COWS

Clinical Opiate Withdrawal Scale

Domain
Substance
Items
11
Rater
Clinician-rated

Cutoffs

BandScore
Mild5–12
Mod13–24
Mod-sev25–36
Severe>36

Diagnostic performance

Sensitivity
Specificity
AUC / note
Withdrawal severity

Clinical notes

Used to time buprenorphine induction (typically ≥8–12).

Cutoffs and performance figures are pooled or landmark estimates and vary by population and comparator. Use only with appropriate clinical training. Not a diagnostic algorithm.