Med-Surg

COWS Opioid Withdrawal Calculator

Score opioid-withdrawal severity across eleven items.

Resting pulse (bpm)SweatingRestlessnessPupil sizeBone or joint achesRunny nose or tearingGI upsetTremor (outstretched hands)YawningAnxiety or irritabilityGooseflesh skin

COWS score

0 / 48 Below the commonly referenced threshold for active withdrawal

FORMULASum of eleven weighted items

Score from observation and patient report together, reassess per protocol, and follow your facility’s treatment thresholds.