The COWS sheet is designed to aid physicians in knowing when it is safe to begin treatment with buprenorphine, the active ingredient in suboxone/subutex.
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It is recommended that you be in moderate/severe withdrawal before taking your first dose of buprenorphine to avoid the dreaded Precipitated Withdrawal (PW).
o A provider will usually start a person at 2-4mg and increase the dose every hour until they notice that withdrawal symptoms have stopped.1
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The Clinical Opiate Withdrawal Scale, or COWS, is a numbered scale designed to help clinicians tailor opioid withdrawal treatment to individual people. clinical opiate withdrawal scale (cows) For Buprenorphine/naloxone induction: Enter scores at time zero, 1-2 h after first dose, and at additional times that buprenorphine/naloxone is given …
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