to gauge the severity of symptoms, and to gauge the severity of symptoms over time and in response to medication/treatment.