EBMcalc Medical Calculator

Clinical Opioid Withdrawal Scale (COWS) for adults and adolescents

The EBMcalc module Clinical Opioid Withdrawal Scale (COWS) for adults and adolescents is available in EBMcalc Complete Edition.

This calculator evaluates the following Clinical Criteria:

Resting pulse rate measured after patient is sitting or lying for one minute
Sweating: Over past half-hour not accounted for by room temperature or patient activity
Restlessness: Observation during assessment
Pupil size
Bone or joint aches: If patient was having pain previously, only the additional component attributed to opioid withdrawal is scored
Runny nose or tearing: Not accounted for by cold symptoms or allergies
GI upset: Over last half-hour
Tremor: Observation of outstretched hands
Yawning: Observation during assessment
Anxiety or irritability
Gooseflesh skin

References

Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive Drugs. 2003 Apr-Jun;35(2):253-9. PubMed ID: 12924748

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