{"uid":"cap_6h-8-D0Cq1r3cfxGt5cZQ","slug":"cows-clinical-opiate-withdrawal-scale-calculator-b77668d8","name":"COWS (Clinical Opiate Withdrawal Scale) Calculator","description":"Wesson 2003 Clinical Opiate Withdrawal Scale (COWS). Eleven caller-assigned appendix integers (pulse 0/1/2/4, GI 0/1/2/3/5, sweating 0-4, tremor 0/1/2/4, restlessness 0/1/3/5, yawning 0/1/2/4, pupils 0/1/2/5, anxiety 0/1/2/4, aches 0/1/2/4, gooseflesh 0/3/5, rhinorrhea/tearing 0/1/4). Max 48. Severity 5-12 mild, 13-24 moderate, 25-36 moderately severe, >36 severe; 0-4 below mild (none). magent does not observe the patient. Not a buprenorphine induction protocol.","url":"https://api.magentlab.com/api/calc/cows","method":"GET","headers":{},"bodySchema":{"type":"object","$schema":"https://json-schema.org/draft/2020-12/schema","required":["input"],"properties":{"input":{"type":"object","required":["type","method"],"properties":{"type":{"type":"string","const":"http"},"method":{"enum":["GET","HEAD","DELETE"],"type":"string"},"headers":{"type":"object","additionalProperties":{"type":"string"}},"queryParams":{"type":"object","required":["resting_pulse_rate","gi_upset","sweating","tremor","restlessness","yawning","pupil_size","anxiety_or_irritability","bone_or_joint_aches","gooseflesh_skin","runny_nose_or_tearing"],"properties":{"tremor":{"type":"integer","description":"Caller-assigned Wesson 2003 tremor points (integer 0, 1, 2, or 4). magent does not observe the patient."},"yawning":{"type":"integer","description":"Caller-assigned Wesson 2003 yawning points (integer 0, 1, 2, or 4). magent does not observe the patient."},"gi_upset":{"type":"integer","description":"Caller-assigned Wesson 2003 GI upset points (integer 0, 1, 2, 3, or 5). magent does not observe the patient."},"sweating":{"type":"integer","description":"Caller-assigned Wesson 2003 sweating points (integer 0, 1, 2, 3, or 4). magent does not observe the patient."},"pupil_size":{"type":"integer","description":"Caller-assigned Wesson 2003 pupil size points (integer 0, 1, 2, or 5). magent does not observe the patient."},"restlessness":{"type":"integer","description":"Caller-assigned Wesson 2003 restlessness points (integer 0, 1, 3, or 5). magent does not observe the patient."},"gooseflesh_skin":{"type":"integer","description":"Caller-assigned Wesson 2003 gooseflesh skin points (integer 0, 3, or 5). magent does not observe the patient."},"resting_pulse_rate":{"type":"integer","description":"Caller-assigned Wesson 2003 resting pulse rate points (integer 0, 1, 2, or 4). magent does not observe the patient."},"bone_or_joint_aches":{"type":"integer","description":"Caller-assigned Wesson 2003 bone or joint aches points (integer 0, 1, 2, or 4). magent does not observe the patient."},"runny_nose_or_tearing":{"type":"integer","description":"Caller-assigned Wesson 2003 runny nose or tearing points (integer 0, 1, or 4). magent does not observe the patient."},"anxiety_or_irritability":{"type":"integer","description":"Caller-assigned Wesson 2003 anxiety or irritability points (integer 0, 1, 2, or 4). magent does not observe the patient."}}}},"additionalProperties":false},"output":{"type":"object","required":["type"],"properties":{"type":{"type":"string"},"example":{"type":"object"}}}}},"responseSchema":{"type":"json","example":{"path":"/api/calc/cows","count":2,"items":[{"score":0,"formula":"cows","citation":{"id":"wesson-2003","doi":"10.1080/02791072.2003.10400007","pmid":"12924748","title":"The Clinical Opiate Withdrawal Scale (COWS)","source":"J Psychoactive Drugs. 2003;35(2):253-259","authors":"Wesson DR, Ling W"},"severity":"none","max_score":48,"components":[{"value":0,"factor":"resting_pulse_rate","points":0,"present":true},{"value":0,"factor":"gi_upset","points":0,"present":true},{"value":0,"factor":"sweating","points":0,"present":true},{"value":0,"factor":"tremor","points":0,"present":true},{"value":0,"factor":"restlessness","points":0,"present":true},{"value":0,"factor":"yawning","points":0,"present":true},{"value":0,"factor":"pupil_size","points":0,"present":true},{"value":0,"factor":"anxiety_or_irritability","points":0,"present":true},{"value":0,"factor":"bone_or_joint_aches","points":0,"present":true},{"value":0,"factor":"gooseflesh_skin","points":0,"present":true},{"value":0,"factor":"runny_nose_or_tearing","points":0,"present":true}],"disclaimer":"Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.","formula_expression":"COWS = resting_pulse_rate + gi_upset + sweating + tremor + restlessness + yawning + pupil_size + anxiety_or_irritability + bone_or_joint_aches + gooseflesh_skin + runny_nose_or_tearing; Wesson 2003 appendix integers only; max 48"},{"score":0,"formula":"cows","citation":{"id":"wesson-2003","doi":"10.1080/02791072.2003.10400007","pmid":"12924748","title":"The Clinical Opiate Withdrawal Scale (COWS)","source":"J Psychoactive Drugs. 