Objective Opioid WIthdrawal Scale (OOWS)

Provides an objective measure of the severity of opiate withdrawal symptoms.

Observe the patient during a 5 minute observation period.

Then indicate a score for each of the opioid withdrawal signs listed below.

Yawning (≥ 1 yawn)

Rhinorrhoea (≥ 3 sniffs)

Piloerection (observe arm)

Perspiration

Lacrimation

Tremor (hands)

Mydriasis (≥ 3 mm)

Hot and Cold flushes (shivering / huddling for warmth)

Restlessness (frequent shifts of position)

Vomiting

Muscle twitches

Abdominal cramps

Anxiety

Interpretation

Source: Handelsman, L., Cochrane, K. J., Aronson, M. J. et al. (1987) Two New Rating Scales for Opiate Withdrawal, American Journal of Alcohol Abuse, 13, 293-308
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