Post-Acute Withdrawal Syndrome (PAWS) is one of the most challenging and misunderstood aspects of addiction recovery. While the acute withdrawal phase—those intense and often debilitating symptoms that come when someone first stops using drugs or alcohol—may pass within days or weeks, PAWS can linger for months, even years. The symptoms are subtle but can profoundly affect a person’s mental and emotional well-being, making it difficult to sustain long-term recovery.
The first step to dealing with PAWS is to understand it. We’ll explore what PAWS is, how it manifests, and why understanding this phase is crucial for both individuals in recovery and their support systems. If you or someone you know is navigating the post-withdrawal journey, this post will shed light on what to expect and how to cope.
PAWS in a Nutshell
Those in recovery often deem the withdrawal phase as the most challenging phase in recovery. The withdrawal journey consists of two stages. The first phase is where the individual experiences acute withdrawal symptoms that occur while detoxing from highly addictive substances. While this phase can be mentally challenging, it is full of physical withdrawal symptoms and tends to last a few weeks.
The second phase is when PAWS kicks in. PAWS primarily involves emotional and psychological symptoms, with physical symptoms generally subsiding over time.
A range of addictive substances can trigger PAWS during recovery. For instance, studies show that about 90% of individuals recovering from opioid addiction experience some form of PAWS, as do 75% of those recovering from alcohol or psychotropic drug abuse.
The Symptoms
People often feel out of kilter when experiencing PAWS. They may even think something is wrong with them. Even after working so hard toward healing, moments of pride and progress can feel fleeting in the PAWS phase, overshadowed by the relentless return of physical and emotional turmoil.
Despite best efforts to nurture the body and resist cravings, temptations, and other lingering obstacles, recovery can feel like an uphill battle. The mental challenges posed by PAWS can take a toll on the body, too.
Those experiencing PAWS might face:
- Sleepless nights, robbing them of rest
- A stubborn loss of appetite, even as their body craves nourishment
- A crushing fatigue that saps their energy
- A clouded mind, struggling to focus or stay present
PAWS can bring with it dark waves of depression, a sense of emotional numbness, a drastic dip in libido, and even the haunting pull of suicidal thoughts. Impulse control can become fragile, and mood swings are both unpredictable and extreme.
Perhaps the cruelest part of it all? PAWS doesn’t follow a clear timeline. There’s no precise beginning or end, just a constant ebb and flow of recovery that can leave people feeling lost.
Why Does PAWS Happen?
Fully understanding the cause of PAWS requires fully understanding the complexity of the human brain, which is impossible. However, we do know that PAWS occurs due to changes in the brain when severe addiction is present.
Drug addiction affects every facet of the brain, changing available neurotransmitters and causing the brain to alter to accommodate such changes. When a severely addicted person stops taking their addictive substance, the neurotransmitters change back, creating excitability.
Long-term substance use can rewire the brain’s ability to handle stress, weakening its natural coping mechanisms. Withdrawal further compounds this, intensifying the brain’s struggle to manage stress effectively.
Researchers believe these physical alterations are behind the persistent symptoms of PAWS. They also suggest that the same changes contribute to the rising tolerance that occurs during active substance use as the brain adapts to the constant presence of the substance.
How Long Can PAWS Last?
There’s no black-and-white answer for how long PAWS lasts. It’s different for each person in recovery. How long it sticks around usually correlates to how long and how much a person used the addictive substance.
On average, PAWS can last a couple of weeks and potentially last for months or years. PAWS symptoms are unpleasant and can continue even when every trace of the substance is gone from the body and brain.
Coping Strategies for PAWS
For many individuals in the trenches of recovery, PAWS is considered their “river of misery,” which is that temporary but highly challenging period where you’re struggling the most with whatever change or challenge you’re facing.
Dealing with PAWS during recovery can be irritating, crippling, and can take an extreme toll on your mental and physical health. However, you are stronger than you know. You can face PAWS and come out the other side stronger. Your recovery can start with your search for an “alcohol detox center near me.” The experienced staff at one of these centers can provide the structure and support you need to help you hold tightly to your sobriety, get through the river of misery, and become stronger on the other side.
Here are some helpful tips when in the throes of PAWS:
- Eat well
- Exercise often
- Practice patience with yourself
- Get eight hours of sleep at night
- Lean on your support system
- Seek professional help
PAWS is a common part of recovery, and though it may feel overwhelming in the moment, it’s actually a sign that you’re on the right path—you’re healing. While navigating through this painful and often traumatic phase can truly feel like the proverbial river of misery, it’s an essential part of breaking free from the addiction that has controlled your life and taken so much from you.
If recovery ever feels unbearable or you’re unsure where to begin, remember that help is always within reach at one of our addiction recovery centers in Bluffdale, Utah (or Boise/Heyburn, Idaho).