When a person abuses opioid drugs, such as heroin, Oxycontin or Vicoden, over a long period, they often experience withdrawal when they cease use. Most of the time, they will experience a myriad of withdrawal symptoms related to their drug of choice. These withdrawal symptoms can be uncomfortable and scary. When a person enters detox, they are usually assessed for these symptoms throughout their stay. The Clinical Opiate Withdrawal Scale (COWS) helps evaluate the intensity of withdrawal so that staff can assist in making the person in withdrawal as comfortable as possible for the duration of their symptoms.

What Does COWS Measure?

COWS measures the intensity of withdrawal symptoms based on a numerical scale. This helps decide the needs of each person with evidence-based treatment. No two people who experience withdrawal have the same symptoms. By measuring the severity of these symptoms, detox clients get evaluations throughout a detox stay. For example, a resting pulse rate is a good indicator of discomfort or distress. A person may enter detox with an average resting pulse rate (typically under 80beats a minute) but after a day of detox; they may experience a higher pulse rate, such as 101 beats a minute or 120 heartbeats a minute. Along with other symptoms, this rate indicates the level of withdrawal symptoms the person is currently experiencing.

COWS can also help a clinician decide about whether or not a patient needs or is ready for buprenorphine treatment, as they will likely experience a certain amount of discomfort with the detox anyway.

Other COWS Indicators

The Clinical Opiate Withdrawal Scale also measures other physical withdrawal symptoms, including:

• Level of sweating/flushing (visible sweating, heavy sweating, etc.)
• Degree of restlessness
• Pupil size
• Complaints of joint/bone pain
• A runny nose and watery eyes
• Stomach cramps, diarrhea, etc.
• Tremors
• Yawning
• Irritability or anxiety
• Goosebumps on skin

The Clinical Opiate Withdrawal Scale assigns numerical values based on the intensity of each symptom. Some people may be withdrawing from other substances, such as anxiety medications like Xanax, which can skew the opioid withdrawal levels.

Patients that want to be treated with buprenorphine should already have completed some of their withdrawal; otherwise, they may experience sudden and severe symptoms of withdrawal upon starting the drug. Using COWS helps clinicians make better decisions about any medication-assisted treatment (MAT).

Getting Help for Addiction

Many people experience withdrawal when they try to cease the use of drugs. While this is normal, it is difficult to go through on your own.

Recovery is possible for anyone, no matter what or how much you used. Call us to start working on a plan of action for getting and staying clean. We can answer all the questions about insurance and our programs. Contact us at 1-866-227-1437.