Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale (COWS) J Psychoactive Drugs.2003;35:253–259.

The National Alliance of Advocates for Buprenorphine Treatment COWS Flow sheet. Published Nov. 2011.

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.

Dr. Donald R. Wesson

COWS Score for Opiate Withdrawal

pulse

sweat

restless

pupil

bone

noise

tremor

yawn

anxiety

skin

Quantifies severity of opiate withdrawal.

COWS Score

Jonathan Avery, MD, is an assistant professor of psychiatry at the Weill Cornell Medical College, where he maintains a practice in general adult and addiction psychiatry. He is also an attending psychiatrist at New York-Presbyterian Hospital. Dr. Avery is a graduate of the New York University School of Medicine, and he completed residency at New York-Presbyterian Hospital/Payne Whitney Clinic. During residency, he was selected as a fellow in the Group for the Advancement of Psychiatry and won numerous awards for his clinical and academic work. Dr. Avery completed an addiction psychiatry fellowship at the New York University School of Medicine, prior to employment on the Cornell faculty. Dr. Avery now teaches addiction psychiatry and inpatient psychiatry to the Weill Cornell medical students and psychiatry residents of New York-Presbyterian Hospital. He has been published on a variety of topics in psychiatry, including clinician attitudes towards patients and how to use buprenorphine. He was also on the editorial board for the DSM-5 Clinical Cases book.

Jonathan Avery, MD

Katherine E. Taylor, MD, practices clinical psychiatry and psycho-oncology in New York City. She completed her psychiatric residency at the Payne Whitney Clinic of New York Presbyterian Hospital/Weill Cornell Medical Center and sub-specialized with a fellowship in consultation-liaison psychiatry at the New York Presbyterian Hospital/Columbia University Medical Center, focusing on the psychiatric treatment of patients with complex medical needs. Dr. Taylor currently serves on the teaching faculty at the NYU School of Medicine in the department of psychiatry, and is an attending physician at NYU Langone Perlmutter Cancer Center. In addition, she maintains a private practice and is completing further studies as a psychoanalytic candidate at the Columbia University Center for Psychoanalytic Training and Research.

Katherine E. Taylor, MD

The COWS Score for Opiate Withdrawal quantifies severity of opiate withdrawal.

WAT-1 for Peds Withdrawal

PAWSS

CAGE Questions

EB Medicine is the premier provider of evidence-based clinical content and CME resources for emergency medicine practitioners.

Listen to the VACO co-creators break down how to use VACO\, what it does\, and what it doesn’t.

Calc Function