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    ClinicalOpiateWithdrawalScale PDF

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    Rajamaniti
    The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale used to rate common signs and symptoms of opiate withdrawal. It can be administered in both inpatient and outpatient settings to objectively monitor withdrawal symptoms over time. The summed score helps clinicians determine the severity of withdrawal and level of physical dependence on opioids. Practitioners sometimes question the objectivity of the items, but opioid withdrawal symptoms are likened to a severe flu and patients should exhibit observable signs in most categories without exceeding the lowest score.

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    ClinicalOpiateWithdrawalScale PDF

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    Rajamaniti
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    The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale used to rate common signs and symptoms of opiate withdrawal. It can be administered in both inpatient and outpatient settings to objectively monitor withdrawal symptoms over time. The summed score helps clinicians determine the severity of withdrawal and level of physical dependence on opioids. Practitioners sometimes question the objectivity of the items, but opioid withdrawal symptoms are likened to a severe flu and patients should exhibit observable signs in most categories without exceeding the lowest score.

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    The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale used to rate common signs and symptoms of opiate withdrawal. It can be administered in both inpatient and outpatient settings to objectively monitor withdrawal symptoms over time. The summed score helps clinicians determine the severity of withdrawal and level of physical dependence on opioids. Practitioners sometimes question the objectivity of the items, but opioid withdrawal symptoms are likened to a severe flu and patients should exhibit observable signs in most categories without exceeding the lowest score.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    243 views2 pages

    ClinicalOpiateWithdrawalScale PDF

    Uploaded by

    Rajamaniti
    The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale used to rate common signs and symptoms of opiate withdrawal. It can be administered in both inpatient and outpatient settings to objectively monitor withdrawal symptoms over time. The summed score helps clinicians determine the severity of withdrawal and level of physical dependence on opioids. Practitioners sometimes question the objectivity of the items, but opioid withdrawal symptoms are likened to a severe flu and patients should exhibit observable signs in most categories without exceeding the lowest score.

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    Clinical Opiate

    Withdrawal Scale

    Introduction
    The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale designed
    to be administered by a clinician. This tool can be used in both inpatient
    and outpatient settings to reproducibly rate common signs and symptoms
    of opiate withdrawal and monitor these symptoms over time. The summed
    score for the complete scale can be used to help clinicians determine the
    stage or severity of opiate withdrawal and assess the level of physical
    dependence on opioids. Practitioners sometimes express concern about
    the objectivity of the items in the COWS; however, the symptoms of opioid
    withdrawal have been likened to a severe influenza infection (e.g., nausea,
    vomiting, sweating, joint aches, agitation, tremor), and patients should
    not exceed the lowest score in most categories without exhibiting some
    observable sign or symptom of withdrawal.

    http://www.drugabuse.gov/nidamed-medical-health-professionals
    Wesson & Ling Clinical Opiate Withdrawal Scale

    APPENDIX 1

    Clinical Opiate Withdrawal Scale

    For each item, circle the number that best describes the patient' s signs or symptom. Rate on j ust the
    apparent relationship to opiate withdrawal. For example, if heart rate is increased because the patient
    was jogging just prior to assessment, the increase pulse rate would not add to the score.

    Patient' s Name: Date and Time !


    _ __ _ !

    Reason for this assessment:


    Downloaded by [HSRL - Health Science Research Library] at 14:04 02 September 2015

    Resting Pulse Rate: beats/minute GI Upset: over last 1/2 hour


    Measured after patient is sitting or lying for one minute 0 no GI symptoms
    0 pulse rate 80 or below 1 stomach cramps
    1 pulse rate 8 1 - 1 00 2 nausea or loose stool
    2 pulse rate 1 0 1 - 1 20 3 vomiting or diarrhea
    4 pulse rate greater than 1 20 5 multiple episodes of diarrhea or vomiting
    Sweating: over past 1/2 hour not accounted for by Tremor observation ofoutstretched hands
    room temperature or patient activity. 0 no tremor
    0 no report of chills or flushing 1 tremor can be felt, but not observed
    1 subjective report of chills or flushing 2 slight tremor observable
    2 flushed or observable moistness on face 4 gross tremor or muscle twitching
    3 beads of sweat on brow or face
    4 sweat streaming off face
    Restlessness Observation during assessment Yawning Observation during assessment
    0 able to sit still 0 no yawning
    1 reports difficulty sitting still, but is able to do so 1 yawning once or twice during assessment
    3 frequent shifting or extraneous movements of legs/arms 2 yawning three or more times during assessment
    5 unable to sit stil l for more than a few seconds 4 yawning several times/minute
    Pupil size Anxiety or Irritability
    0 pupils pinned or normal size for room light 0 none
    1 pupils possibly larger than normal for room light 1 patient reports increasing irritability or anxiousness
    2 pupils moderately dilated 2 patient obviously irritable or anxious
    5 pupils so dilated that only the rim of the iris is visible 4 patient so irritable or anxious that participation in
    the assessment is difficult
    Bone or Joint aches if patient was having pain Gooseflesh skin
    previously, only the additional component attributed 0 skin is smooth
    to opiates withdrawal is scored 3 piloerrection of skin can be felt or hairs standing up
    0 not present on arms
    1 mild diffuse discomfort 5 prominent piloerrection
    2 patient reports severe diffuse aching of joints/muscles
    4 patient is rubbing joints or muscles and is unable to sit
    still because of discomfort
    Runny nose or tearing Not accounted for by cold
    -symptoms or allergies
    Total Score
    0 not present
    1 nasal stuffiness or unusually moist eyes The total score is the sum of all 1 1 items
    2 nose running or tearing Initials of person
    4 nose constantly running or tears streaming down cheeks completing assessment:
    Score: 5- 1 2 = mild; 1 3-24 = moderate; 25-36 = moderately severe; more than 36 = severe withdrawal

    This version may be copied and used clinically.

    Journal of Psychoactive Drugs Volume 35 (2), April - June 2003

    Source: Wesson, D. R., & Ling, W. (2003). The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive
    Drugs, 35(2), 2539.

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