Patient presents with symptoms consistent with opioid withdrawal.  Onset of symptoms began approximately [duration] after last opioid use of [specific opioid and dosage if known].  Patient reports experiencing [list specific symptoms e.g., diaphoresis, rhinorrhea, lacrimation, piloerection, myalgias, arthralgias, abdominal cramping, nausea, vomiting, diarrhea, yawning, insomnia, anxiety, irritability, dysphoria, andor drug cravings].  Severity of withdrawal symptoms assessed using the Clinical Opiate Withdrawal Scale (COWS) with a score of [COWS score].  Physical examination reveals [objective findings e.g., dilated pupils, elevated heart rate, elevated blood pressure, tremors].  Diagnosis of opioid withdrawal (ICD-10 F11.23) is made based on clinical presentation, reported opioid use history, and COWS score.  Differential diagnosis considered and ruled out [list ruled out differentials e.g., acute gastroenteritis, influenza].  Treatment plan includes [specific interventions e.g., symptomatic management with medications such as clonidine for autonomic instability, loperamide for diarrhea, ibuprofen for muscle aches, ondansetron for nausea and vomiting].  Consideration for opioid agonist therapy with [medication and dosage] may be indicated depending on severity and patient preference.  Patient education provided regarding opioid withdrawal symptoms, management strategies, and relapse prevention.  Referral to addiction treatment services offered and discussed.  Follow-up scheduled in [timeframe] to reassess symptoms and adjust treatment plan as needed.  Patient advised to return to the clinic or seek emergency care if symptoms worsen.