Are You in Danger of Developing Post-Acute Withdrawal Syndrome (PAWS)?

Going through withdrawal is one of the most challenging steps in taking your life back and getting sober. Yet as difficult as the symptoms of physical withdrawal are, they typically pass within a couple of weeks, and medical help is available to make the detox process safer, less uncomfortable, and more manageable.

Unfortunately, some recovering addicts find themselves facing an extended period of withdrawal symptoms as they experience a condition known as post-acute withdrawal syndrome (PAWS).

What is post-acute withdrawal syndrome?

The term Post-Acute Withdrawal Syndrome (PAWS)  describes the persistent, ongoing symptoms of withdrawal that some addicts face after going through the initial withdrawal process.  The acute physical symptoms associated with the initial stages of withdrawal (such as nausea, headache and cramping) rarely return, but the features of PAWS can be equally intense, and in some individuals, can increase the chances of relapse.

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What are the symptoms of post-acute withdrawal syndrome?

Typical symptoms of PAWS include anxiety, depression, irritability, aggression, increased stress, exhaustion, trouble concentrating, insomnia, reduced sex drive, memory issues and a reduced ability to experience pleasure. Those suffering from PAWS do not always experience all of these symptoms simultaneously. Often, symptoms tend to come and go, with each episode lasting several days. Those with PAWS can experience this rollercoaster of symptoms for up to a year, and in rare cases, even longer.

What causes PAWS?

Those who misused or abused drugs and/or alcohol extended periods of time are at the greatest risk of developing PAWS. However, the syndrome and its causes are not completely understood. Lack of research into PAWS means that many professional organizations do not formally recognize the syndrome, although prolonged symptoms of drug or alcohol withdrawal are simply a reality for some. Additionally, doctors and psychologists with experience treating PAWS are often in disagreement about the root causes of this prolonged withdrawal syndrome, and occasionally at odds on how to treat it.

However, several commonly-held theories may hint at why certain recovering addicts face PAWS. One hypothesis asserts that physical dependence on intoxicating substances leads to changes in brain chemistry that effect the release of neurotransmitters. After ceasing drug or alcohol use, it can take time for the brain to find its original balance, and PAWS symptoms arise during this period. Another theory suggests that the body’s need to overcome other physiological adaptations throughout the body (such as in the digestive or cardiovascular systems) can trigger PAWS. Lastly, the emotional and psychological stress of breaking the habit of substance abuse alone may be enough to lead to PAWS.

How is post-acute withdrawal syndrome treated?

If you believe you are experiencing the signs and symptoms of PAWS, you do have options to help you deal with the syndrome. Most of the symptoms of the syndrome are emotional or psychological, and seeking support from a professional therapist or support group can be beneficial. Some medications are available to help with PAWS symptoms following abuse of certain drugs. For example, naltrexone can help with ongoing opioid cravings. Keep in mind that working with medical professionals and joining a rehabilitation program at the beginning of your recovery process will lessen the chances that you’ll experience PAWS.

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