What is Post Acute Withdrawal Syndrome (PAWs)?

Post Acute Withdrawal Syndrome (PAWS) refers to the set of impairing symptoms a person may struggle with after discontinuing use of alcohol, opiates, benzodiazepines, antidepressants, and other substances. These symptoms, which vary from person to person, typically include some combination of mood swings, profound depression, insomnia, extreme craving for the substance, anxiety, panic attacks, suicidal thoughts and feelings, and problems with thinking and memory. Read on to learn more about the effects of and treatment for PAWs.

Effects of Post Acute Withdrawal Syndrome

The effects of Post Acute Withdrawal Syndrome are typically intermittent and affect those recovering from addiction in different ways and at different intensities. These symptoms can occur any time from within a year after detoxification from the substances until several decades later; symptoms closely mirror the effects of mental illness. Experts estimate that Post-Acute Withdrawal Syndrome affects about 90 percent of people who have been addicted to Heroin and 75 percent of those who were addicted to other drugs or alcohol.

Post-Acute Withdrawal Syndrome is sometimes considered the second phase of addiction withdrawal. The first phase, acute withdrawal, occurs in the first few weeks or months after detoxification from the substance and typically includes physical withdrawal symptoms. By contrast, Post Acute Withdrawal Syndrome refers to the lingering psychological and emotional withdrawal symptoms that linger for an unpredictable amount of time.

Because drugs affect the fundamental neurobiology of the brain, an extended amount of time may be required for these changes to heal and for brain chemistry to return to normal. For example, recovering addicts may suffer from a lack of dopamine in the brain, a chemical that is responsible for feelings of joy and pleasure. Because key brain structures were impaired over time with drug use, over time these structures will become heal and normal function will return.

Experts who study Post Acute Withdrawal Syndrome classify the symptoms into three major areas. The first, cognitive, refers to difficulty with mental processes, characterized by having racing thoughts, trouble concentrating, and difficulty with reasoning and abstract thinking. The second area, emotional, refers to self-awareness, having feelings of shame, anger, guilt, and sadness that many other addicts also experience during the recovery process. The third category, memory, refers to difficulty with short term memory, learning new skills or processes and recalling older memories.

Because of the difficulty of experiencing these symptoms, recovering addicts who are struggling with Post Acute Withdrawal Syndrome may have challenges with daily function, including things like maintaining a long-term job. Because of these challenges, people with Post Acute Withdrawal Syndrome are at higher risk for relapse and should continue in a treatment program such as Narcotics Anonymous.

Post Acute Withdrawal Syndrome symptoms are most severe during the first six months of recovery and usually gradually abate thereafter over a period of months and years, depending on each individual. If you or a family member is struggling with Post Acute Withdrawal Syndrome, keeping self-care in your routine can help alleviate some symptoms. Self-care includes doing activities that lower stress, eating healthy meals, exercising regularly, and getting at least eight hours of sleep each night. The key is to remove oneself from situations that cause high anxiety as much as possible, so look into techniques that may help you cope. Talk with your doctor about other ways to manage these challenging symptoms. He or she may prescribe certain medications or recommend therapeutic techniques.

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