Journal ArticleDOI
The Clinical Opiate Withdrawal Scale (COWS)
Donald R. Wesson,Walter Ling +1 more
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TLDR
The history of opiate withdrawal scales is reviewed and a template version of the COWS that can be copied and used clinically is appended.Abstract:
The clinical opiate withdrawal scale (COWS) is a clinician-administered, pen and paper instrument that rates eleven common opiate withdrawal signs or symptoms. The summed score of the eleven items can be used to assess a patient's level of opiate withdrawal and to make inferences about their level of physical dependence on opioids. With increasing use of opioids for treatment of pain and the availability of sublingual buprenorphine in the United States for treatment of opioid dependence, clinical assessment of opiate withdrawal intensity has received renewed interest. Buprenorphine, a partial opiate agonist at the mu receptor, can precipitate opiate withdrawal in patients with a high level of opioid dependence who are not experiencing opioid withdrawal. Since development of the first opiate withdrawal scale in the mid-1930s, many different opioid withdrawal scales have been used in clinical and research settings. This article reviews the history of opiate withdrawal scales and the context of their initial use. A template version of the COWS that can be copied and used clinically is appended. PDF formatted versions of the COWS are also available from the websites of the American Society of Addiction Medicine, the California Society of Addiction Medicine, the UCLA Integrated Substance Abuse Programs, and AlcoholMD.com.read more
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Journal ArticleDOI
The 21st Century Opioid Addiction: A Concept Analysis and Implications for Nursing.
TL;DR: A concept analysis of opioid addiction in the 21st century is conducted and its implications for nursing are presented, enhancing understanding of the current opioid addiction crisis that is affecting the country.
Journal ArticleDOI
Neonatal opioid withdrawal syndrome: a review of the science and a look toward the use of buprenorphine for affected infants.
Lori A. Devlin,Leslie Young,Walter K. Kraft,Elisha M. Wachman,Adam J. Czynski,Stephanie L. Merhar,Theresa Winhusen,Hendrée E. Jones,Brenda B. Poindexter,Lauren S. Wakschlag,Amy L. Salisbury,Abigail G. Matthews,Jonathan M. Davis +12 more
TL;DR: The use of buprenorphine for the treatment of neonatal opioid withdrawal syndrome (NOWS) was discussed by a panel of experts during a virtual workshop hosted by the National Institutes of Health as mentioned in this paper.
Journal ArticleDOI
Clinical Opioid Withdrawal Scale (COWS): Implementation and Outcomes.
Lilian J Canamo,Nicole B Tronco +1 more
TL;DR: A nursing-driven opioid withdrawal management tool using the validated Clinical Opioid Withdrawal Scale (COWS) to address an increase in opioid-addicted patients is developed and results in improved withdrawal management.
Journal ArticleDOI
Identification and Treatment of Opioid Withdrawal and Opioid Use Disorder in the Emergency Department
TL;DR: A 1-hour introductory workshop for the identification and treatment of opioid withdrawal and OUD in the ED for medical students going into EM and for EM interns resulted in a short-term improvement in medical students’ and interns’ knowledge.
Journal ArticleDOI
Does Cannabis Dependence Add on to the Neurocognitive Impairment Among Patients With Opioid Dependence? A Cross‐Sectional Comparative Study
TL;DR: In this paper, the authors investigated whether patients with opioid and cannabis dependence perform poorly compared with those with opioid dependence alone, and found that both OD and OCaD had significant impairment on the Wisconsin card sorting test (WCST), Iowa gambling task (IGT), trail making tests A and B (TMT-A and B), verbal and visual N-back test (NBT), and standard progressive matrices for intelligence quotient.
References
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Journal ArticleDOI
Assessment of Alcohol Withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)
TL;DR: A shortened 10-item scale for clinical quantitation of the severity of the alcohol withdrawal syndrome has been developed and can be incorporated into the usual clinical care of patients undergoing alcohol withdrawal and into clinical drug trials of alcohol withdrawal.
Journal ArticleDOI
Two New Rating Scales for Opiate Withdrawal
Leonard Handelsman,Kenneth J. Cochrane,Marvin J. Aronson,Robert Ness,Karen J. Rubinstein,Philip D. Kanof +5 more
TL;DR: In this paper, two rating scales for measuring the signs and symptoms of opiate withdrawal are presented: Subjective Opiate Withdrawal Scale (SOWS) contains 16 symptoms whose intensity the patient rates on a scale of 0 (not at all) to 4 (extremely).
Two new rating scales for opiate withdrawal
Leonard Handelsman,Kenneth J. Cochrane,Marvin J. Aronson,Robert Ness,Karen J. Rubinstein,Philip D. Kanof +5 more
TL;DR: Good interrater reliability for the OOWS and good intrasubject reliability over time for both scales are demonstrated to be valid and reliable indicators of the severity of the opiate withdrawal syndrome over a wide range of common signs and symptoms.
Journal ArticleDOI
The development of a Short Opiate Withdrawal Scale (SOWS)
TL;DR: The processes whereby a shorter 10-item version of the Opiate Withdrawal Scale was developed are described, suggesting that the SOWS provide a useful instrument which can be used both in research and clinical practice with opiate addicts.