What Is Post-Acute Withdrawal Syndrome (PAWS)?

When you quit substances, your brain initiates numerous internal processes. It needs time to get rid of toxins and to adjust to living without the negative pressure. The first process you face is withdrawal. It is the body’s instant reaction to the absence of the substance, accompanied by specific physical and emotional symptoms. One of them is post-acute withdrawal syndrome. It can appear suddenly, even after weeks of stability. Despite its discouraging character, it is a natural period of your healing. Keep reading to learn more about PAWS and how long it lasts.

Explaining the Post-Acute Withdrawal Syndrome

The abstinence phase is a period when the human organism relearns to function without chemicals. It has three stages: acute withdrawal, protracted withdrawal with possible post-acute withdrawal syndrome, and stabilization.

Acute withdrawal is the initial phase, which requires medical care for severe cases. It has intense physical signs and spans from a couple of days to weeks. Then comes protracted withdrawal. During this period, physical symptoms usually subside, but individuals may become emotionally unstable. It is because our brain demands more time to restore itself compared to the body. Our psychological state becomes similar to a roller coaster with unpredictable ups and downs. Such lingering effects are termed post-acute withdrawal syndrome. It’s like a turbulence zone, and one should seek proper guidance and support, not to lose faith in reaching lasting sobriety.

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Common PAWS Symptoms

PAWS primarily affects the brain and emotional state. Many patients note that it is more difficult than going through the acute withdrawal when you feel completely drained.

You might face:

• Sudden anger or frustration over minor stress situations.
• Persistent nervousness.
• Difficulty staying productive.
• Insomnia, interrupted sleep, or nightmares.
• Problems with concentration and memory lapses.
• Ongoing desire to intake drugs despite awareness of harm.
• Feeling completely tired all the time.

Post-acute withdrawal symptoms tend to fluctuate in intensity, and not everyone experiences all of them. Nevertheless, sleep disorders (when you cannot fall asleep or stay asleep) are the most frequently occurring issue, and many patients complain of restless nights.

Why PAWS Happens After You Quit

After taking drugs or alcohol for a long time, your brain’s chemistry changes. When the substance is removed, neurotransmitters, stress hormones, and sleep cycles need time to rebalance. Mood swings, irritability, and other manifestations are natural reactions to this. They aren’t signs of weakness and mean your body is slowly healing.

Following all specialists’ instructions will allow us to mitigate the reactions, but not escape such a condition. All you have to do to alleviate the process is to complete medical detox, avoid extreme stress situations, and join outpatient treatment programs.

How Long Does This Syndrome Last?

The timeframe of post-acute withdrawal syndrome varies. The kind of substance used, overall health, and individual reactions significantly impact its duration. Most often, PAWS lasts for several months. The peak of symptoms is in the first weeks after the end of acute withdrawal.

Types of PAWS and their durations differ depending on addiction type:

• Benzodiazepine dependence: This PAWS is referred to as the most difficult and prolonged. Its signs can persist for over a year due to the drug’s strong impact on the receptors and long-term chemical imbalances. Such patients feel emotional instability, sleep disorders, and panic attacks much more strongly compared to others.
• Alcohol issues: In the case of AUD, post-acute withdrawal syndrome typically lasts several weeks to half a year. Among the complaints are uncontrolled anxiety, irritability, fatigue, insomnia, and low motivation.
• Opioid addiction: Individuals recovering from opioid use disorder may experience PAWS for six months or longer. Even after rehab programs, cravings may persist. This creates a heightened risk of relapse without using proper coping strategies.

As practices show, PAWS doesn’t follow a linear timeline. Symptoms fluctuate, appearing stronger some days and milder on others. Realizing the nature of the syndrome helps individuals to stay patient and try different methods to minimize the risk of relapse.

Why Do Many People Relapse during PAWS?

When acute withdrawal finishes, patients begin to believe the hardest part is behind them and overlook the next stages. Post-acute withdrawal symptoms are difficult to manage and control. They emerge unexpectedly. During this period, mood and emotions are unstable, and if a person struggles to manage their feelings, the risk of relapse increases.

Statistically, every patient has at least one setback, and specialists say it is normal during recovery. These moments don’t mean failure. You should consider them as learning opportunities, revise and redirect your treatment plan, and focus on highlighted bottlenecks. Reflecting on what triggered the setback helps identify weak points in coping strategies or daily routines. Seeking additional support or a sober living environment allows one to strengthen emotional resilience and reduce the likelihood of future slips. Even such a difficult experience brings valuable insight, moving you closer to lasting sobriety.

Treatment Options for PAWS

There is no pill to treat post-acute withdrawal syndrome overnight. You can feel discouraged and even lose motivation, but it is a manageable state with the proper guidance and coping skills. Below are the main and time-tested approaches helping individuals cope effectively.

Medication Support

When facing post-acute withdrawal syndrome, medications are not necessary for everyone and are used only as a supportive tool to relieve some conditions. If needed, doctors may prescribe:

• pills to manage insomnia
• antidepressants to stabilize mood
• anti-anxiety medications to reduce growing nervousness.

In some cases, mood stabilizers that regulate neurotransmitters help the brain recover faster without swing effects on your condition.

It’s essential to remember: all medication should be taken according to the medical prescription. The goal is not to replace one dependency with another but to support recovery safely and temporarily, as part of a broader treatment plan.

Various Types of Therapy

For PAWS, Cognitive Behavioural Therapy (CBT) is a main element of the treatment plan. Your sessions will be focused on helping you to recognize negative thinking and behaviour patterns, and replacing them with healthier coping mechanisms. The goal of your mentor is to teach you how to solve problems without returning to substances. Also, you will try various emotional regulation techniques to make it easier to cope with conflicts and triggers.

To achieve better results, CBT sessions may be supplemented with motivational interviewing. It aims to overcome feelings of shame and guilt and find inner motivation to move forward. For those with a history of trauma or co-occurring disorders, Dialectical Behavior Therapy (DBT) can provide additional emotional stability and self-awareness.

To sum up, specialists have a variety of methods to help you. All you need is to be honest and work hard. Therapy and consistent self-improvement make it possible to cope even with long-term withdrawal effects.

Stress Control

Stress intensifies all symptoms. It easily disrupts your inner balance and triggers post-acute withdrawal syndrome flare-ups, which is why stress control is crucial. Try guided meditation, deep breathing exercises, and progressive muscle relaxation to calm your nervous system and lower anxiety.

Mindfulness is a popular method to reduce stress and improve mental well-being. It teaches how to keep your feelings under control and prevent impulsive reactions or cravings.

Also, it is recommended to increase physical activity, take strolls, and spend time outdoors. New hobbies, especially drawing, empower you to shift focus from obsessive thoughts and process emotions in a healthy way.

Struggling with addiction?

Recovering is a long and challenging process, but you don’t have to be alone. We are here to guide you and offer a safe and substance-free environment to regain control of your life and create a new path for your future.

Bottom Line

Substance abuse treatment consists of several periods, and all of them are challenging. Post-acute withdrawal syndrome affects emotional regulation. Its symptoms may feel like a roller coaster, testing both patience and inner strength. To go through this stage, you need to have a well-structured daily routine, an experienced mentor by your side, and a safe environment. Communicating with people who understand the challenges of recovery empowers motivation.

Eco Sober is a perfect place to stay on track. We provide a substance-free living space for those who battle alcohol or drug addiction. Our facility is MAS-certified, ensuring that accommodation is safe and meets the highest benchmarks. If you need a place for transitional living, schedule a meeting with our facility manager to see the rooms and explore our rules.