What is Post Acute Withdrawal Syndrome (PAWS)?

Post acute withdrawal syndrome (PAWS), also known as chronic withdrawal or protracted withdrawal, encompasses a wide variety of symptoms (sometimes debilitating) that continue after acute withdrawal from stopping drug or alcohol use is over. Depending on the substance and how it was used, these symptoms can hang on for a long period of time, causing discomfort and frustration, which can lead to relapse. Understanding these symptoms and how to treat them is essential to moving forward in recovery and preventing relapse.

What is the Difference Between Acute Withdrawal and PAWS?

When you use drugs or alcohol for a period of time, your brain chemistry changes to accommodate the presence of the substance. In other words, it gets used to having drugs or alcohol in your system. When you stop using the substance, your brain once again has to recalibrate its chemistry to adjust to the change. As it does this, you will feel the symptoms of withdrawal.

Acute withdrawal (AW), most commonly just called withdrawal, is generally used to describe the uncomfortable physical symptoms that are associated with stopping the use of drugs or alcohol that the body is used to having. As acute withdrawal diminishes, your body and brain will begin to function normally. However, some individuals continue to have these and other symptoms long after acute withdrawal is over. The period of time that an individual suffers symptoms after AW is finished is known as post acute withdrawal. PAWS commonly affects users who have stopped using alcohol, benzodiazepines, opioids, antidepressants, and antipsychotics, but it may affect users of other types of drugs as well.

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How Long Does Acute Withdrawal and PAWS Last?

Just how long a person experiences withdrawal symptoms depends on the type of substance, how long it was used, in what amounts and what manner it was used, along with other individual physical and medical factors. However, there are some average time frames for the duration of withdrawal symptoms – both acute and post acute.

  Acute Withdrawal Post Acute Withdrawal
Alcohol Four to seven days Two years or more, with some sleep disturbances potentially lasting up to three years
Benzodiazepines One to four weeks Up to several months
Opioids Four to ten days Several weeks to several months
Marijuana About 5 days Up to 45 days
Cocaine and Methamphetamines One to two weeks One to two months, with some impulse control issues lasting longer

What are the Symptoms of Post Acute Withdrawal Syndrome?

While the symptoms of post acute withdrawal can vary from individual to individual, there are some common symptoms that occur most frequently. Some of these include:

  • Cravings for drugs or alcohol
  • Irritability
  • Depression or anxiety
  • Sleep problems
  • Reduced libido
  • Reduced ability to enjoy things or feel pleasure
  • Short-term memory issues
  • Chronic fatigue
  • Difficulties focusing
  • Difficulty making decisions
  • Decreased control of executive functions
  • Physical issues, like aches and pains that are not attributed to a specific cause

These symptoms will eventually subside, but it’s easy to become frustrated in the meantime. That frustration, along with the discomfort of the symptoms, is often a cause for relapse. That’s why it is extremely important that you learn to deal with the symptoms of PAWS in order to prevent relapse and remain sober.

How to Deal with the Symptoms of PAWS

If you are feeling overwhelmed with the symptoms of PAWS, it’s undoubtedly hard to deal with. After getting clean and sober, and starting the long journey toward recovery, it probably feels intimidating to have to deal with yet another trial of the process. But, there are some things that you can do to make the process less difficult and to alleviate PAWS symptoms.

Focus on your progress – Withdrawal symptoms can steer your focus to the negative. It’s important during this time to focus on the progress that you have made and continue to make in your recovery. Remind yourself of where you started – addicted and needing help – to where you are now and where you are headed.

Stay involved and active – It’s easy to shut down and isolate when you are feeling depressed or suffering other symptoms of PAWS. Try to maintain relationships with those people who are supportive of your recovery and take part in activities that you enjoy. Staying active can greatly help minimize psychological withdrawal symptoms.

Maintain a healthy lifestyle – Getting enough sleep, eating healthy foods, staying hydrated, and getting some exercise daily will help you combat the symptoms of PAWS physically.

Find support – Support groups like 12-step programs or other recovery groups are essential during recovery, especially when you are feeling post acute withdrawal symptoms. They often provide members with valuable information and coping skills that others have learned during recovery. If you attended inpatient or outpatient treatment, it’s likely that the facility you went to offers some type of aftercare program. Don’t ignore that – use what is available to you to help you make it through this period of time.

Continue medical and mental health care – Be sure that you see your primary care doctor regularly and let him or her know how you are doing with your recovery and withdrawal symptoms. Also, if you are involved in therapy or psychiatric care, continue seeing those medical professionals. The work of recovery doesn’t end when you complete treatment, it’s important to your recovery that you continue to receive care or as long as you need it.

Maintain balance – When you have lived a life (or even a short period) of addiction, it’s easy to try to make up for lost time once you get clean. Some people tend to overdo things, hoping to make a bunch of changes all at once to build a better life. While those changes may be positive ones, attempting to do them all at once can be overwhelming. Be careful that you don’t overwhelm yourself. Take time each day to relax, meditate, or just have some down time to maintain balance in your new, sober life.

Final Thoughts about PAWS

Making through post acute withdrawal symptoms isn’t easy, but just like sobriety, it is possible. If you are suffering from PAWS, try some of the above techniques and be patient with yourself. You will make it through the withdrawal symptoms – it just takes time. Stay focused on what is important, your health and your recovery from addiction.

Call Summit Behavioral Health Today

Summit Behavioral Health has both inpatient and outpatient programs to help people overcome drug addiction and deal with post acute withdrawal syndrome (PAW). Our experts have helped people conquer drug addictions with lasting success. Our programs are personalized and medically supervised. Call our behavioral health professionals today to speak to a substance abuse expert about a program that will help you reclaim your life.

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