What is the Clinical Opiate Withdrawal Scale (COWS)?
The Clinical Opiate Withdrawal Scale is a clinically validated method of assessing someone's withdrawal symptoms. It consists of 11 items that allow medical providers to determine how severe a person's opioid dependency is, as well as monitoring the progress of their symptoms over time. These symptoms are:
1) Resting Pulse Rate: Patients who are going through withdrawal often experience a faster pulse rate.
2) Sweating: Doctors will ask you whether you are experiencing any chills or flushing and will observe any external indications of changing temperature.
3) Restlessness: Withdrawal is often accompanied by an inability to sit still. 4) Pupil Size: The level of opioids in your system can cause your pupils to dilate.
5) Bone or Joint Aches: Bone and muscle pain and aches are common.
6) Runny nose or tearing: Tearing is common during withdrawal.
7) Gastrointestinal Upset: This can range from mild stomach cramps to regular vomiting and diarrhea.
8) Tremor: The doctor will ask you to hold out your hands to determine if you are experiencing any tremor or muscle twitching.
9) Yawning: Another sign that your body is adjusting to the cessation of your substance use.
10) Anxiety/Irritability: Feelings of anxiety intensify during withdrawal and can be very uncomfortable.
11) Gooseflesh skin: This is a common reaction in withdrawal.