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What to Know About Post-Acute
Withdrawal Syndrome (PAWS)

Post-Acute Withdrawal Syndrome (PAWS) can happen to anyone transitioning into recovery. One of the most dangerous things about this syndrome is that individuals affected by it have an inclination to relapse.

This is because a fair amount of symptoms tend to be difficult for people to overcome, especially in high-stress situations. And people in high-stress situations generally fall back to previously reliable coping mechanisms like substance use. But what exactly is PAWS and what are these relapse-inducing symptoms? Let’s explore the term.

What is PAWS?

Post-Acute Withdrawal Syndrome or PAWS refers to symptoms of intoxication that can persist for weeks or even months after abstaining from substance use. PAWS is also synonymous with post-withdrawal syndrome, prolonged withdrawal syndrome, or protracted withdrawal syndrome. This condition is characterized by symptoms that present similarly to mood disorders and anxiety disorders. PAWS symptoms develop after a period of withdrawal from alcohol, benzodiazepines, and opioids, but are occasionally seen in withdrawal from other psychoactive substances. Research estimates that 90 percent of recovering opioid users experience PAWS as well as 75 percent of recovering alcohol and benzodiazepine users.

Signs and Symptoms

PAWS symptoms tend to fluctuate in severity based on the length of sobriety achieved and the amount of stress stimulus an individual may be under. Symptoms may even disappear entirely only to reappear later with no apparent trigger. Some common symptoms include:

  • Difficulty with cognitive tasks, such as problem-solving or memory recall
  • Irritability
  • Feelings of anxiety or panic
  • Depression
  • Obsessive-compulsive behaviors
  • Difficulty maintaining social relationships
  • Craving originally used substances
  • Apathy or pessimism
  • Disturbances in sleep patterns
  • Increased sensitivity to stress

Again, these symptoms may come and go over time with some cases even developing chronic life-long symptoms. However, in most cases, symptoms usually last a couple of days at most depending on the severity of the addiction. In a typical case of addiction, it may take anywhere from 6 months to 2 years for the brain to begin naturally producing endorphins and dopamine again.

Treatment for Post-Acute Withdrawal Syndrome

Treatment for PAWS tends to stretch over an extended period of time due to the unpredictable fluctuating in symptoms. Some treatments may last up to two years, again, depending on the severity of the addiction. Acamprosate has been found to be effective in managing some PAWS symptoms, though it’s not a cure-all. The most effective treatment options generally include psychotherapy in the form of behavioral therapy, group therapy, or a combination of the two. In therapy, patients learn valuable coping skills to manage symptoms and gain support from individuals with shared experiences. 

Some coping strategies include:

  • Journaling to document experiences and identify triggers
  • Disrupt cyclical thinking by doing something different (go for a walk, draw a picture, talk to a friend)
  • Practice healthy habits like exercising, eating right, and avoiding known triggers
  • If your memory has been affected by PAWS write things down as soon as they come into your mind
  • If you’re experiencing insomnia, limit caffeine intake, set up a sleep schedule, and refrain from doing wakeful activities in your bedroom.

Detox With Briarwood

Briarwood Detox Center offers detox treatment for alcohol, opioid, methamphetamine, prescription drugs, and much more. Our experienced clinical staff provides round-the-clock monitoring throughout the detox process and our therapy team provides support to help manage the emotional response to treatment. Additionally, we have detox facilities located in Austin, Houston, and Colorado Springs with state-of-the-art amenities.

Briarwood is dedicated to facilitating a healthy and safe environment that empowers people to make significant and lasting changes in their lives. We look forward to supporting you or your loved one on the journey to recovery. Call (512) 277 – 3103 today for more information on our programs and admission process.

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