PAWS: Understanding Post-Acute Withdrawal Syndrome

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Post-acute withdrawal syndrome (PAWS) is the term for the cluster of lasting psychological and mood-related symptoms that very often accompany the physical withdrawal from a substance.

Although PAWS rarely involves aches and pains, nausea, cramping, headaches, or other physical symptoms, it can be just as intense as acute withdrawal—and it puts a person at risk of relapse, as they may return to drug use to stop the discomfort.

What is PAWS?

To understand PAWS, one must first understand the two stages of detoxification or withdrawal symptoms.

The first stage of detoxification, acute withdrawal, is primarily physical withdrawal symptoms that can last from a few days up to 2 weeks. Acute withdrawal symptoms are the immediate or initial withdrawal symptoms that occur upon rapidly reducing or suddenly ceasing the use of addictive substances.

PAWS occurs as the brain re-calibrates after active addiction. Unlike acute withdrawal, which is primarily physical withdrawal symptoms, the symptoms of post-acute withdrawal are primarily psychological and emotional symptoms. Depending on the intensity and duration of alcohol or drug use, PAWS is known to last many months, and in some cases, as much as one to two years.

However, the severity and frequency of symptoms tend to dissipate as time goes by without the use of addictive substances. Therefore, it is critically important to seek help with this stage of recovery to avoid relapse. PAWS can be effectively managed with the right treatment.

Recognizing Common Symptoms

Regardless of the addictive substance(s) used, PAWS is typically the same for most individuals in early recovery from substance use disorders.

Some of the most common post-acute withdrawal symptoms include:

  • Irritability and hostility
  • Depression
  • Anxiety
  • Mood swings
  • Low energy and fatigue
  • Sleep disruption, including insomnia
  • Limited ability to focus or think clearly
  • Lack of libido
  • Inexplicable chronic pain

A Multi-Layered Treatment Process

PAWS can be challenging to deal with, especially after going through detox and then working to resist relapse. It can feel like a rollercoaster ride, with symptoms coming and going unexpectedly.

While the unpredictable nature of PAWS can be stressful, a combination of therapies has proven beneficial in helping people cope with them and make them more manageable. Treatment is generally administered over an extended period because the symptoms of PAWS can continue for months or years.

The New England Recovery Center can help you recover from addiction and co-occurring mental health conditions as well as deal with the ongoing symptoms of PAWS. Do not hesitate to reach out to us for help.

If you or a loved one is struggling with addiction, call the New England Recovery Center today at 1-877-MyRehab. 

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