The Clinical Opiate Withdrawal Scales (COWS)

Measuring the severity of withdrawal from opioids during medically assisted detoxification has become paramount recently, due to the nation’s continuing opioid crisis.  However, the standard which is used today – the Clinical Opiate Withdrawal Scale (COWS) – was first developed back in the 1930s.

Assessing the severity and nature of a patient’s opiate detox is vital for clinicians to determine the risks which are involved in the opiate detox as it progresses.  This is why the use of the COWS system is vital in the field of addiction treatment and is crucial in ascertaining the physical well-being of a patient during an opiate detox.

Opiate Withdrawal Timeline and Symptoms

The COWS assessment was designed to measure a patient’s detox and withdrawal from opiates, enabling clinicians to respond to the symptoms of a patient with the medication which is required.  This is the main requirement of opioid withdrawal management.

It is vital to remember that opiate withdrawal, if left untreated, can sometimes be fatal.

Opiate Withdrawal Symptoms

Opiate withdrawal symptoms include diarrhea, vomiting, anxiety, insomnia, hot and cold flushes, muscle cramps, sweating, nausea and runny nose.

Opiate Withdrawal Timeline

Opiate withdrawal from short acting opiates like heroin usually begins 8-24 hours after the drug was last used, and symptoms last for between 4 to 10 days.  Longer acting opiates, such as methadone, usually present symptoms within 12-48 hours of the last time they were used and will last for around 10-20 days.

How Does the Clinical Opiate Withdrawal Scale Work?

It is recommended that any patient who is experiencing opiate withdrawal should be monitored at least 3-4 times daily for complications that might arise.  Clinicians use the COWS scale to monitor the severity of a patient’s withdrawal.

What Does the COWS Scale Measure?

The COWS scale works by assignment numerical values for 11 symptoms of opiate withdrawal, providing an individual measure of severity.  When these values are then added together, the number that results is an indication of where the patient is in the opiate withdrawal process.

This information assists clinicians in tailoring the next step of the opiate withdrawal plan to fit with the patient’s condition.  The 11 opiate withdrawal symptoms are:  runny nose or tearing, gooseflesh skin, joint aches, anxiety or irritability, pupil size, yawning, restlessness, tremor, sweating, gastrointestinal upset and resting pulse rate.

Who Can Give a COWS Assessment?

COWS assessments can only be performed by trained professionals.  Though most assessment are carried out as part of opiate addiction treatment, there are also healthcare facilities that give patients opiates for pain treatment which lead to adverse withdrawal symptoms.

How Quickly can COWS Assessments Change?

COWS assessments are undertaken during the process of opiate withdrawal and should be administered when any change in the medical condition of the patient is observed, and at least 3 times a day.

Management of Medically-Assisted Detox

During a medically assisted detox for opiates, the COWS assessment is crucial in enabling clinicians to manage the process in a safe manner, and with the use of appropriate medications when required.

With opiate withdrawal, if professional help is not provided, the process of detoxing can take far longer, with the patient suffering from symptoms from withdrawal form many weeks and in some cases months.  Using Medication-Assisted Treatment (MAT) can help a patient be eased off their dependence to opiates.  This leads to patient to feel more positive about their decision to end their addiction and helps them to stay focused during their counseling sessions.

Opiate Agonists and Antagonists

Opiates affect us by attaching to receptors within our brains.  They then send signals which block pain, slow down breathing, and help to make us feel calm and at ease.  This is done by flooding the reward system of the brain with dopamine, a neurotransmitter which evokes feelings of happiness.

Drugs like opiates are known as agonists – they stimulate certain receptors in our brains.

If you are looking for a treatment center by searching for “detox near me”, be sure to read the next part carefully, as it lists medication options for those going through opiate withdrawal.

Antagonists attach themselves to these receptors, but with the opposite outcomes   They bind to opiate receptors in the brain more strongly than agonists do, but do not activate these receptors, and prevent the brain from responding to the opiates that have been used.  Methadone, buprenorphine, Naloxone and Lofexidine are all used to help opiate users cease their use of opiates.

In addition to agonists and antagonists, other medications can be given to alleviate opiate withdrawal symptoms.  These drugs include loperamide, Dicyclomine, Clonidine, Trazodone and Ibuprofen.

Should you search for a “detox near me”, the results of this search will hopefully assist you in finding a treatment center which provides these drugs.  If your search for “detox near me” is not successful in finding treatment centers like this, you could try asking friends if they can recommend a suitable center.