Quitting alcohol or drugs is the first step to sobriety, and it comes with many challenges. The first stage of recovery is known as the withdrawal stage, and it’s the one where your body cleanses itself from the substance you are dependent on. They’re typically only a couple of days long and characterized by flu-like symptoms. However, you may experience prolonged and psychologically difficult withdrawal, also known as post-acute withdrawal symptom or PAWS for short. PAWS in addiction recovery brings a new set of challenges, and you are likely to need professional assistance to overcome them. You can rely on Resova Health to guide you and support your lifelong recovery.
What is Post-Acute Withdrawal Syndrome
When you stop using drugs or alcohol after a long period of dependence, you are likely to experience a range of mostly physical symptoms that indicate the substances are leaving your body. These symptoms are intense and short-lived, often uncomfortable, but they can also be dangerous. Therefore, it is advisable to seek professional detoxification services to ensure your safety.
Sometimes, after this acute stage of withdrawal, people experience so-called “post-acute withdrawal symptom,” which involve numerous neurological and psychological changes. It is believed it is happening because the body is recalibrating its brain chemistry.
Long-term substance use impacts neurotransmitters, and when the substance is removed, the brain needs to restore the balance. This process can lead to cognitive fog, mood swings, and sleep disturbances.
Post-acute withdrawal symptom (PAWS) is most common when recovering from alcohol use, but also opioids, benzodiazepines, stimulants, and methamphetamines. These symptoms can surface regardless of the type of treatment you choose whether it is in-person or online addiction treatment.
Common PAWS Symptoms
PAWS symptoms are numerous and typically more daunting and dangerous than the acute withdrawal ones. Other than physical symptoms, PAWS entails a number of emotional and cognitive challenges.
Emotional and Cognitive Symptoms
PAWS can significantly impact your emotional regulation. You can experience an array of emotional symptoms, including:
- Intense anxiety or even panic episodes that seem to appear without any warning.
- Persistently low mood or even depression, making your daily tasks feel overwhelming
- Mood swings and irritability that can impact and strain your personal relationship, as well as your overall quality of life.
- Low motivation and emotional apathy may also take place, making it difficult for you to find Joy or purpose in life.
As for cognitive symptoms, the most important one is the so-called brain fog. This lack of cognitive clarity implies the inability to focus, remember details, or think clearly.
Physical Symptoms of PAWS
Like with acute withdrawal, when experiencing PAWS, your body will struggle. For many, the following are the most common physical symptoms, making the recovery process difficult and uncomfortable.
- Sleep disturbances, including chronic insomnia or vivid and unsettling dreams.
- A chronic fatigue even after a full night’s sleep, making it difficult to be productive and focused the day after.
- Intense cravings, especially during periods of emotional stress, may resurface as well.
- Some people experience a decline in coordination and fine motor skills, interfering with everyday activities.
Keep in mind, these symptoms can appear suddenly or come in waves, making your recovery journey a non-predictable one. Your daily functioning may become hard, and professional help may become a must.
How Long Does PAWS Last?
Anybody struggling with the post-acute withdrawal symptom undoubtedly wonders how long PAWS lasts. It’s one of those questions that does not have a single answer, as the timeline depends on several factors, such as:
- Type of substance used: PAWS has different durations for alcohol and drug users. Furthermore, the type of drugs also plays a role. For example, when recovering from alcohol or benzodiazepine use, PAWS can take 3-12 months, and symptoms may spike during stressful times. When recovering from opioids, the PAWS timeline can take 6-18 months. Finally, PAWS can prolong meth addiction treatment as it takes 6-12 months.
- Individual factors: Factors related to your overall health will contribute to your post acute withdrawal timeline. Your age and body mass influence the metabolization of substances, which in turn influences the cleansing process. Co-occurring medical or psychiatric conditions are also impacting the process.
- Previous treatment history: Your post acute withdrawal recovery is likely to be shorter if your addiction was properly addressed in the past. For instance, if you went through online alcohol treatment at Resova Health, you certainly worked on psychological aspects of your addiction, making you better prepared for what PAWS entails.
Recovery from the post-acute withdrawal symptoms will not happen overnight, and it will require your active participation.
PAWS vs. Relapse: Know the Difference
Those experiencing PAWS may fear that they are relapsing. This fear is understandable given that some symptoms of post-acute withdrawal, such as intense cravings, are similar to those of relapse.
Talking about PAWS vs relapse signs is an important part of psychoeducation, as it can help you react properly and on time. One thing to always keep in mind is that PAWS symptoms arise without any new substance use.
This most important distinction is critical because it prevents guilt and fear from interfering with the recovery process. Post-Acute Withdrawal Symptoms can raise doubts about an individual’s ability to maintain sobriety and may even tempt them to give up.
We recommend that you monitor your progress and manage your emotions effectively. Sharing your experiences with a therapist or using self-help techniques such as journaling can provide you with additional perspective and clarity and help you stay on the right track.
Professionals can help you clear any doubts, distinguish between PAWS and actual relapse, and make timely adjustments to your recovery plan if needed. Finally, they can support you in developing strategies for coping with post acute withdrawal.
Coping Strategies for Managing PAWS
Before turning to experts for assistance and support, you can try implementing several coping strategies that can potentially help you manage PAWS.
The following strategies and techniques are useful for your well-being overall, but they can be especially important when dealing with a crisis, such as experiencing post acute withdrawal symptoms.
- Structuring your routine: Choosing to have a consistent pattern, regular meals, and physical activity during the day stabilizes your brain chemistry.
- Relying on mindfulness: Mindfulness can be easily introduced into your daily routine, whether as a part of an exercise routine (e.g., yoga, walking) or as a standalone, meditative experience. Mindfulness helps you manage stress successfully.
- Introducing balanced nutrition: Getting sufficient protein, omega-3s, and complex carbs can support the production of neurotransmitters.
- Finding peer support: Whether you choose in-person or online support groups, you will benefit from hearing other people’s experiences, and you will potentially be inspired by their success stories.
- Seeking professional guidance: If you cannot go through struggles alone, rely on professionals who can provide you with tailored psychotherapeutic support that addresses your particular needs and challenges.
When to Seek Help
Your inner strength is crucial for overcoming PAWS, but it might be insufficient in certain situations. Professional assistance is, at times, crucial.
The most obvious case is when you’re considering using drugs or alcohol again. If cravings are strong and you’re losing the motivation to stay on the right track, finding support in professionals or peer support groups can offer clarity, different perspectives, or inspirational stories to guide you through these challenging times.
Another situation where professional assistance is necessary is the existence or suspicion of a co-occurring mental health disorder. Recovering from addiction while trying to manage so far untreated mental health issues is a whole new level of challenge, as these two problems typically impact each other, requiring a more complex treatment.
Seeking expert help early on can reduce the effects of PAWS and empower you to keep on fighting for your well-being.
You’re Closer Than You Think—Push Through PAWS with Support
Although PAWS is a temporary stage of your recovery process, it’s a serious one that deserves proper addressing. With support from both your loved ones and professionals, post-acute withdrawal symptoms can be successfully managed. Surpassing this critical moment in your recovery will make you stronger in the face of new struggles. We at Resova Health can help you grow from this challenge. Contact us and ensure a stable recovery path.
Resources:
https://pmc.ncbi.nlm.nih.gov/articles/PMC9798382/
https://www.medicalnewstoday.com/articles/post-acute-withdrawal-syndrome
