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Post Acute Withdrawal Syndrome: Symptoms and Solutions

Getting Past PAWS

You’ve cleared the hurdle of physical detox. Now what?

Physical substance abuse withdrawal is just the first part of a long recovery process. When you stop a drug addiction, the effects of your body’s physical detox are uncomfortable at best, and life threatening at worst. This phase is known as post acute withdrawal syndrome, and can last for one to three weeks depending on the individual, the substance he or she was using, quantities and frequency of use, and the length of the addiction. Post acute withdrawal symptom is typically flagged as the largest hurdle for addicts to clear in the course of early recovery, and ideally entails medical supervision.

“Sometimes the hurdles aren’t really hurdles at all. They’re welcome challenges, tests.”

Paul Walker

And it all goes up from there, right?

Actually, post acute withdrawal syndrome (PAWS) is a more overlooked part of recovery. PAWS refers to the emotional and psychological effects of quitting alcohol or drugs as your brain and body adjust to a natural chemical balance without the substance they were dependent on. Normalizing to a healthier, albeit unfamiliar, equilibrium can be a long, taxing process for the body. It can be a confusing deterrent in recovery for those who aren’t prepared for it, or think it’s abnormal.

PAWS is known to come in episodes that can be brief—as short as a few minutes—or last up to several days. It’s not necessarily triggered by anything external. It’s important to understand that the initial detox from drugs or alcohol might not be the only obstacle to face, although it’s the most uncomfortable physically. When those in recovery start to experience PAWS symptoms, they might get discouraged and become more vulnerable to relapse. Why stay clean and sober if you don’t feel better? Education and awareness can help you understand what to expect and how to cope with the ups and downs that come with prolonged substance abuse withdrawal in order to get on the other side of it.

PAWS can manifest in a variety of ways, including:

  • Trouble sleeping

Addicts in their first two years of recovery may experience PAWS in the form of difficulty falling, or staying, asleep. Restlessness, even when tired, tends to fuel racing thoughts and feelings of anxiety. Irregularity in sleep patterns may ensue for months to years of recovery. Vivid dreams, or nightmares, are also a form of PAWS.

  • Mood swings and irritability

Even individuals with no history of irregular mood swings, bipolar disorder or other mental illness can experience rapid changes in mood with no apparent trigger. Gradually, these episodes become fewer and farther between. It’s important to see a healthcare professional to either rule out or address an undiagnosed condition, which often contributes to drug addiction in the first place.

  • Depression

Individuals suffering from PAWS may find themselves feeling depressed, consistently or in sudden spurts. Anhedonia, or the inability to experience pleasure, and suicidal thoughts also fall under the PAWS umbrella. Withdrawal symptoms may include losing interest in basic activities like eating, showering, socializing and more.

  • Lack of motivation

Addicts in recovery who don’t feel all of the signs of depression may instead just feel unambitious to face tasks, large or small. Indifference, low or fluctuating energy levels, and antipathy to things you used to enjoy often characterize PAWS.

  • Difficulty focusing

Trouble concentrating can be frustrating for recovering individuals who are trying to rejoin the work force, go back to school or simply interact with society, family and friends. Brain fog, absent-mindedness and difficulty remembering things are all associated with PAWS.

  • Anxiety and amplified responses to stress

Stress, whether it stems from memories of using, social situations, finances—you name it—can feel like more of a burden in early recovery from drug addiction. Anxiety may crop up and give way to panic attacks, even if you’ve never had them before.

  • Poor balance and coordination

Whether it’s missing the trashcan or taking a misstep more than a few times in a day, PAWS can make you feel clumsy and uncoordinated. Even athletic individuals tend to take longer to get back on their feet. It’s important to remember to take it easy on yourself and give your mind and body ample time to relax and gradually improve its coordination.

  • Thoughts of using

Sometimes known as the “pink cloud” phase, recovering addicts with a few months of clean time sometimes feel like they’re on top of the world. Don’t be disappointed if your thoughts take unexpected twists and turns, or you begin to develop cravings after a period of feeling great. Being prepared, honest and open if you find yourself fixated on using all of the sudden is the key to getting on the other side of those thoughts.

  • Increased sensitivity

Your body is more sensitive than it was while you were using, and sometimes you can get so engulfed in an emotion that it’s hard to think clearly. In fact, your body is also more physically sensitive in early recovery. Individuals tend to have lower pain thresholds. Keep in mind that your body’s extreme sensitivity needs to be treated with care and patience.

  • Magnified emotions

Happiness, sadness, anger, fear and the like can all feel more intense. You may find yourself acting out in ways that you never have before (for example, crying or becoming confrontational with others), or feeling a greater range of emotions than you did before.

What Can I Do About My Post Acute Withdrawal Syndrome?

It’s best to prepare yourself for the emotional rollercoaster that PAWS can put you on while you navigate through early recovery. Understanding PAWS, and knowing that it’s only temporary, helps you bypass the discouragement and confusion during substance abuse withdrawal that can make you more vulnerable to relapse. An easy mantra is to remind yourself to PAUSE when you notice PAWS crop up. Pause to recognize what’s happening before acting out, and turn to a positive influence for help.

Some tips for coping with PAWS include:

  • Devoting time to your self-care routine (proper nutrition, adequate rest, hygiene and exercise)
  • Building your recovery network and leaning on others who can relate to what you’re going through
  • Finding a hobby
  • Keeping things in perspective
  • Reminding yourself not to rush the delicate process of recovery, which comes with a unique set of growing pains for each individual

On the Other Side of PAWS

You may be thinking, ”Oh great. Now I have even more tough time to go through to stay sober. What’s the use?” Those of us who are sober today have thought the same thing. While the symptoms of PAWS may seem daunting, remember that they will pass. Once you make it through this, there can be a great feeling of release. There is a feeling of peace and calm that comes with recovery. Your health will return. Your relationships will heal. You can feel useful and alive. All this, and more, will come to you if you just hold on and trust the process.

Recovery from drug addiction and alcoholism takes time, consistency and diligence. Ventura Recovery Center offers long-term treatment plans that will see you through.

We understand, and we’re here to help. Call now: 800-247-6111.

The process may be difficult at first, but the results will be beautiful.

Post Acute Withdrawal Syndrome: Symptoms and Solutions
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Post Acute Withdrawal Syndrome: Symptoms and Solutions
PAWS is a temporary adjustment period immediately following drug or alcohol detoxification. Know the symptoms and how to get past this phase of recovery.
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Ventura Recovery Center
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