COWS v.1
The Clinical Opiate Withdrawal Score (COWS) measures the severity of opiate withdrawal
The COWS tool combines both subjective and objective aspects to help provide a more balanced assessment of opiate withdrawal assessment
The COWS score has value when used in both in and out-patient situations within the detox, pain treatment and in the emergency department as well as during buprenorphine induction.
Whilst the tool aids in buprenorphine/naloxone prescription, there are legal issues that outline its use in opioid addiction and must constitute part of a full clinical picture and not to be used on its own in decision-making.
Ref. 1: Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale (COWS) J Psychoactive Drugs.2003;35:253–259. Ref. 2: Tompkins DA, Bigelow GE, Harrison JA, Johnson RE, Fudala PJ, Strain EC. Concurrent Validation of the Clinical Opiate Withdrawal Scale (COWS) and Single-Item Indices against the Clinical Institute Narcotic Assessment (CINA) Opioid Withdrawal Instrument. Drug and alcohol dependence 2009;105(1-2):154-159. doi:10.1016/j.drugalcdep.2009.07.001.
OBSERVATION.pulse.v2, OBSERVATION.cows_score_for_opiate_withdrawal.v1
