Modified Himmelsbach Opiate Withdrawal Scale

The MHOWS (Eissenberg et al. 1996) is a modified Himmelsbach (1941) withdrawal severity scale, with each of seven signs being rated by the observer on a 3 point scale where 0 = none and 1and 2 were ratings individualized for each sign. The signs were: Yawning, Lacrimation, Rhinorrhea, Perspiration, Gooseflesh, Bowel sounds (a stethoscope was placed on the subject's abdomen), and Restlessness. The scores for the individual items were summed to form a composite modified Himmelsbach score.