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?
Post-Acute Withdrawal Syndrome (PAWS) occurs when withdrawal symptoms persist beyond the expected acute phase of drug and alcohol detox. During the acute phase of detox, your withdrawal symptoms will peak in their severity. Afterward, most people have some lingering symptoms for about a week or two as they transition from detox to long-term addiction treatment programs.
While PAWS symptoms aren’t as severe as the acute phase of detox, symptoms can linger for weeks, months, or even years. In addition, while acute withdrawal symptoms include mostly physical effects, like headaches, nausea, and sweating, PAWS symptoms tend to be more emotional and psychological.
However, not everyone in recovery will experience PAWS. Thus, it is important to understand the causes and risk factors of 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:
- Duration and severity of your addiction
- Type of substance that you abused
- Polysubstance abuse (abusing more than one substance)
- History of trauma
- Dual diagnosis disorder
- Chronic stress
- Genetic predisposition
- Poor state of overall health and wellness
Even if you have some of the risk factors above, you might not develop PAWS. Therefore, it is crucial to know the signs and symptoms 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:
- Anxiety and depression
- Trouble concentrating and making decisions
- Mood swings and irritability
- Memory problems
- Insomnia
- Inability to feel pleasure
- Decreased libido
- Urges and cravings
- Headaches and muscle pain
- Digestive problems
These symptoms can be difficult to manage without help. That’s why people with PAWS are at an increased risk of relapsing. In essence, you might think that you are unable to overcome addiction when withdrawal symptoms linger. But, PAWS doesn’t last forever.
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:
- Set reminders for appointments with mental health providers, therapists, and any support groups, like 12-step groups
- Engage in self-care activities, such as eating nutritious meals, exercising, holistic practices, and getting enough sleep
- Discuss your PAWS symptoms and experiences with peers in recovery and supportive family or friends
- Explore why your PAWS symptoms flare up to get a better understanding of any triggers
- Set limits and be gentle with yourself during early recovery from addiction
- Try diversionary activities, such as art, music, journaling, or going for a walk to take your mind off of your symptoms
Remember that the PAWS symptoms timeline doesn’t last forever. With support and professional help, you can get through PAWS and stay on the path to recovery.
Find Help for PAWS Today
Post-Acute Withdrawal Syndrome (PAWS) can feel like a massive setback during early recovery. PAWS symptoms can continue for months or years after you stop using or drinking. You might feel hopeless about your recovery as a result.
Buckhead Behavioral Health in Atlanta, Georgia, can help you through the PAWS symptoms timeline with aftercare services like outpatient rehab, medication-assisted treatment (MAT), and relapse prevention strategies.
Contact us today to overcome PAWS symptoms and regain your sense of control in addiction recovery.
Additional Information
- What Happens When You Stop Drinking: A Timeline
- How Long Does It Take to Detox From Fentanyl?
- What Do I Do After a Relapse?
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