Which score on the COWS scale is considered an indicator of severe withdrawal?

The Clinical Opiate Withdrawal Scale (COWS) is a tool used to assess the severity of opiate withdrawal symptoms. It provides a standardized method for clinicians to quantify withdrawal and make decisions regarding treatment. A COWS score of 36 or higher indicates a severe level of withdrawal.

This severity is characterized by pronounced symptoms, which may include significant agitation, pronounced sweating, visual disturbances, and intense drug cravings. These symptoms suggest a considerable physiological response to the absence of opioids, indicating that the individual is in a state of severe withdrawal. It is crucial for clinicians to recognize this severity to manage the patient's care effectively and determine appropriate treatment interventions.

Scores below 36 do not reflect the same level of withdrawal severity. For instance, a score in the range of 25-36 indicates moderate withdrawal, while scores of 13-24 and 5-12 signify mild to moderate withdrawal symptoms, respectively. Understanding these distinctions helps clinicians tailor their approaches and provide the most effective support for individuals experiencing opiate withdrawal.