Clinical Opiate Withdrawal Scale (COWS) Test

Example Questions From the Test

• 1Resting pulse rate (beats per minute). Measure after the patient has been sitting or lying down for one minute.
  • 0: pulse rate 80 or less
  • 1: pulse rate 81–100
  • 2: pulse rate 101–120
  • 4: pulse rate greater than 120
• 2Sweating: over the past half-hour, not due to room temperature or physical activity.
  • 0: No report of chills or flushing
  • 1: Subjective report of chills or flushing
  • 2: Flushed or visibly moist face
  • 3: Beads of sweat on the forehead or face
  • 4: Sweat streaming down the face
• 4Pupil size
  • 0: Pupils constricted or normal size for room light
  • 1: Pupils possibly larger than normal for room light
  • 2: Pupils moderately dilated
  • 5: Pupils so dilated that only the rim of the iris is visible