Although the experience of going through withdrawal is different for everyone, the most intense symptoms typically only last from a few days to a few weeks. However, some people may experience a prolonged withdrawal known as post-acute withdrawal syndrome (PAWS). Knowing what to expect from PAWS can help you keep your recovery efforts on track.
Understanding the Stages of Withdrawal
In addiction treatment, detox is the time period in which a person is removing an abused substance from their system. During detox, it is common to experience a range of physical and psychological symptoms. This is referred to as withdrawal.
Acute withdrawal is marked by symptoms such as muscle aches, headaches, nausea, and increased heart rate. These symptoms represent the start of the body’s healing journey and are best managed in a supervised setting where trained medical professionals can keep a person comfortable and prevent dangerous complications.
The symptoms of acute withdrawal are generally short-lived, but a type of secondary withdrawal can occur a few weeks or even a few months after acute withdrawal symptoms have faded. PAWS means that the brain is recalibrating itself to restore normal functioning after active addiction.
PAWS is most often seen in people who abuse alcohol, opioids, or benzodiazepines (benzos). People who abuse these substances in large quantities for an extended period of time are most likely to suffer from PAWS. This is also some evidence to suggest that individuals who have co-occurring mental health disorders face an increased risk of PAWS.
Experiencing PAWS does not mean that a person isn’t committed to their recovery efforts or that lasting sobriety isn’t possible for them. Struggles with PAWS are fairly common and completely normal. There is no need for a person experiencing PAWS to feel guilty, ashamed, or embarrassed about what they are going through.
Symptoms of PAWS
PAWS is often described as a rollercoaster of symptoms that tend to ebb and flow over time. Some people find their symptoms are triggered by stress, while others say they struggle the most when they are around people or places they associate with their addiction.
PAWS symptoms are primarily psychological and can include:
- Mood swings
- Trouble concentrating
- Memory impairment
- Anxiety or panic attacks
- Sleep disturbances
- Lack of initiative
- Low libido
- Difficulty managing chronic pain
- Diminished fine motor skills
- Strong cravings for the previously abused substance
A flare-up of PAWS typically only lasts for a few days, and evidence suggests that episodes decrease as a person progresses in their recovery efforts. The full process of calibrating the brain to adjust to life without the presence of addictive substances can take between six months and two years, depending on the substances being abused and the length of a person’s active addiction.
PAWS is not officially recognized as a disorder by the Diagnostic and Statistical Manual of Mental Disorders or any major medical associations. However, addiction treatment professionals still urge people in recovery who are struggling with PAWS to take their symptoms seriously. Ignoring the problem can increase a person’s risk of relapse.
Since the symptoms of PAWS are largely psychological, self-care is vital. Recommended treatment includes:
- Practicing good sleep hygiene by keeping a consistent bedtime and a soothing evening routine
- Exercising regularly
- Eating a healthy diet, including snacks as needed to manage blood sugar
- Regularly participating in mutual support groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA)
- Seeing a therapist to address co-occurring mental health conditions
- Creating a schedule that allows for plenty of breaks and plans tasks that require focus when energy levels are highest
- Turning to supportive friends, family, and spiritual leaders to talk about how you’re feeling
For those with severe PAWS symptoms, medication may be recommended. Antidepressants are often particularly useful in managing symptoms because they help stabilize serotonin levels in the brain.
We’re Here for You
At Mountain Laurel Recovery Center, we understand that every person faces unique challenges and obstacles on their recovery journey. We strive to provide graduates of our Pennsylvania residential addiction treatment center with the tools to build a strong foundation for a lasting recovery, but we understand that a full continuum of care is needed to successfully transition back to independent living. We encourage clients to take advantage of our extended care program, as well as our various alumni services, so they can face the future with confidence.