Post-Acute Withdrawal Syndrome (PAWS) is a condition that can occur following the acute withdrawal phase from substances like alcohol, opioids, and benzodiazepines. While acute withdrawal typically lasts from a few days to a couple of weeks and involves immediate physical symptoms, PAWS manifests as lingering psychological and emotional symptoms that can persist for months or even years.
Symptoms of Post-Acute Withdrawal Syndrome are often characterized by multiple symptoms that can differ in intensity and duration depending upon a variety of factors.
Common symptoms include:
- Inability to sleep or sleep disturbances
- Feeling irritated and mood swings
- Anxiety and panic attacks
- Depression
- Fatigue and less energy
- Cravings for the drugs
- Cognitive problems, like trouble focusing and remembering things The brain’s attempt to rebalance following the chemical imbalances brought on by long-term substance use is what causes these symptoms.
Causes of Post-Acute Withdrawal Syndrome (PAWS)
When substance use stops, especially after acute withdrawal, the brain adjusts, resulting in the development of Post-Acute Withdrawal Syndrome (PAWS). The brain’s attempts to realign itself following the chemical imbalances brought about by active addiction are the main cause of the syndrome. Substances such as alcohol, opioids, and benzodiazepines change neurotransmitter levels during addiction, which causes dependence.
The brain finds it difficult to restore its natural balance when these substances are abruptly stopped, which leaves psychological and emotional symptoms that don’t go away. Numerous things, such as stress, environmental cues, and memories of previous substance use, can cause PAWS. People who have a history of heavy or prolonged substance use are more likely to develop PAWS.
Mood swings, anxiety, depression, sleep issues, and cognitive impairments are a few possible symptoms. In addition to being uncomfortable, these symptoms may raise the chance of relapse because people may turn to drugs once more in an attempt to ease their discomfort. Individual differences exist in the length and severity of PAWS symptoms, which frequently span several months to several years. This variation reflects the difficulty of recovery and the brain’s gradual return to normal functioning.
Management Strategies
Effective management of PAWS is essential for recovery.
Strategies include:
- Consult a healthcare professional: Before starting the detox, consult with a doctor and share your alcohol abuse history as well as other medical reports to avoid any complications in future and also to ensure if it’s the safest option for you along with that you also get medical consultation before starting your detox journey.
- Do not engage in negative self talk: Surround yourself with close friends and family members to help you support your journey, avoid triggering situations and influences that might make you relapse. Try reading out some affirmations or write it down on a wall to stay positive and motivated.
- Therapeutic interventions: Cognitive Behavioral Therapy (CBT) can alleviate and manage triggers along with emotional difficulties.
- Support groups: : Having the support of a family and friends can make the journey easy and comforting. There are many online support groups for people who can join groups anonymously.
- Lifestyle changes: Incorporate healthy lifestyle habits such as regular exercise, a balanced diet, and mindfulness practices to support your mental and physical health during recovery.
Understanding and addressing PAWS is crucial for individuals in recovery, as recognizing these symptoms as part of the healing process can help reduce the risk of relapse and promote sustained recovery.
Phases of PAWS
Post-Acute Withdrawal Syndrome (PAWS) usually opens up in three different stages: early stage, middle stage, and late stages, with symptoms persisting for a few months to a couple of years.
Duration and phases of PAWS Symptoms :
- Early Stage: The acute withdrawal phase, which lasts for a few days to two weeks, ends shortly before this phase starts. During the first few weeks of recovery, mood swings, anxiety, and sleep disturbances are examples of early PAWS symptoms. Although early symptoms can be severe, they frequently change in intensity.
- Middle Stage: This stage can last from many weeks to a couple of During this period, symptoms may become less recurrent but can still resurface suddenly. Some people may undergo continuous emotional challenges, like depression and irritability, along with some cognitive difficulties like trouble in concentrating.
- Late Stage: This stage can stretch out from a number of months up to two years or longer. Symptoms normally become less severe and occur less often.
Even so, some people may continue to have periodic episodes of PAWS symptoms.
Emotional and psychological health gradually improves as the brain continues to repair and realign. In general, acute withdrawal symptoms usually go away quite quickly, but post-acute withdrawal symptoms (PAWS) can linger and change over time. For this reason, it is crucial for those in recovery to be aware of and ready for these stages as part of their healing process.
