psychiatry

Subjective Opiate Withdrawal Scale (SOWS)

16-item self-rated scale measuring severity of opiate withdrawal symptoms. Score 0–64. Complements objective COWS scale. Used to monitor withdrawal in opioid detoxification.

I feel anxious*

I feel like yawning*

I am perspiring (sweating)*

My eyes are tearing*

My nose is running*

I have goosebumps*

I am shaking*

I have hot flushes / chills*

My bones and muscles ache*

I feel restless*

I feel nauseous*

I feel like vomiting*

Muscle twitching*

Stomach cramps*

I feel like bugs are crawling on/under my skin*

My heart is racing*

References

Handelsman L et al. Two new rating scales for opiate withdrawal. Am J Drug Alcohol Abuse. 1987;13(3):293–308.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Brief Addiction Monitor (BAM) · Substance Use
CRAFFT Substance Use Screening Tool · Substance Use
Revised Opioid Risk Tool (ORT-OUD) · Substance Use

Drugs

Clonidine · Alpha-2 Adrenoceptor Agonist (ADHD / Opioid Withdrawal / Tic Disorders)
Remifentanil · Opioid (Ultra-Short-Acting)
Morphine (IV/IM — Anaesthesia/ICU) · Strong Opioid Analgesic
Alfentanil · Opioid Analgesic (Ultra-Short Acting)
Fentanyl (IV — Anaesthesia/ICU) · Opioid Analgesic (Short-Acting)
Sufentanil · Opioid Analgesic (Ultra-Potent)

Pathways

Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
Self-Harm Presentation · NICE NG225 (2022)
Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
Acute Psychosis Management · NICE CG178 2014
Depression Management · NICE CG90 2022
Lithium Therapy Monitoring · NICE CG185 / BNF

Decision support only — verify against MDCalc, NICE, or your local guideline before clinical use.

References

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