Post-Acute Withdrawal Syndrome: What Is It and How Is It Treated?

What Is Post-Acute Withdrawal Syndrome (PAWS)?

Recovering from drug or alcohol addiction is a long-term process. Even after detox and rehab, recovering addicts can experience something called Post-Acute Withdrawal Syndrome (PAWS), a group of psychological and emotional problems.

These symptoms are not physical, like the headache, cramping, and nausea associated with early withdrawal, but the impact can be so uncomfortable that a real risk of relapse is possible. Knowing the symptoms of PAWS and how to manage them will help ease the transition to successful recovery from addiction.

Symptoms of PAWS

Depending on how long you were using the substance you’ve given up, you can undergo varying degrees of discomfort from PAWS symptoms, which can include:

• Moodiness and irritability
• Anxiety and depression
• Trouble sleeping
• Brain fog: trouble thinking clearly and making decisions
• Memory problems
• Low energy
• Lack of interest in activities once enjoyed

Risk Factors for Post-Acute Withdrawal Syndrome

Many factors will affect whether and how intensely you will experience PAWS after your initial withdrawal is over. These can include:

• Time: The longer you abused your drug of choice, the more difficult your PAWS experience can be.
• Level of abuse: The frequency of drug use and its amount will impact your PAWS.
• Your emotional state: If emotional issues come up during your post-recovery, you may find yourself struggling with PAWS.
• Co-occurring trauma: If you are working through physical or sexual abuse experiences impacting your mental health, you may find PAWS more challenging.
• Support: Having a network of supportive friends and family will increase your chance of successfully coping with PAWS.

What Causes PAWS?

Because it is emotional rather than physical, PAWS has no apparent cause. Some researchers believe changes in the brain caused by addiction may affect the recovering addict’s susceptibility to PAWS, but no clear studies have established that.

Psychologists and physicians think some or all of these factors may cause it:

• Brain chemistry: Addiction changes brain chemistry and balances it differently. When you take away the addictive substance, the brain must change again. This process can alter mood swings, cause exhaustion, increase cravings, and enhance psychological problems.
• Physical readjustment: PAWS is not as physical as acute withdrawal, but if your body has had a drug for an extended time, the acute symptoms may continue for some time.
• Lack of support: If you quit cold-turkey and try to do it on your own, PAWS can be even more stressful. Without a strong support system, you can find yourself coping with profound mental and emotional stress that puts you at significant risk of relapse.

How to Treat the Symptoms of PAWS

Each person’s experience with PAWS will vary. One person may struggle with it for only a few weeks or months, while another may go through it for years. The syndrome also can come and go; you’ll think you’re over it, and then it will come back more strongly than ever.

As with rehab and immediate withdrawal, treatment of PAWS usually focuses on treating the symptoms. If you are experiencing mood swings, your doctor or counselor will help you find better coping mechanisms without relying on drugs. If you are undergoing treatment for any PAWS symptom, be sure to inform your physician or therapist of your substance disorder so it can be part of your treatment plan.

It’s important not to dismiss psychological or emotional disorders as merely being symptoms of PAWS. Drug withdrawal can make an existing condition worse, but the underlying disorder still needs to be managed as a legitimate problem rather than something you’ll get over with addiction recovery.

With awareness of PAWS and your individual risk to the symptoms, you can manage the syndrome and successfully overcome it. Treatment of PAWS is part of a long-term plan to help Muse Treatment clients manage their recovery and maintain long-term sobriety. For help on managing your recovery from drug or alcohol addiction, contact Muse Treatment at 800-426-1818 today.

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