COWS skala (Clinical Opiate
Withdrawal Scale)
Resting pulse rate
0 - pulse rate at or below ---------------------
1- pulse rate ----- to -----
2- pulse rate ---- to -----
4 pulse rate greater than ---------------
(remember there is no 3) - answer0 <80
1 81-100
2 101-120
4 >120
Sweating
0
1
2
3
4
mix and match
Sweat streaming off face
Flushed or observable moistness on face
beads of sweat on brow/face
No chills or flushing
Subjective report of chills or flushing - answer0 No chills or flushing
1 Subjective report of chills or flushing
2 Flushed or observable moistness on face
3 Beads of sweat on brow or face
4 Sweat streaming off face
Restlessness
, 0 able to -------------
1 reports difficulty sitting still, but ------------------
3 frequent --------- or extraneous movements of arms/legs
5 unable to sit still for more than a few ----------------
(no 2 or 4) - answer0 able to sit still
1 reports difficulty sitting still, but is able to do so
3 frequent shifting or extraneous movements of legs/arms
5 unable to sit still for more than a few seconds
Pupil size
0-pupils ----------- or normal size for room light
1- pupils possibly ----------- than normal for room light
2-pupils moderately ------------
5-pupils so ---------------- that only the rim of iris is visible - answer0 pupils pinned or
normal size for room light
1 pupils possibly larger than normal for room light
2 pupils moderated dilated
5 pupils so dilated that only the rim of the iris is visible
Bone or Joint aches
0-not present
1--------------- diffuse discomfort
2- patient reports ----------- diffuse aching of joints/muscles
4- Patient is --------- joints of muscles and is unable to --------- because of discomfort
(no 3) - answer0 Not present
1 Mild diffuse discomfort
2 Patients reports severe diffuse aching of joints/muscles
4 Patien is rubbing joints or muscles and is unable to sit still because of discomfort
Runny nose or tearing
0-none
Withdrawal Scale)
Resting pulse rate
0 - pulse rate at or below ---------------------
1- pulse rate ----- to -----
2- pulse rate ---- to -----
4 pulse rate greater than ---------------
(remember there is no 3) - answer0 <80
1 81-100
2 101-120
4 >120
Sweating
0
1
2
3
4
mix and match
Sweat streaming off face
Flushed or observable moistness on face
beads of sweat on brow/face
No chills or flushing
Subjective report of chills or flushing - answer0 No chills or flushing
1 Subjective report of chills or flushing
2 Flushed or observable moistness on face
3 Beads of sweat on brow or face
4 Sweat streaming off face
Restlessness
, 0 able to -------------
1 reports difficulty sitting still, but ------------------
3 frequent --------- or extraneous movements of arms/legs
5 unable to sit still for more than a few ----------------
(no 2 or 4) - answer0 able to sit still
1 reports difficulty sitting still, but is able to do so
3 frequent shifting or extraneous movements of legs/arms
5 unable to sit still for more than a few seconds
Pupil size
0-pupils ----------- or normal size for room light
1- pupils possibly ----------- than normal for room light
2-pupils moderately ------------
5-pupils so ---------------- that only the rim of iris is visible - answer0 pupils pinned or
normal size for room light
1 pupils possibly larger than normal for room light
2 pupils moderated dilated
5 pupils so dilated that only the rim of the iris is visible
Bone or Joint aches
0-not present
1--------------- diffuse discomfort
2- patient reports ----------- diffuse aching of joints/muscles
4- Patient is --------- joints of muscles and is unable to --------- because of discomfort
(no 3) - answer0 Not present
1 Mild diffuse discomfort
2 Patients reports severe diffuse aching of joints/muscles
4 Patien is rubbing joints or muscles and is unable to sit still because of discomfort
Runny nose or tearing
0-none
