What Is Post-Acute Withdrawal Syndrome?

post-acute withdrawal syndrome

What Is Post-Acute Withdrawal Syndrome?

People who have developed a long-term addiction to drugs or alcohol experience unpleasant withdrawal symptoms when they quit using, including nausea, chills, vomiting, body aches, insomnia, mood swings and even hallucinations. Although these symptoms can be uncomfortable, they seldom last longer than two to three weeks, especially when a team of medical professionals supervises the detoxification process.

While the initial phase of drug and alcohol withdrawal is short-lived, some drugs can lead to persistent withdrawal that may last up to a year – a condition known as post-acute withdrawal syndrome (PAWS). You are more likely to develop PAWS if you consumed a large amount of drugs and alcohol for a long time.

What Makes PAWS So Challenging?

Although post-acute withdrawal rarely involves the painful and occasionally harsh physical symptoms associated with ridding the body and mind of chemicals, they can still be just as intense as acute withdrawal, putting you at a greater risk of relapse as you attempt to stop the discomfort.

PAWS refers to a set of psychological and mood-related symptoms that persist after the initial acute withdrawal period has ended, including depression, anxiety, paranoia, fatigue, irritability, trouble concentrating and loss of interest in formerly pleasurable abilities. These issues can be unpredictable, as they appear cyclically. Each episode can last up to a few days. Though PAWS can manifest in people who have used any intoxicant, it is most common after ceasing to use the following drugs:

  • Alcohol
  • Benzodiazepines
  • Opioids
  • Stimulants
  • Antidepressants
  • Marijuana

What Causes PAWS?

Like addiction itself, PAWS is a complex condition with many causes. The medical community has not reached a consensus on reasons why recovering addicts experience PAWS – and, in fact, PAWS is not currently an official medical diagnosis – many addiction experts suggest the chemical changes addiction causes in the brain over time may contribute to the development of PAWS.

Prolonged drug and alcohol use affects the reward and pleasure center in your brain, specifically the way your neurons can send and receive specialized chemicals called neurotransmitters. When you cease using these substances, your brain can no longer reach equilibrium on its own, which can result in the mood swings, cravings, anxiety and other psychological symptoms that are hallmarks of PAWS.

Habit is another reason PAWS may manifest in recovering addicts. When you have allowed drugs and alcohol to assume an outsized role in your life, it can be difficult for you to fill that void and make sense of your new sober lifestyle. The loss of tradition and the feeling as if you have too much time on your hands may enhance a psychological response such as depression, exhaustion or cravings.

Treating PAWS

The growing concern about the prolonged experience of withdrawal has led to many professionals in the addiction community calling for a more thorough investigation of what causes PAWS and how to treat it.

However, because PAWS symptoms are primarily emotional and mood-related, ongoing support from a therapist or counselor is essential in helping reduce the intensity of the experience and teach you to avoid triggers that may put you at increased risk of a relapse. During individual or group therapy, you can also learn healthy ways to work through your feelings and assess any co-occurring disorders that might be at the root of your addiction.

Your Recovery Begins With Detox

Are you struggling with drug and alcohol abuse and are concerned that you might experience PAWS as part of your recovery process? You can reduce your chances by undergoing professional detox, followed by enrolling in an accredited rehab facility and arranging to receive ongoing support and treatment in the years after your initial substance abuse treatment has ended. Start by contacting our admissions team today.

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