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Post-Acute Withdrawal Syndrome


What Is Post-Acute Withdrawal Syndrome (PAWS)?

Post-acute withdrawal syndrome (PAWS) is a condition that recovering substance abusers experience during the first two years of sobriety. It involves a host of emotional and psychological conditions that occur as brain chemistry is returning to normal. PAWS can be responsible for a wide variety of symptoms that can include:

  • Sleep disturbances
  • Inability to concentrate
  • Fear and anxiety
  • Low enthusiasm, no initiative and low motivation
  • Mood swings
  • Chronic tiredness
  • Fuzzy thinking
  • Inability to manage stress
  • Irritability
  • Fluctuating energy levels
  • Feeling powerless over emotions
  • Cravings
  • Guilt feelings
  • Inability to feel pleasure
  • Problems in relationships and with other people

How Does Post-Acute Withdrawal Syndrome Feel?

In early sobriety, PAWS can feel unbearably intense and erratic. Emotions can go from one extreme to another in a matter of minutes. The good news is that the longer you are sober, the more the symptoms of PAWS will balance out. Good feelings will increase, grow stronger, and last longer. There will also be difficult feelings that may be very uncomfortable. Always remind yourself that, no matter what you’re feeling,“this too shall pass.”

Someone once said that “feelings aren’t facts.” This is a good thing to remember when emotional storms hit. If you can just hang on for a day or two, whatever you’re feeling will change into something else. As time passes, you’ll discover that all emotions, even the difficult ones, are just a collection of energies that constantly shift and change.

How Long Does PAWS Last?

On average, post-acute withdrawal syndrome lasts for about two years. It can also last much longer. The duration and severity of PAWS depends on the emotional maturity of the addict. The stronger the emotional development, the faster the progress. Addicts who started treating their emotions with substances as teenagers will be most challenged by emotions in sobriety. Sudden and intense feelings typical of PAWS can be quite unsettling for anyone who is just beginning to learn basic coping skills.

What’s The Best Way To Cope With Emotions?

Acceptance is an essential part of recovery, so don’t fight your feelings or try to change them. Instead, just ride the waves of emotion without judging them, attaching to them, acting on them, or allowing them to frighten you. Go with the flow, and remember that every emotion you feel is constantly subject to change.

Avoiding Relapse During Post-Acute Withdrawal Syndrome

Good feelings can predispose addicts to relapse just as easily as bad feelings. One of the best things you can do for yourself in recovery is to remember that emotions can seem real and feel awful. In truth, however, they are just fleeting and transitory states that have no real substance unless you give them power.

To protect against relapse, continue any aftercare you are receiving such as counseling and therapy. Attend 12-Step meetings often and get an AA or NA sponsor with whom to work the Steps.

When To Seek Help

If by the end of two years you still feel that you are getting slammed by PAWS, make an appointment with an addiction specialist. Many recovering addicts have psychological disorders that interfere with sobriety. Conditions like depression, panic disorder, and bipolar disorder can usually be treated with medications designed specifically to address these conditions.

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