13 physically observable signs, rated present or absent, based on a timed period of observation of the patient by a rater.
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.
Data are collected on thepast 3 months use of smokeless tobacco products: use of any smokeless tobacco product more that 5 times a day; more than 10 times a day; usual use within 30 minutes after waking; use of e-cigarettes, and if so, how many times per day.
Oral fluid sample testing for amphetamines, methamphetamine (MDMA), cocaine/metabolite, opiates, oxycodone, phencyclidine, THC, barbiturates, benzodiazepines, and methadone. Samples can be analyzed by enzyme immunoassay (EIA). Oral fluid testing has been found to have adequate reliability compared to urine testing. (Bosker & Huestis, 2009; Cone & Huestis, 2007)
