Post-Acute Withdrawal and What to Do About It
For people with drinking or drug problems, quitting can be extremely difficult. Though this is sometimes due to a lack of desire or lack of will power, it is often because of powerful withdrawal symptoms. Withdrawal symptoms are immediately eased by going back to alcohol or drugs, making it difficult for many people to stay on the proverbial wagon.
Some of these symptoms occur soon (or immediately) after a person stops using, while others begin after the acute phase has ended. The latter symptoms are often a result of Post-Acute Withdrawal Syndrome (PAWS).
PAWS Defined
Per the University of Wisconsin, PAWS can be defined as a group of symptoms that occur after the initial symptoms of alcohol or drug cessation. It is often considered the second stage of withdrawal (the first stage is the acute phase; it causes physical symptoms and typically lasts for a few weeks) and usually causes emotional and psychological symptoms.
The symptoms associated with PAWS happen as the brain chemistry is returning to normal and the organs are being repaired. This causes brain chemicals to fluctuate, leading to fluctuating emotions and moods. According to the Oklahoma State University Medical Center, the length of this phase can vary, but PAWS usually starts 7-14 days after quitting alcohol or drugs and peaks over the next 3-6 months. Ultimately, it can last for two years or more (though most people have periods of remission over this period) and tends to get better as time goes on.
Its length is often dependent on a variety of factors, including: how long a person was addicted (and what they were addicted to); the severity of their addiction; their age; their gender; and their overall state of health.
In general, the longer a person has been addicted to drugs or alcohol, the longer PAWS will last and the more pronounced the symptoms will be.
The Symptoms of PAWS
Depending on the person, the symptoms of PAWS may drastically vary. In fact, some people may experience very few symptoms, whereas others will experience many. For the average person, these symptoms include: mood swings; anxiety; lethargy; trouble sleeping; low energy; inability to concentrate; panic attacks; cravings; feelings of hostility or aggression; feelings of guilt; lack of motivation; depression; a tendency to overreact to little things; numbness; boredom; problems socializing; an increased sensitivity to pain; memory problems; and irritability.
Treatment for PAWS
Unfortunately, there is no magic pill that can cure PAWS. However, there are measures that sufferers can take to assuage their symptoms. Sometimes this involves avoiding certain items, such as drinks high in caffeine or foods lacking in nutrition; other times it involves the practice of mind over matter.
People with PAWS can often find relief by being patient, taking it one day at a time, accepting the symptoms as part of recovery (rather than trying to fight them), practicing good health habits, staying busing with a hobby or activity, exercising, spending time focusing on relaxation, and taking advantage of a support system. For people whose symptoms are severe, relief may be obtainable by psychiatrist-supervised cognitive behavioral therapy, or through certain medications prescribed by a doctor.
This article was written by Laura Green. She knows that PAWS can lead to relapse if you don’t know what’s happening to you, and recommends getting clean with the help of a compassionate drug treatment center, or a 12 step support group.