What is Post-Acute Withdrawal?


Many people believe the misconception that, after we go through the process of withdrawal, we will return to a state of mental and physical normalcy. Unfortunately, after we go through detox, we still may face some uncomfortable symptoms for a longer period of time. Post-Acute Withdrawal Syndrome (PAWS) occurs after the acute stages of withdrawal and bring a variety of symptoms that can be similar to acute symptoms, but are generally milder and more manageable.

In a 2015 Psychology Today article, Don Mager explains, “Depending on the length and intensity of active addiction—that is, how frequently, how much, and for how long an individual has used mind- and mood-altering substances—this second phase can last for weeks or even months after someone has stopped using. This exquisite phenomenon is known as post-acute withdrawal (sometimes referred to as protracted withdrawal). Post-acute Withdrawal (PAW) is a constellation of often brutally uncomfortable symptoms that persist even after all physical traces of alcohol and other drugs have left the body and brain.” There is no exact timeline for how long PAWS will last. It is dependent upon how long, how frequently, and how much an individual was using during their addiction. The more intense our addiction was, the longer it may take for our brains and bodies to go through the process of healing.

Symptoms of PAWS include, but are not limited to, anxiety, panic, irritability, depression, lethargy, insomnia, and aggression. PAWS symptoms are particularly common in recovery from opiates, alcohol, and benzodiazepines, as these drugs create major changes in brain chemistry that require a longer period of time to heal. Mager explains, “In early abstinence, the brain’s stores of both endorphins and dopamine are severely depleted. Dopamine, the neurotransmitter that floods the brain during drug use to produce titanic highs, is also involved in the regulation of mood, and a certain amount of it is necessary in order to maintain a “normal” mood. The absence of enough dopamine creates a biochemically based depression. It can take four weeks to up to six months for the brain to naturally manufacture enough endorphins and dopamine to replenish its inventory of these vital brain chemicals.” Fortunately, the symptoms of Post-Acute Withdrawal Syndrome are entirely manageable with therapeutic techniques and do not require medical intervention, unlike acute withdrawal. Overtime, the discomfort of PAWS symptoms will gradually go away and we will feel mentally and physically healthier with each passing day.

Recovery is possible. You can achieve a happy, joyous, and free life in sobriety by making the decision to seek help now. The Lakehouse Recovery Center utilizes a variety of highly effective therapeutic techniques, including individual and group therapy, workshops, yoga, wellness, nutrition, and physical fitness to give you the best chance of achieving and maintaining sobriety. For information about individualized treatment options, please call today: (877) 762-3707


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