Post-Acute Withdrawal Syndrome

Don’t let the funny name fool you: Post-acute withdrawal syndrome (PAWS) affects many people in recovery. PAWS is more than what you experience during detox; rather, it builds upon that experience. Some common symptoms of PAWS can include a lack of energy, concentration or attention issues, memory problems, sleep issues, appetite problems, and mood fluctuation.1

It is not fully understood why PAWS is an issue for some people and not for others.Because of this, it can be troublesome for individuals who want to understand why PAWS is happening to them. Whether you’ve been using for years or if you’re fairly new to drug abuse and addiction, you’re at risk of PAWS. It can stem from hard substance abuse, smoking cigarettes or even regular binge drinking that allows dependence to form.

When Does PAWS Occur?

Man in detox by windowEven persistent use or abuse of drugs can leave you with PAWS. This condition occurs after the initial acute withdrawal period has passed, and it stems from the body’s reaction to the absence of the abused substances.

In many cases, the development of PAWS depends on what substance was abused and how long it takes to complete the first stage of withdrawal. For example, an alcoholic can detox in as little as a week’s time. He may find himself battling PAWS a week after that, but someone who is detoxing from painkillers might not develop PAWS until later if it fully detoxing takes weeks or months. PAWS typically happens one to two weeks after the first stage of withdrawal is over. Generally, the physical side effects of withdrawal will remain at bay;with PAWS, psychological effects and emotions can intensify which leads to discomfort.

However, PAWS can surface weeks or months after drug detox. This fact can be disheartening, but ignoring it will not make it go away. If you have PAWS, you may become very forgetful at times and have difficulty learning new things or retaining new information. Some people may have racing thoughts where you feel like your mind is all over the place. If you think you may have PAWS, please contact your doctor and discuss any changes you feel.

Treatment for PAWS

Doctor talking with patientA treatment approach that includes both detox and continued follow-up care is the best way to be a drug-free and sober individual. There is no official standard of treatment for post-acute withdrawal syndrome. Naltrexone and acamprosate are sometimes used to treat PAWS in alcoholics, but most of the knowledge we have about treating PAWS is still in its experimental stages.3

Approximately 2 million people in the United States aged 12 or older received substance use treatment in the past year according to the 2015 National Survey on Drug Use and Health.1 Anyone who has received treatment has just as much of a chance of developing PAWS as you do. If you think you may be struggling with PAWS, please know you are not alone. Help is available.

“I had to ask for help and get new information,” writes Anthony F. at Heroes in Recovery. If I would have known how to handle the situation, I probably would have done so. Reach out and ask for help.”

Michael’s House is a leader in treating addiction and coping with post-acute withdrawal syndrome. Here, you’ll meet people who will inspire you, and you’ll learn how to make the necessary changes in your life to ensure that addiction stays in the past while you walk into your future. Call today for more information.

1 Mager, Dan,  “Detoxing after Detox: The Perils of Post-Acute Withdrawal.” Psychology Today. 26 May 2015. Accessed 9 November 9 2017.

2 Swanson, Jeanene. “How to Isolate and Treat Protracted Withdrawal Symptoms.” The Fix, 14 February 2014. Accessed 9 November 9 2017.

3 Lipari, Rachel N., “America’s Need For And Receipt Of Substance Use Treatment In 2015.” Substance Abuse and Mental Health Services Administration. Accessed 9 November 9 2017.


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