Post-Acute Withdrawal Syndrome

Post-Acute Withdrawal Syndrome (PAWS) can occur long after detoxing from drugs and alcohol. For some, this can make long-term recovery seem impossible. However, by understanding the PAWS symptoms timeline, you get a glimpse of what to expect on your recovery journey.

At Buckhead Behavioral Health in Atlanta, Georgia, we know that recovery from addiction is challenging. PAWS can feel like a significant setback as you rebuild your life in recovery. But, with programs like aftercare, peer support groups, medication-assisted treatment (MAT), and outpatient therapy, you can overcome PAWS as you navigate the ups and downs of addiction recovery.

What is PAWS?

Causes and Risk Factors of PAWS

For the most part, PAWS occurs because your brain needs time to heal itself from the effects of active addiction. Drugs and alcohol alter the way that your brain functions. These substances essentially hijack your brain’s reward system.

When you abuse substances, you flood your brain with natural chemicals that make you feel good. While these chemicals occur naturally as part of your brain’s reward system, drugs and alcohol cause your brain to release more than usual. As a result, the effects of drugs and alcohol are difficult to mimic naturally. And so, your brain craves more substances for these effects.

As you continue abusing substances, you alter natural pathways in your brain associated with pleasure and pain reduction. Then, when you stop abusing substances, your brain doesn’t bounce back right away. It will take time to heal. In that time, you could have PAWS—especially if you abused drugs or alcohol for a long time.

Not everyone in recovery will have PAWS. The following risk factors increase your chances of PAWS:

Signs and Symptoms of Post-Acute Withdrawal Syndrome

Most signs and symptoms of PAWS will affect a person’s mental health. However, PAWS can also cause physical symptoms. This is because your mental health can affect your physical well-being—and vice versa.

Common signs and symptoms of PAWS include the following:

PAWS Symptoms Timeline

The timeline of PAWS symptoms can vary from one person to the next. After acute withdrawal, you might have PAWS symptoms for several weeks to months. During this time, it is critical to begin long-term addiction treatment from residential facilities to outpatient programming. That way, you will have the support you need to overcome PAWS and prevent relapsing in early recovery.

Still, some people will have symptoms that linger for years afterward. Others could have symptoms that come and go in cycles—adding frustration to the process of long-term recovery.

Factors that contribute to a protracted PAWS symptoms timeline include the types of substances abused, underlying mental health disorders, how much and how often you abused substances, and the duration of your addiction.

PAWS Alcohol Timeline

Alcohol is one of the most difficult substances to quit due to the severity of withdrawal symptoms. That is why the FDA has approved several medications specifically to treat alcohol withdrawal symptoms. Those with a severe and long-term alcohol addiction are more likely to experience PAWS.

The timeline for PAWS from alcohol can last years. This is because alcohol has significant effects on your body and mind. Oftentimes, PAWS symptoms will last about two years or longer. In addition, sleep disturbances from alcohol-related PAWS can last one to three years.

How is PAWS Diagnosed?

PAWS isn’t officially named as a diagnosis. However, the symptoms of PAWS have been observed by many practitioners and experienced by many in recovery.

Regardless of the lack of an official diagnosis, if you have lingering symptoms of withdrawal long after detox, you likely have PAWS. The protracted withdrawal symptoms of those with PAWS can make addiction recovery challenging. Therefore, it is important for you to get specialized treatment for PAWS.

How is Protracted Withdrawal Treated?

Protracted withdrawal symptoms from PAWS are treated in a number of ways. These treatments vary based on your symptoms as well as the substance that you abuse. Still, many treatments for protracted withdrawal mimic those of long-term addiction treatment.

For instance, medication-assisted treatment (MAT) programs help those in recovery from opioid and alcohol addiction. Some people taking medications like methadone or buprenorphine for opioid use disorder might take these medications for years to prevent relapse and overdose.

Other treatment options include support groups, outpatient mental health therapy, and sober living programs. In fact, if you do have PAWS, it might be best for you to live in a sober living home to decrease your risk of relapsing during the first several months of recovery. In addition, there are several tips to help you get through PAWS that you can use in everyday life.

How Do I Get Through PAWS?

Getting through PAWS can be challenging and frustrating. You might feel great for a long time and then symptoms recur without warning. This can put you at an increased risk of relapsing.

Fortunately, there are some tips to prevent symptoms or help you when your symptoms flare up, such as: