Management of Opioid Use Disorder in the Hospitalized Adolescent: Tips for the Pediatric Nurse-Clinical Opiate Withdrawal Scale

Clinical Opiate Withdrawal Scale

Pdf Summary

The Clinical Opiate Withdrawal Scale (COWS) is an 11-item tool used by clinicians to assess and monitor symptoms of opiate withdrawal. This scale is applicable in both inpatient and outpatient settings. It evaluates common withdrawal signs such as resting pulse rate, gastrointestinal upset, sweating, tremor, restlessness, yawning, pupil size, anxiety or irritability, bone or joint aches, gooseflesh skin, and runny nose or tearing. Each symptom is scored based on its severity, with the total score indicating the overall withdrawal severity: mild (5-12), moderate (13-24), moderately severe (25-36), and severe (greater than 36). The tool is designed to provide a reproducible and objective assessment of the physical dependence on opioids, equating opioid withdrawal symptoms to those of a severe flu. This version of the COWS, published in the Journal of Psychoactive Drugs by Wesson and Ling, is intended for clinical use and may be freely copied.

Keywords

Clinical Opiate Withdrawal Scale

COWS

opiate withdrawal

symptom assessment

inpatient

outpatient

withdrawal severity

opioid dependence

Wesson and Ling

Journal of Psychoactive Drugs