2003;35(2):253-259","authors":"Wesson DR, Ling W"},"severity":"none","max_score":48,"components":[{"value":0,"factor":"resting_pulse_rate","points":0,"present":true},{"value":0,"factor":"gi_upset","points":0,"present":true},{"value":0,"factor":"sweating","points":0,"present":true},{"value":0,"factor":"tremor","points":0,"present":true},{"value":0,"factor":"restlessness","points":0,"present":true},{"value":0,"factor":"yawning","points":0,"present":true},{"value":0,"factor":"pupil_size","points":0,"present":true},{"value":0,"factor":"anxiety_or_irritability","points":0,"present":true},{"value":0,"factor":"bone_or_joint_aches","points":0,"present":true},{"value":0,"factor":"gooseflesh_skin","points":0,"present":true},{"value":0,"factor":"runny_nose_or_tearing","points":0,"present":true}],"disclaimer":"Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.","formula_expression":"COWS = resting_pulse_rate + gi_upset + sweating + tremor + restlessness + yawning + pupil_size + anxiety_or_irritability + bone_or_joint_aches + gooseflesh_skin + runny_nose_or_tearing; Wesson 2003 appendix integers only; max 48"}]}},"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.005","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.005/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_0mi__zPKiWq9ysOEsuHA9","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.005","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Computes the Wesson 2003 Clinical Opiate Withdrawal Scale (COWS) total score and severity category from 11 caller-assigned symptom subscores","exampleAgentPrompt":"Calculate the COWS score for a patient with resting pulse rate 2 points, GI upset 1 point, sweating 2 points, tremor 1 point, restlessness 3 points, yawning 1 point, pupil size 2 points, anxiety 1 point, bone/joint aches 2 points, gooseflesh 0 points, and runny nose/tearing 1 point — what's the total score and severity?","exampleUseCases":[{"title":"Triage opioid withdrawal severity in ED","prompt":"I'm assessing a patient in the emergency department: pulse rate scores 2, GI upset 2, sweating 3, tremor 2, restlessness 3, yawning 2, pupils 2, anxiety 2, bone aches 2, gooseflesh 0, runny nose 1 — can you calculate their COWS score and tell me how severe the withdrawal is?"},{"title":"Document withdrawal level before medication decision","prompt":"Before we consider next steps, I need a COWS score: resting pulse 1, GI upset 0, sweating 1, tremor 0, restlessness 1, yawning 1, pupil size 1, anxiety 1, bone aches 1, gooseflesh 0, tearing 0 — what's the total and severity band?"},{"title":"Track withdrawal progress across serial assessments","prompt":"Compare this current COWS assessment: pulse 4, GI upset 3, sweating 4, tremor 4, restlessness 5, yawning 4, pupils 5, anxiety 4, bone aches 4, gooseflesh 5, runny nose 4 — what's the score and how severe is this withdrawal?"}],"resultDescription":"Returns the COWS total score (sum of the 11 subscores, maximum 48) and a severity classification: 0–4 = none/below mild, 5–12 = mild, 13–24 = moderate, 25–36 = moderately severe, >36 = severe. Does not include clinical recommendations or buprenorphine induction guidance.","failureModes":["Missing any of the 11 required query parameters returns an error","Submitting out-of-range values (e.g. tremor=3 which is not valid) may return a validation error or unexpected result","Network or payment (x402) failure results in no score returned","All-zero inputs return a score of 0 with no-withdrawal classification"],"whenToPreferThis":"Use this endpoint when you need a standardized, reproducible COWS total score and severity band computed from caller-observed symptom subscores according to the Wesson 2003 scale. Prefer this over manual summation to avoid arithmetic errors and to obtain a validated severity classification. Not suitable as a replacement for clinical judgment, direct patient observation, or buprenorphine induction protocols.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-14T19:13:16.522Z","isFirstParty":false}