All About Post Acute Withdrawal Syndrome (PAWS)

Post acute withdrawal syndrome goes by many names—post-withdrawal syndrome, protracted withdrawal syndrome, and prolonged withdrawal syndromes, to name a few. All of these terms collectively refer to the set of persistent impairments that come to someone after he or she chronically abuses alcohol, opiates, benzos, and other substances and then ceases use. 

It’s important to note that PAWS occurs after the initial acute phase of withdrawal, which lasts for a few weeks at most. During the acute phase of withdrawal, an individual typically experiences the bulk of physical symptoms that coincide with suddenly ceasing use of a particular drug. During the PAWS phase, on the other hand, that individual will experience more emotional and psychological withdrawal symptoms. This is because while the body may have more or less adjusted to the absence of a particular substance, the chemistry in the brain is still returning back to normal. 

Most people experience post acute withdrawal symptoms to some degree. And while the physical symptoms of withdrawal that occur during the acute withdrawal stage can vary significantly depending on the drug and the individual, many recovering addicts experience very similar post acute withdrawal symptoms. 

Symptoms 

Symptoms of PAWS can come and go, almost in wave-like recurrences, or fluctuations in severity of symptoms—much like a roller coaster. This is because as chemical levels in the brain return to normal, the chemicals actually fluctuate. PAWS might begin with symptoms changing by the minute and hour, and then even eventually these symptoms will disappear for weeks or months, only to come back again. The longer a person gets down the road to recovery, the longer the stretches between symptoms cropping up. 

Some of most common post-acute withdrawal symptoms are: 

Mood swings 
Anxiety 
Irritability 
Fatigue 
Low enthusiasm 
Depression 
Impaired interpersonal skills 
Variable concentration 
Memory problems 
Physical coordination problems 
Sleep disturbance 
Cravings 
Outlook 

PAWS typically improves over a period of time that can range anywhere from six months to a matter of years. One thing to remember about PAWS is that when symptoms crop up, those symptoms are time limited. A recovering addict can take comfort in the fact that while symptoms of fatigue or low enthusiasm might come suddenly and unexpectedly, they will eventually subside in much the same manner. Overall, it’s important for a recovering addict who is coping with PAWS symptoms to practice self-care, reaching out for help when needed.

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