Author: Charles Frank

PAWS: What is Post-Acute Withdrawal Syndrome?

Whether you’ve experienced addiction or are withdrawing after using prescription medication, it can be helpful to find a support group. Some sources report that PAWS symptoms for morphine users usually start between 6 to 9 weeks after the acute withdrawal phase and persist until 26 to 30 weeks. The PAWS symptoms of alcohol withdrawal can come and go — you might feel well one day and very uncomfortable the next. According to a 2021 study, PAWS is one of the major causes of relapse in people with alcohol use disorder. Get professional help from an addiction and mental health counselor from BetterHelp via phone, video, or live-chat. Benzodiazepines, such as Xanax, Ativan and Klonopin, are known for having common PAWS, including  intense anxiety, panic attacks, irritability, and severe sleep disturbances, including insomnia.

Get professional help from an online addiction and mental health counselor from BetterHelp. Post-Acute Withdrawal Syndrome, or PAWS, is a persistent occurrence of withdrawal symptoms that can last for months after a person gets sober. PAWS is a set of impairments that happen immediately after you experience withdrawal from alcohol or other substances. As it tries to reach equilibrium, it causes brain chemicals to fluctuate until they’re stable. Recovered is not a medical, healthcare or therapeutic services provider and no medical, psychiatric, psychological or physical treatment or advice is being provided by Recovered. If you are facing a medical emergency or considering suicide or self harm, please call 911 immediately.

Ioana has a Ph.D. in Communication Sciences and has been a freelance writer for over ten years. Ioana uses her passion for psychology, research, and mental health to create reliable resources on various topics relating to addiction and treatment. Addiction experts describe PAWS as the brain’s way of correcting those changes, specifically the chemical imbalances that take place during active addiction. With most substances, PAWS is less common — not everybody experiences it — and the symptoms are usually less intense. Stress can be a trigger for people with PAWS, and some research suggests that PAWS can lead to increased sensitivity to stress. In some cases, these sleep disturbances — which may include strange, vivid dreams — persist for weeks or even months.

1. After the acute withdrawal stage, some uncomfortable symptoms may linger.
2. This is true even for people who are fully committed to staying clean and sober.
3. Common PAWS from Marijuana include insomnia, anxiety, irritability, headaches and other physical symptoms, such as stomach pain and changes in appetite.
4. BetterHelp can connect you to an addiction and mental health counselor.

The available research suggests that some symptoms of opioid-related PAWS can last for weeks, and in some cases, 6 to 9 months after last use. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs), can be an effective way to manage your mood. According to American Addiction Centers, anecdotal evidence indicates that PAWS symptoms can last 2 years or longer after someone stopped drinking alcohol. PAWS is unique as compared to other withdrawal issues because of how extensive it is; PAWS can last from six months up to two years after the person stops using the substance. The symptoms involved in PAWS can vary and are dependent upon many factors, such as the type of dependency, physical size and gender, and overall health. Join the thousands of people that have called a treatment provider for rehab information.

PAWS is a dangerous withdrawal period with a high potential to cause relapse. If you experience PAWS, contact medical professionals or addiction specialists to help manage your symptoms. PAWS symptoms are extremely uncomfortable and typically affect a person’s mental health and physical health. The condition is described as ongoing withdrawal symptoms, typically mood-related. PAWS refers to the more emotional and psychological symptoms that happen during the second stage of withdrawal.

Reduce and manage stress

When in active addiction, self-care is often put on the back burner, making self-care vital while in recovery, as recovery is the opposite behavior as active addiction. Be patient and give it time, as the symptoms will decrease through time in severity and occurrence as long as there is continued abstinence. Learning healthy coping strategies for managing PAWS is one of the best ways to overcome the discomforting symptoms that may appear. You can control the symptoms with professional oversight and medical intervention at a treatment center. Working with a substance use specialist can provide methods and medications to combat PAWS symptoms.

