When you detox, your body flushes out any alcohol residues that you have ingested. This painful withdrawal period is the only way to overcome alcohol addiction. It is determined by how dependent a person has become.
Detoxification from alcohol causes the brain to create the chemicals that it previously depended on alcohol to secrete. During the early stages, withdrawal symptoms such as irregular heartbeat, anxiety, headaches, fever, nausea, and even hallucinations may develop. Detoxing is required to begin the rehabilitation process.
Professionals may use some well-known indications and symptoms to determine whether or not someone is at risk for alcohol withdrawal syndrome and what kind of treatment they may need. The CIWA protocol system determines the next course of action based on these symptoms and their associated ratings. Continue reading to find out more!
What Does CIWA Stand for?
The CIWA procedure, commonly known as CIWA-Ar, is an objective evaluation of the severity of alcohol withdrawal. The CIWA medical abbreviation’s full meaning is “Clinical Institute Withdrawal Assessment for Alcohol.” This procedure may assess a person’s risk of alcohol withdrawal syndrome objectively. Moreover, it allows for more accurate diagnosis and treatment planning. It is significantly safer to follow the CIWA protocols than to go through a “cold turkey” alcohol detox. This safety guarantee has made it a top choice for experts.
Clinical Use of the CIWA Protocol
Only ten symptoms are recorded on the CIWA-Ar scale. These symptoms are scaled from 0-7, except for the orientation questions, which are 0-4.
The CIWA protocol checks the following to assess the severity of alcohol withdrawal:
- High blood pressure and perspiration
Drinking alcohol has been shown to cause an increase in heart rate and dilated blood vessels in the skin. People undergoing alcohol withdrawal typically report experiencing ‘night sweats,’ which is why this is so common. You’ll notice this in the first few days after stopping alcohol consumption, but it’ll only last for a few days.
- Tremors in the hands
Hand tremors are one of the most visible signs of alcoholism. You may notice this symptom six hours after your previous alcoholic beverage. Alcohol depresses the central nervous system and reduces the body’s energy levels.
A person’s brain releases more neurotransmitters than usual when they consistently drink large quantities of alcohol. As a result of the significant changes in brain chemistry caused by excessive alcohol use, the brain expects to continue producing enough neurotransmitters to compensate for the absence of the ingested alcohol. ‘The shakes’ are caused by a heightened sensation of worry and tension in the body.
Alcohol messes with the brain’s natural method for calculating how much sleep it needs each night based on how long it has been up. As a diuretic, alcohol impairs sleep quality by increasing the frequency of people waking up to use the toilet.
Alcohol withdrawal causes nausea in a variety of circumstances. Alcohol has a direct impact on the body’s hydration levels. Dehydration may occur due to the increased output of urine from the body. Dizziness, lightheadedness, and severe thirst are common side effects. Hence, alcohol has been linked to an increase in the production of stomach acids, which may lead to nausea and vomiting. It also weakens body immunity by causing dizziness, nausea, a loss of focus, and a lack of appetite.
Alcohol irritates the stomach and damages the intestinal lining. Vomiting after drinking alcohol happens due to the stomach’s gastric muscles constricting, which causes nausea initially. Aside from that, the “dry heaves” imply that the stomach’s greatest component goes into respiratory spasms. Finally, the mouth expelled the small intestine contents, resulting in vomit. It’s important to address vomiting during alcohol withdrawal with the utmost seriousness.
A condition known as “delirium tremens” encompasses hallucinations during alcohol withdrawal. Once you’ve been here a few days, this normally happens. It’s possible that the ‘shakes,’ as we called them before, have now spread to the brain and body, resulting in incoordination and extreme disorientation of the mind. Delusions and hallucinations are common side effects of this.
Serotonin is responsible for our memory, sleep, and mood. However, alcohol has been shown to affect brain chemistry. Low amounts of this natural substance lead to sleep disturbances, memory loss, irritability, and depression.
Although alcohol is a mild sedative, it has been shown to interfere with the brain’s normal chemical processes (which explains the chilled-out feeling after that first drink). Alcohol-induced anxiety results from the body and brain’s inability to handle the chemicals released by drinking. During detoxification, the brain still believes it should be able to manufacture enough neurotransmitters to account for the alcohol, even if the effects of alcohol have worn off after long-term addiction. The body’s inability to cope without the calming and soothing effects of alcohol is causing the shivers, bewilderment, and anxiety that accompany them.
- Grand mal seizures
Because of the brain-altering effects of alcohol addiction, the body begins to assume that it cannot function without the toxin. As soon as the body removes this toxin, it enters into a state of shock. The rapid discontinuation of alcohol causes a chemical imbalance on both sides of the brain, resulting in grand mal seizures. Sending signals to the muscles, glands, and nerves is the job of these organs. Disruption of this process may lead the brain to direct the body’s processes to go into overdrive, resulting in excessive muscle spasms.
Each of the 10 symptoms on the CIWA-Ar list has a question the doctor or nurse should ask to verify that replies are within the right range required to complete the scale.
However, symptoms like the existence of excitement, tremors, or sweat may be detected visually without the need for further questioning.
The CIWA-Ar form has the following questions:
- “Do you have an upset stomach?” “Have you thrown up?”
- “Has your skin been irritated by itching, numbness, or the feeling of creatures crawling on and under your skin?”
- “Are you more conscious of the noises around you? Is it fair to say that they are harsh? Do they terrify you? Is there anything that you find upsetting? Do you hear things you know aren’t there?”
- “Does it seem like the light is too bright?” Is there a difference in the shades? Is it hurting your vision in any way? Are you disturbed by what you’re seeing? “Do you think you’re seeing things that aren’t there?”
- “Are you nervous?”.
- “Does it feel different in your head? Does it feel like a band is holding your head?
- “Which day is it?” What’s your current location? ‘Who am I?’
What sort of drug and dosage they should give based on the patient’s reaction will then be determined using the CIWA protocol. Responses to these questions have a corresponding point, and here’s how it works.
How Clinicians Use the CIWA-Ar Score to Treat Withdrawal Symptoms
As the detox develops, the CIWA protocol scale may be quite helpful in measuring the severity of the symptoms. For detoxification, the objective is to utilize the smallest quantity of medicine feasible for the shortest period possible, which will help prevent the patient from becoming dependent on the drug.
It is more probable that physicians and nurses will know whether extra IV fluids or nutrients are needed because of extreme sweating, vomiting, or other symptoms that may cause dehydration if they utilize the CIWA-Ar score.
As part of a person’s effort to get their system back in balance during a detox, they’re given multivitamins, magnesium sulfate, thiamine, and glucose supplements. Doctors may use the CIWA-Ar scale to better understand a patient’s condition and the appropriate medication.