What It Is and How To Manage It

Post-Acute Withdrawal Syndrome: What It Is and How To Manage It

What is Post-Acute Withdrawal Syndrome and How To Manage Symptoms

Post-acute withdrawal syndrome (PAWS) is a collection of serious physical and emotional withdrawal symptoms which are a major factor contributing to relapse.  Recognizing and managing the symptoms of PAWS early on helps to ensure long-term success in recovery.   

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Withdrawal and Acute Withdrawal

Alcohol and drug withdrawal is the result of the toxic effects these chemicals have on the brain and body. Acute withdrawal refers to the symptoms that occur when a substance-dependent person abruptly stops taking that substance. Both illicit and prescription drugs can cause withdrawal. Acute Withdrawal may last anywhere from a few days to a couple weeks.

In the first days and weeks following cessation of drug and alcohol use, individuals may experience acute withdrawal symptoms.  Whether mildly unpleasant or seriously uncomfortable, these withdrawal symptoms are often severely prevalent in the early stages of recovery from alcohol or drug addiction.

Post-Acute Withdrawal Syndrome

While withdrawal refers primarily to the body’s process of healing, a second phase of withdrawal symptoms known as post-acute withdrawal syndrome, or PAWS, occurs as the brain recalibrates after active addiction. These symptoms, unlike the first stage of acute withdrawal, persist after acute withdrawal has resolved. They often come and go unexpectedly and typically involve more of the psychological and emotional aspects of withdrawal. Depending on the duration and intensity of the addiction and what substance was being abused, this secondary withdrawal syndrome can occur from a few weeks into recovery to few months and even a year after abstinence.    

Concerningly, PAWS is one of the major factors contributing to relapse.    

PAWS can occur with any intoxicating substance, but most often occurs from discontinuing the use of: 

  • Alcohol 
  • Antidepressants 
  • Antipsychotics 
  • Benzodiazepines 
  • Opioids 
  • Stimulants 

Common Symptoms of PAWS

It is important to recognize that many of the unpleasant or uncomfortable sensations and feelings experienced early in the recovery process could be symptoms of PAWS. These include: 

  • Mood swings  
  • Irritability and hostility 
  • Depression 
  • Anxiety 
  • Low energy and fatigue 
  • Urges and cravings 
  • Sleep disturbances—insomnia or vivid dreams 
  • Issues with fine motor coordination 
  • Stress sensitivity 
  • Anxiety  
  • Impaired ability to focus 
  • Lack of libido 
  • Inexplicable chronic pain 

Managing PAWS

Because the medical risks associated with relapse are so severe, a comprehensive treatment plan is essential and should anticipate PAWS symptoms analyzing each person’s propensity for them. Drug and alcohol addiction treatment centers are largely successful because PAWS treatment begins immediately under the guidance of trained professionals. These treatment centers provide group and individual counseling to aid each recovering addict. They identify each addict’s unique circumstances and risk factors and tailor a personalized treatment plan for them.  

Positive Influences

During and after treatment, the more positive influences in a person’s life the better their chances for recovery. Close friends, family and co-workers are encouraged to participate in counseling so they can understand the full scope of PAWS symptoms as they will likely see and be affected by the recovering addict’s PAWS symptoms. These symptoms are often displayed in ways that appear irrational causing frustration for both the recovering addict and all those around them. Joint participation in the counseling sessions gives both the addict and their loved-ones effective tools to manage PAWS symptoms. 

In addition, the following strategies helps reduce PAWS symptoms:

  • Avoid Unnecessary Stress and Demands  
  • Continue Therapy. Friends and family play an important role, but counselors help reveal layers of emotion to find the root cause and provide an objective perspective 
  • Engage in healthy habits and friendships. Replacing old, unhealthy habits like drug and alcohol addiction with a new, healthy habit will help distract the mind from cravings. Focusing on building new friendships and avoiding those “friends” that are still using reduces temptation and negative influence   
  • Practice Compassion. Develop compassion for yourself when PAWS symptoms surface and be compassionate for those people your behaviors affect. 
  • Plan Ahead. When entering a potentially stressful situation, anticipate possible triggers and identify tools to deal with these triggers. That way you’re not caught off guard. 
  • Ask for Help. Ensure people in your support network are prepared for you to lean on them for support, even at inopportune times. 
  • Finally, if you’re at the point of relapse, don’t let pride get in the way, utilize all options you have in your support network. 

At Legacy Healing Center we understand that addiction and recovery are complex and multilayered.  Our holistic approach to treatment supports your healing from the inside out addressing the physical, mental, emotional and spiritual factors.  Our mission is to lay the foundation for you to recover, address underlying issues and get you on track to achieve a better life than you’ve ever dreamed possible.  

 

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Sources

https://patient.uwhealth.org/healthfacts