Home » Blog » Symptoms of Post Acute Withdrawal Syndrome

Symptoms of Post Acute Withdrawal Syndrome

Detoxing from alcohol and addictive substances should be done under medical supervision because acute withdrawal can cause more dangerous and life threatening complications. It is generally accepted that withdrawal from alcohol or other drugs can range from physical discomfort to life-threatening conditions. But, in some cases, individuals can develop post acute withdrawal syndrome symptoms.

When a person stops using alcohol or other addictive substances after an extended period of use, there is the potential for acute withdrawal. Symptoms of acute withdrawal include:

  • Muscle aches
  • Nausea
  • Headache
  • Tachycardia (or increased heart rate)

Following this initial detox, a person may experience a second phase of symptoms that involve more of the psychological and mood-related aspects of withdrawal. These symptoms once again puts a person at risk of relapse as they may return to drug or alcohol use to try and stop the uncomfortable withdrawal symptoms.  When someone is in early recovery from alcohol or other substance use, they may experience lingering effects of drug and alcohol withdrawal.  Withdrawal can occur in two phases: acute withdrawal (commonly known as detox) and Post-Acute Withdrawal Syndrome (PAWS). 

What is Post Acute Withdrawal Syndrome (PAWS)?

Post-Acute-Withdrawal Syndrome (PAWS) is a group of withdrawal symptoms that persist after acute withdrawal symptoms have subsided. This condition can seriously challenge sobriety. Post acute withdrawal syndrome symptoms may be mildly unpleasant or seriously uncomfortable, but either way they put a person at a higher risk of relapse because a person in early recovery may resort to taking the drug or drinking in order to get rid of the withdrawal symptoms. Recovery from PAWS usually takes somewhere between six and 24 months and it is important to manage expectations accordingly.

What Are the Symptoms of Post Acute Withdrawal Syndrome (PAWS)?

This occurs because the brain is trying to recover from the effects of active addiction and reset itself. PAWS occurs most commonly and intensely when a person has abused alcohol, benzodiazepines, heroin or medically prescribed opioid pain medications for an extended amount of time. As such, the withdrawal symptoms of PAWS are often the opposite of the effects of the drugs abused as the brain tries to recalibrate itself to correct the chemical imbalances associated with active drug or alcohol addiction. It is important for a person in early recovery to know that these symptoms are temporary and unlike an underlying mood or anxiety disorder, will happen less often and fade as time passes and the brain has a chance to recalibrate.

Common symptoms of PAWS include:

  • Inability to focus
  • Short term memory problems
  • Depression 
  • Mood swings
  • Emotional overreaction or emotional numbness
  • Irritability and hostility
  • Overwhelming fatigue
  • Issues with fine motor skills
  • Lack of coordination
  • Anxiety or panic attacks
  • Sensitivity to stressful situations
  • Insomnia or vivid dreams leading to difficulty sleeping
  • Cravings
  • Decreased libido

Unlike acute withdrawal symptoms, PAWS symptoms can last from 3 months to multiple years, which can be very discouraging to a person in early recovery. It is important to recognize these signs and symptoms and to be aware of this second phase of withdrawal because it can catch people in early recovery off guard and result in relapse if not addressed. 

In general, people who are older in age, have used drugs or drank alcohol for years or decades, have existing renal or liver damage may be more susceptible to developing PAWS and to have it last longer. The symptoms of PAWS may not be persistent and consistent and instead may be more cyclical in nature and happen in unexpected waves. While it isn’t possible to prevent PAWS from happening, it is possible to manage the symptoms to help a person feel better physically and emotionally, and to help reduce the risk of relapse. It is also helpful to be aware that PAWS symptoms are often triggered by stress or by situations that remind the person of past usage.

It is important to consult a physician if symptoms become extreme or dangerous and if you have thoughts of suicide or hurting yourself or someone else.

How to Cope With and Manage Symptoms of PAWS

While most symptoms of PAWS can last for a few days at a time, it can take the brain anywhere from 3 months to several years to reset itself after active addiction. Some practice ways to cope and manage with symptoms and PAWS:

  • Find support:
    • Support in the form of professional psychiatric and psychological care will be important to learn and understand symptoms, develop coping strategies and process the difficult emotions associated with PAWS
    • Support in fellowships and other support groups are also important to develop a network of others in recovery who may have experienced similar withdrawal symptoms in the past
    • Talking about PAWS symptoms and experiences 
  • Self care:
    • Often in active addiction people forget to practice basic self care. Early recovery is a time to develop healthy habits: eating well, incorporating exercise, establishing supportive relationships, meditation, journaling
  • Manage symptoms:
    • Being prepared and knowledgeable about the symptoms of PAWS can be helpful because a person can adjust their expectations accordingly. For example, a person can warn their family and friends about possible symptoms so that they can help them with short term memory, stressful situations, sleep disturbances etc.
    • If a person in early recovery understands what the symptoms are, they are in a better position to manage them. Successful management of alcohol or drug withdrawal symptoms will help a person in early recovery feel better physically and emotionally, improving their self-esteem, and reducing the risk of relapse.

Drug and Alcohol Rehab in Nashville

If you or a loved one is struggling with PAWS in addiction recovery or may be in need of substance use disorder treatment, Detox Nashville can help. Our trained professionals will walk you through the admissions process and make sure all of your questions are answered. The first step is admitting you need help, and is often the hardest. Once you take that first step, there will be a team on your side to help you be successful in your new future.

24/7 Help Is Standing By, Call Us Now.

24/7 Help Is Standing By, Call Us Now.