Symptom counts mask withdrawal severity

Counting the number of new or worsened symptoms (as with the DESS scale) can understate or misrepresent how severe or disabling withdrawal episodes are, because the metric treats all symptoms as equal and does not record impairment. When systematic reviews report 'one more symptom' without clarifying severity or functional impact, clinicians, patients, and journalists may mistakenly conclude risk is minor. — This framing matters because it changes how the public and health systems interpret evidence about medication harms, with direct consequences for prescribing, informed consent, coverage, and patient advocacy.