Psychometric evaluation of the 10-item Short Opiate Withdrawal Scale-Gossop (SOWS-Gossop) in patients undergoing opioid detoxification

Vernon, Margaret; Reinders, Stefan; Mannix, Sally; Gullo, Kristen; Gorodetzky, Charles W.; Clinch, Thomas E.

doi:10.1016/j.addbeh.2016.03.028

Cited by 25 publications

(23 citation statements)

References 9 publications

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“…15 The opioid withdrawal syndrome is a collection of characteristic clinical signs, which include hypertension, tachycardia, mydriasis, piloerection (ie, goose bumps), lacrimation, rhinorrhoea, yawning, insomnia, nausea, vomiting, and diarrhoea. 2,16,17 The time course of opioid withdrawal is dependent principally on the half-life of the opioid used. For example, opioids with short half-lives (eg, heroin at 3-5 h) are associated with withdrawal onset within 12 h of last use, whereas cessation of opioids with longer half-lives (eg, methadone at up to 96 h), could result in withdrawal symptoms occurring 1-3 days after last use.…”

Section: Opioid Withdrawal: Clinical Syndrome and Pathophysiologymentioning

confidence: 99%

New directions in the treatment of opioid withdrawal

2020

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The treatment of opioid withdrawal is an important area of clinical concern when treating patients with chronic, non-cancer pain, patients with active opioid use disorder, and patients receiving medication for opioid use disorder. Current standards of care for medically supervised withdrawal include treatment with μ-opioid receptor agonists, (eg, methadone), partial agonists (eg, buprenorphine), and α2-adrenergic receptor agonists (eg, clonidine and lofexidine). Newer agents likewise exploit these pharmacological mechanisms, including tramadol (μ-opioid receptor agonism) and tizanidine (α2 agonism). Areas for future research include managing withdrawal in the context of stabilising patients with opioid use disorder to extended-release naltrexone, transitioning patients with opioid use disorder from methadone to buprenorphine, and tapering opioids in patients with chronic, non-cancer pain.

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Section: Opioid Withdrawal: Clinical Syndrome and Pathophysiologymentioning

confidence: 99%

New directions in the treatment of opioid withdrawal

2020

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“…Severity of opioid withdrawal symptoms —measured using the Short Opiate Withdrawal Scale (ShOWS). 22 …”

Section: Methodsmentioning

confidence: 99%

“…The response to each question is attributed to an individual score of 0–3, with 0 indicating no symptoms, 1 mild, 2 moderate and 3 severe. 22 Higher overall scores (estimated as the sum of all individual scores with a maximum score of 30 and a minimum score of 0) indicate higher severity of opioid-withdrawal symptoms.…”

Section: Methodsmentioning

confidence: 99%

Protocol for an economic analysis of the randomised controlled trial of Improving the Well-being of people with Opioid Treated CHronic pain: I-WOTCH Study

et al. 2020

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IntroductionOver the last two decades, the use of opioids for the treatment of chronic pain in England has steadily increased despite lack of evidence of both long-term effectiveness in pain relief and significant, well-documented physical and mental adverse events. Guidelines recommend tapering when harms outweigh benefits, but the addictive nature of opioids hinders simple dose-reduction strategies. Improving the Well-being of people with Opioid Treated CHronic pain (I-WOTCH) trial tests a multicomponent self-management intervention aimed to help patients with chronic non-malignant pain taper opioid doses. This paper outlines the methods to be used for the economic analysis of the I-WOTCH intervention compared with the best usual care.Methods and analysisEconomic evaluation alongside the I-WOTCH study, prospectively designed to identify, measure and value key healthcare resource use and outcomes arising from the treatment strategies being compared. A within-trial cost-consequences analysis and a model-based long-term cost-effectiveness analysis will be conducted from the National Health Service and Personal Social Service perspective in England. The former will quantify key parameters to populate a Markov model designed to estimate the long-term cost and quality-adjusted life years of the I-WOTCH intervention against best usual care. Regression equations will be used to estimate parameters such as transition probabilities, utilities, and costs associated with the model’s states and events. Probabilistic sensitivity analysis will be used to assess the impact of parameter uncertainty onto the predicted costs and health outcomes, and the resulting value for money assessment of the I-WOTCH intervention.Ethics and disseminationFull ethics approval was granted by Yorkshire & The Humber—South Yorkshire Research Ethics Committee on 13 September 2016 (16/YH/0325). Current protocol: V.1.7, date 31 July 2019. Findings will be disseminated in peer-reviewed journals, scientific conferences, newsletters and websites.Trial registration numberInternational Standard Randomised Controlled Trial Number (49 470 934); Pre-result.

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“…The Short Opiate Withdrawal Scale (SOWS)-Gossop, a more straightforward ten-item questionnaire, derives from the OWS. The SOWS-Gossop scale was validated in a clinical trial that showed it had good psychometric properties and was an appropriate, precise, and sensitive metric [3, 4]. Other instruments used were the Modified Himmelsbach Opiate Withdrawal Scale (MHOWS), the Objective Opioid Withdrawal Scale (OOWS), and the OOWS-Handelsman survey.…”

Section: Methodsmentioning

confidence: 99%

The Role of Lofexidine in Management of Opioid Withdrawal

et al. 2018

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Fear of withdrawal symptoms has been cited by survey respondents as the main reason that they continued to use opioids. Lofexidine is an α 2 -adrenergic agonist that decreases the sympathetic outflow that results in the characteristic symptoms of opioid withdrawal. A structural analog of clonidine, lofexidine has a higher affinity and specificity for the α 2a receptors and does not reinforce opioid dependence. Withdrawal symptoms correlate approximately to the half-life of the opioid; patient factors such as age, duration of opioid exposure, physical status, and other considerations may influence the nature and duration of withdrawal symptoms. For patients with opioid use disorder and psychiatric comorbidities, withdrawal may be destabilizing and may exacerbate mental health status. Lofexidine has been shown in clinical trials to be safe and effective in helping to manage the symptoms of withdrawal and has been recommended in guidelines for this purpose. Adverse events associated with lofexidine include QT prolongation, hypotension, orthostasis, and bradycardia. The maximum course of treatment is 14 days, and doses should be titrated, with the recommended maximum dose to coincide with the most severe withdrawal symptoms (about 5–7 days after opioid discontinuation).

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Psychometric evaluation of the 10-item Short Opiate Withdrawal Scale-Gossop (SOWS-Gossop) in patients undergoing opioid detoxification

Cited by 25 publications

References 9 publications

New directions in the treatment of opioid withdrawal

New directions in the treatment of opioid withdrawal

Protocol for an economic analysis of the randomised controlled trial of Improving the Well-being of people with Opioid Treated CHronic pain: I-WOTCH Study

The Role of Lofexidine in Management of Opioid Withdrawal

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