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The Clinical Opiate Withdrawal Scale (COWS).

Donald R Wesson1, Walter Ling

  • 1CNS Medications Development, Oakland, California, USA. dwesson@mindspring.com

Journal of Psychoactive Drugs
|August 20, 2003
PubMed
Summary

The Clinical Opiate Withdrawal Scale (COWS) assesses opioid withdrawal severity. This review details the history and clinical use of COWS, providing a template for its application.

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Area of Science:

  • Addiction Medicine
  • Clinical Pharmacology

Background:

  • Opioid use for pain management and buprenorphine availability have increased interest in assessing opioid withdrawal.
  • The Clinical Opiate Withdrawal Scale (COWS) is a clinician-administered tool for rating eleven common withdrawal signs/symptoms.

Purpose of the Study:

  • To review the history and initial use of opioid withdrawal scales.
  • To provide context for the renewed interest in clinical assessment of opioid withdrawal intensity.

Main Methods:

  • Historical review of opioid withdrawal scales.
  • Clinical assessment using the COWS instrument.

Main Results:

  • The COWS scale provides a summed score to assess withdrawal level and physical dependence.
  • Various opioid withdrawal scales have been used since the 1930s.

Conclusions:

  • The article reviews the history of opioid withdrawal scales and their clinical context.
  • A template and resources for the COWS are provided for clinical use.

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