What is Post-Acute Withdrawal Syndrome (PAWS)?

woman suffering from PAWS

When it comes to drug and alcohol withdrawal and detox, no two experiences are alike. There are several factors that will influence a person’s withdrawal experience, therefore, it’s impossible to predict exactly what symptoms a person will experience or how long the entire process will take.

In some cases, a person may experience what’s known as post-acute withdrawal syndrome or PAWS. This may result in more severe psychological or emotional effects that last much longer than the initial physical effects a person may experience while in detox.

The Two Stages of Withdrawal

When a person suddenly reduces or stops the long-term abuse of a drug, he or she will experience certain physical symptoms. These symptoms are known as withdrawal.1 The symptoms of withdrawal can last for several days or weeks, depending on several different factors, but they can be treated with medication to reduce discomfort.

There are two main stages of drug and alcohol withdrawal: acute and post-acute.2

  • Acute: The acute stage of withdrawal is the first stage. It typically lasts several days to a few weeks. It’s impossible to say exactly how long this first stage will last or what types of symptoms a person will experience during this time, as every person and drug is different.
  • Post-acute withdrawal: The post-acute stage of withdrawal is the second stage. During this time, a person won’t experience as many physical symptoms, but the psychological symptoms will increase as the brain gradually adjusts to changes.

The second stage of withdrawal, known as post-acute withdrawal, can last anywhere from several months to several years. This may increase a person’s risk of relapse, even after completing a detox program.

Factors that Influence Withdrawal Symptoms

There are many different factors that will influence a person’s withdrawal experience during drug and alcohol detox. Depending on the factors listed below, a person may experience a variety of different physical and psychological symptoms during withdrawal in varying levels of intensity.

  • Drug abuse history
  • Family history/genetics
  • Physical and psychological health
  • Tolerance
  • Type of drug(s) abused
  • Method of drug abuse
  • Type of detox used (cold turkey, medicated, tapered, etc.)

Symptoms of Post-Acute Withdrawal Syndrome

As mentioned above, the physical symptoms during the acute phase of drug withdrawal will vary greatly from person to person. However, during the post-acute withdrawal stage, most people will experience the same types of psychological symptoms. These symptoms most often include:

  • Mood swings
  • Cognitive impairment
  • Drug cravings
  • Depression
  • Fatigue
  • Anxiety
  • Low threshold for stress
  • Insomnia/sleep disturbances
  • Irritability
  • Anhedonia (problems experiencing pleasure)

Not every person who completes a drug or alcohol detox program will experience PAWS, but some will. Due to a lack of scientific research, the syndrome is not recognized in the Diagnostic and Statistical Manual of Mental Disorders, but many people in recovery have reported experiencing these symptoms for months and years after completing detox and rehab programs.3

The Dangers of Post-Acute Withdrawal Syndrome

The symptoms of post-acute withdrawal syndrome can be threatening for a person’s recovery for many reasons.

  • A person may give up on their recovery because the symptoms of PAWS make a life of sobriety seem very unsatisfying.
  • A person may view unpleasant PAWS symptoms as a justified reason to relapse.
  • A person may begin substituting other addictive behaviors such as unhealthy amounts of exercise or shopping to cope with unpleasant PAWS symptoms.
  • A person might continue with the same negative and harmful behaviors despite their ongoing abstinence from drugs and alcohol.

Medically-Assisted Detox: A Safe and Comfortable Detox Experience

At Briarwood Detox, we provide safe medically-assisted detox programs for all types of addictive substances. Our professional team of medical and clinical experts is experienced in treating all kinds of symptoms and phases of drug and alcohol withdrawal.

If you complete a detox program at Briarwood, our medical team will ensure your safety and comfort throughout the acute stage of withdrawal. During detox, you will attend individual and group therapy sessions (as you are able) to help you cope with the psychological changes that accompany drug withdrawal.

If your psychological symptoms continue and worsen upon completion of your program, our staff can provide professional recommendations for ongoing treatment to help you cope with the mental stressors of detox and withdrawal.

Unpleasant PAWS symptoms don’t have to keep you from reaching your full potential in a life of recovery. Contact Briarwood Detox Center today to learn more about our medically-assisted detox programs and the services and assistance we can provide upon completion of your program.


  1. https://www.drugabuse.gov/faqs#withdrawal
  2. https://www.addictionsandrecovery.org/post-acute-withdrawal.htm
  3. https://en.wikipedia.org/wiki/Post-acute-withdrawal_syndrome

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