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

The American Academy of Pediatrics (AAP) focuses on the health, safety, and well-being of infants, children, and young adults. With about 67,000 members, including pediatricians, medical subspecialists, and surgical specialists, the AAP supports optimal care. Over 45,000 members are board-certified Fellows of the AAP (FAAP). Its mission is to promote children's health and well-being while supporting members' professional needs.

American Academy of Pediatrics (AAP)

The American Association for Physician Leadership&reg; (AAPL) is the world&rsquo;s oldest and largest professional association dedicated solely to maximizing physician leadership.&nbsp;From the moment physicians begin their leadership journey through the time they are seasoned leaders, AAPL provides education and training, resources and tools, and content and experiences needed to close gaps between hands-on clinical care, organization system improvements and optimized business outcomes.

American Association for Physician Leadership (AAPL)

American Association for the Study of Liver Diseases

The American College of Emergency Physicians (ACEP) represents more than 38,000 emergency physicians, emergency medicine residents and medical students. ACEP promotes the highest quality of emergency care and is the leading advocate for emergency physicians and their patients, and the public. Members may earn up to 850 continuing medical education hours every year through ACEP&rsquo;s robust catalog of peer-reviewed publications and on-demand courses presented by world-renowned emergency medicine experts.

American College Of Emergency Physicians

The American College of Gastroenterology (ACG) supports clinicians in delivering high-quality, evidence-based care to gastroenterology patients. Its mission is to advance care for those with gastrointestinal disorders through excellence, innovation, and advocacy. ACG provides members with up-to-date scientific information through annual meetings, the American Journal of Gastroenterology, training courses, and research grants, focusing on digestive health and GI disorder treatments.

American College of Gastroenterology

American College of Rheumatology

The American Gastroenterological Association (AGA), founded in 1897, provides leadership and education to over 16,000 members worldwide, all dedicated to advancing gastroenterology. The AGA&rsquo;s mission is to empower clinicians and researchers to improve digestive health through clinical guidance, practice resources, and peer-reviewed research. Key journals include Gastroenterology, Clinical Gastroenterology and Hepatology, Cellular and Molecular Gastroenterology and Hepatology, and others.

American Gastroenterological Association

American Heart Association

American Urological Association

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

EB Medicine

MDCalc CME

Postgraduate Institute for Medicine

The Rome Foundation is a nonprofit organization dedicated to advancing the diagnosis and treatment of Disorders of Gut-Brain Interaction (DGBI), also known as functional gastrointestinal disorders. Its mission is to improve the lives of people with DGBI. For over 30 years, the Rome Foundation has worked with scientists and clinicians worldwide to classify and assess GI function and dysfunction, creating symptom-based criteria used in clinical trials and daily practice to guide diagnosis and treatment.

The ROME Foundation

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

Calc Function