Whether your symptoms are mild or serious, if they pop up during the first months of recovery, they can increase your chances of relapse, or returning to opioid misuse. Gain as much education on symptoms of post-acute withdrawal in order to be prepared for unexpected symptoms appearing. You may go a few weeks with no PAWS, but wake up one morning after having disturbed, unrestful sleep, extreme fatigue, irritability and anger outbursts, as well as various mood swings. If you’re not prepared for it, you may find yourself at risk for relapse. Education is key in order to be prepared and learn how to manage the various symptoms. Regardless of the addictive substance(s) used, PAWS are typically the same for most individuals in early recovery from substance use disorders (SUD).

Graduate School of Addiction Studies

It typically lasts for several months or years, depending on the severity of addiction. Certain drugs and medications can change the structure and chemistry of your brain. Similarly, SSRIs can be used to help people who are experiencing depression and anxiety, but not everybody responds well to SSRIs. If certain situations, people, or activities bring you stress and no joy, consider letting them go. If your plate is full, try to avoid adding unnecessary responsibilities to the mix. After all, if you’re currently experiencing fatigue and nausea, skipping meals and sleeping too little will only make you feel worse.

Cocaine is known for various PAWS that last for prolonged periods of time. Many users report symptoms of depression, fatigue, low motivation, and poor impulse control. These symptoms typically reach their peak between three to six months after the start of abstinence. Because of these factors, you may experience acute symptoms for just a few days or weeks. BetterHelp can connect you to an addiction and mental health counselor. It can even cause sober people to start using alcohol or drugs again.

When does post-acute withdrawal syndrome occur?

In the beginning, post-acute withdrawal symptoms may begin to feel as if you are on an emotional rollercoaster, with mood swings ranging from happy, to irritable, to sad. It can be overwhelming at first, but as you make progress in your recovery, symptoms of post-acute withdrawal syndrome begin to dissipate. After time, you may go a month without experiencing any PAWS and suddenly they will reappear unexpectedly. One of the hardest parts of PAWS is often the unpredictability of the occurrence of symptoms, making PAWS a major barrier for recovering from a substance use disorder (SUD). Post-acute withdrawal symptoms that persist or randomly occur during early recovery can become a risk factor for relapse. The symptoms can be discomforting, and without healthy coping skills, can lead to a relapse, no matter how committed one is to remaining clean and sober.

Whether used for medical or recreational reasons, stopping cannabis use might induce withdrawal symptoms, especially if you use it regularly and in high doses. To understand Post-Acute Withdrawal Syndrome (PAWS), one must first understand the 2 stages of detox or withdrawal symptoms. The severe effects of PAWS exacerbate the cravings you’ll be going through throughout the recovery process. This can make it difficult for you to participate in counseling and therapy sessions productively. Psychoactive substances render different PAWS symptoms due to their distinct effects on the brain, so we will review them below.

Avoid Triggers

The first stage of detox, 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 sudden cessation or rapid reduction of the use of addictive substances, including alcohol. Post-acute withdrawal syndrome (PAWS) is a symptom that occurs after the initial acute withdrawal stage. Although it doesn’t have intense physical symptoms, it can have intense mood-related or mental side effects. If your PAWS symptoms seem overwhelming or dangerous, you should seek medical treatment.

It can also lessen the risk of relapse because of medical support and supervision. Stopping alcohol use cold turkey or attempting to recover from drug addiction is not recommended. Because of the severity of the symptoms, people often feel the need to drink or use drugs to make them go away. Has been contributing to medical fields including mental health and addiction since she retired from medicine; with over 19 years of practicing clinical experience.

Your triggers could include stress, sleeplessness, or even certain foods. Some people may experience minimal withdrawal symptoms that may last for days or just a few weeks; others will continue to experience PAWS symptoms for years. Seeking treatment at a detox or rehabilitation center can increase the chance of a successful recovery.