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Understanding the Clinical Opiate Withdrawal Scale

About Opiate Withdrawal

Opiates are the number one drug that people seek out addiction treatment help for. This is likely due to the intense withdrawal symptoms people go through when detoxing from opiates, as well as the powerful compulsion most people experience when they are addicted to opiates.

When a person becomes addicted to opiates, whether it is heroin, morphine, or prescription painkillers, such as Oxycontin, they will most likely develop a dependency to the drug as well. Once a person’s body becomes dependent on a drug to function properly; if the person stops taking the drug their body will negatively react to the absence of the drug.

The physical withdrawal symptoms from opiates typically do not last longer than a week’s time and are usually similar to symptoms of the flu. According to the US National Library of Medicine and National Institutes of Health, the physical withdrawal symptoms for opiates typically include nausea, sweating, dilated pupils, vomiting, diarrhea, runny nose, increased tearing, muscle aches, and Goosebumps.

The Clinical Opiate Withdrawal Scale

opiate withdrawal

The opiate withdrawal scale helps doctors determine the intensity of a patient’s withdrawal.

According to an article published by the US National Library of Medicine and National Institutes of Health, eleven common opiate withdrawal symptoms are rated through the clinical opiate withdrawal scale. The total of the eleven items is utilized to evaluate the individual’s level of withdrawal and to determine the person’s level of physical dependence on opiates.

The elven items of the clinical opiate withdrawal scale that are rated include the following:

Resting Pulse Rate: Measured on a scale from 0 to 4. Zero meaning very low pulse rate and four being the highest pulse rate.

GI: Measured on a scale from 0 to 5. Zero meaning no GI symptoms and five meaning multiple episodes of GI symptoms, typically including diarrhea and excessive vomiting.

Sweating: Measured on a scale from 0 to 4. Zero meaning no sweating or cold chills and four meaning excessive sweating.

Tremors: Measured on a scale from 0 to 4. Zero meaning no present tremors and four meaning tremors are extremely noticeable.

Restlessness: Measured on a scale from 0 to 5. Zero meaning the individual is able to sit still and five meaning the individual cannot sit still for more than a few seconds.

Yawning: Measured on a scale from 0 to four. Zero meaning no yawning and four meaning several yawns per minute.

Anxiety: Measured on a scale from 0 to 4. Zero meaning the individual reports no anxiety and four meaning the individual is so anxious that they cannot even participate in the evaluation.

Pupil Dilation: Measured on a scale from 0 to 4. Zero meaning that pupil size is normal and four meaning that the pupils are so dilated that the iris is barely visible.

Joint and Bone Aches: Measured on a scale from 0 to 4. Zero meaning no joint or bone aches are present and four meaning the individual is experiencing extreme discomfort from the aches to the point where they cannot even sit still.

Goosebumps: Measured on a scale from 0 to 5. Zero meaning no Goosebumps are present and five meaning they are constantly present.

Runny nose or tearing: Measured on a scale from 0 to 4. Zero meaning the individual’s nose is not runny and four meaning it is constantly runny.

Once the clinical opiate withdrawal scale has been filled out, the physician will total up the number of points from the eleven items. The total number of summed up points will let the physician know the intensity of the withdrawal symptoms and the dependency to opiates the individual has. For example, if an individual totals more than 36 points, it means that they are experiencing severe withdrawal symptoms, where as, if they total 5 to 12 points they are experience mild withdrawal symptoms.

A copy of the clinical opiate withdrawal scale from the Physical Clinical Support System can be found here.

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