Post Acute Withdrawal Syndrome (PAWS)

Post Acute Withdrawal Syndrome (PAWS)

Medically Reviewed Are you or someone you love struggling with substance addiction and considering getting professional help? Then it’s time…

Are you or someone you love struggling with substance addiction and considering getting professional help? Then it’s time to recognize the challenges that may come up during the recovery process, like post acute withdrawal syndrome (PAWS). PAWS is a long-term condition that can affect people who have stopped using alcohol or drugs, and can cause significant suffering, particularly if untreated.

In this article, we’ll explore what post acute withdrawal syndrome is, the symptoms it causes, how long it lasts, and some tips on dealing with its effects. Understanding PAWS can help you or someone you care about make a successful recovery from addiction.

What Is Post Acute Withdrawal Syndrome?

Post Acute Withdrawal Syndrome (PAWS) is a time when you feel bad after you stop using drugs or alcohol. You might feel emotional and want to use drugs or alcohol again. PAWS happens after the first few days or weeks of withdrawal.

PAWS can happen when your brain's reward system has been damaged by drugs or alcohol. This can cause certain symptoms when you stop using them. PAWS can affect your body and mind and make it hard to stop using drugs or alcohol.

If you used drugs or alcohol for a long time, PAWS might be worse and last longer. Everyone feels PAWS differently. It's best to talk to a doctor about how to get better.

PAWS can happen after you stop using tobacco or prescription drugs too. When you make a plan to get better, think about what you used and how long you used it.

Read about: Substance Use, Abuse, and Chemical Dependency

Post Acute Withdrawal Symptoms

The symptoms of PAWS vary from person to person, but generally include physical, psychological, and cognitive side effects. These can range from mild to severe and may last for several months or even longer.

Physical Symptoms

Common physical symptoms include:

  • Insomnia
  • Fatigue
  • Headaches
  • Nausea
  • Sweating
  • Muscle aches

Psychological Symptoms

Psychologically speaking, you may experience:

  • Depression
  • Anxiety
  • Difficulty with concentration
  • Memory problems

Cognitive Symptoms

Cognitively, you may experience:

  • Issues with judgment
  • Inability to process information quickly
  • Difficulty making decisions efficiently

PAWS can also cause emotional issues, such as irritability, mood swings, and difficulty regulating emotions. This can make it difficult to engage in meaningful conversations or relationship building and can lead to isolation if left untreated.

Many people find themselves avoiding social situations due to fear or anxiety related to the side effects of PAWS. If you’re struggling with PAWS, it’s time to seek out supportive people who can provide an understanding and non-judgmental space for you during this time.

In addition to these symptoms, you may experience cravings for the substances you used before quitting. These cravings are often intense and can be very difficult to deal with on one’s own. Therefore, professional help is recommended if you are trying to overcome PAWS, as it can be a crucial part of the recovery process.

Causes And Risk Factors of Post Acute Withdrawal Syndrome (PAWS)

The exact causes of PAWS are not yet fully understood, but research suggests that it may be related to changes in the brain's chemistry and function. Prolonged substance abuse can cause significant damage to the brain, including alterations in neurotransmitter systems, which can lead to a range of physical and psychological symptoms.

Some of the known risk factors for developing PAWS include:

  • Using drugs or alcohol for an extended period
  • Heavy use of drugs or alcohol
  • Abruptly stopping drug or alcohol use
  • Previous history of withdrawal symptoms
  • Co-occurring mental health disorders

It’s important to note that not everyone who experiences substance withdrawal will develop PAWS. However, those who have abused substances for an extended period are more likely to experience these symptoms.

When Does Post-Acute Withdrawal Syndrome Occur?

Post-acute withdrawal syndrome (PAWS) occurs after the initial acute withdrawal period, which can last for a few days to several weeks depending on the substance used.

The symptoms of PAWS typically begin two or more weeks after the cessation of drug or alcohol use and can persist for months or even up to two years.

According to research, 90% of people who quit drinking experience PAWS, while 75% of individuals who stop using opioids and 50% of those who stop using benzodiazepines may experience this condition.

It's important to note that not everyone will experience PAWS, and those who do may have varying degrees of severity in their symptoms.

How Long Does Post-Acute Withdrawal Syndrome Last?

If you're wondering how long post-acute withdrawal syndrome (PAWS) lasts, it's different for everyone.

Usually, it lasts between 6 and 24 months after you stop using drugs. But if you've been using for a long time, your PAWS may be worse and last longer. Everyone's experience is different, so it's best to talk to a doctor about how to treat it.

During PAWS, you might want to use drugs again to feel better. But don't do it! Using drugs again can make your symptoms worse and last longer. It's important to stay strong and get support from doctors and people who care about you.

Can Post-Acute Withdrawal Syndrome (PAWS) Be Avoided?

Unfortunately, the answer is no. PAWS is a natural part of the recovery process for many people who have abused drugs or alcohol for an extended period. However, there are steps that can be taken to minimize the risk of experiencing these symptoms.

One way to reduce the likelihood of developing PAWS is to seek professional help when quitting drugs or alcohol. A medical detox program can provide support and guidance during the acute withdrawal phase, which may reduce the severity of symptoms during the post-acute phase.

Another way to potentially avoid PAWS is by engaging in healthy lifestyle habits, such as regular exercise, a balanced diet, and getting enough sleep. These practices can help support overall physical and mental health, which may mitigate some of the effects of substance abuse on the body and brain.

It's important to remember that everyone's experience with addiction and recovery is unique, so there's no foolproof way to prevent PAWS from occurring. However, taking proactive steps towards sobriety can improve your chances of success in long-term recovery.

Learn more: Alcohol Withdrawal: Symptoms, Treatment, and Prevention

Tips On Dealing With Post Acute Withdrawal Syndrome

In order to successfully manage PAWS, you must stay dedicated to your recovery plan and practice self-care on a regular basis. This includes eating healthy meals, getting plenty of restful sleep, exercising regularly, engaging in meaningful activities or conversations, and avoiding triggers or situations that may lead to a relapse.

These practices help to reduce the intensity of PAWS symptoms and make it easier for you to stay on track with your recovery. Make sure to reach out for professional help if needed–therapy or medication can be very helpful in managing the symptoms of PAWS.

Natural remedies

Natural remedies for PAWS can play an important role in helping you manage your symptoms and stay dedicated to your recovery plans. Some strategies that may be beneficial include: yoga or meditation, journaling, mindful eating, reducing stress levels through activities such as walking or listening to music, engaging in social activities with supportive people, and making sure to get regular exercise.

Proper nutrition

Focus on proper nutrition while managing the symptoms of PAWS. Eating a balanced diet that includes plenty of fruits and vegetables can help to reduce cravings and fatigue, while avoiding processed foods and refined carbohydrates can keep energy levels stable throughout the day. Staying hydrated and drinking herbal teas such as ginger or chamomile may be beneficial for calming anxiety and improving sleep quality.

Medication Assisted Treatment

Sometimes people use Medication Assisted Treatment (MAT) like methadone and buprenorphine when they are coming off opioids, to lessen the effects of PAWS. This can be tremendously effective, but you need to make sure that you are using these medications under the care of a professional. This cannot be overstated. Attempting to use MAT without professional guidance will likely mean that you will end up addicted to the MAT, and this can be just as harrowing as being addicted to street drugs.

Ultimately, it is down to what works best for you. Make a plan and stick to it. Remember that when you’re in the grips of PAWS it may feel like it’s going to last forever, but it will end.

Inpatient Residential Rehab

The absolute best advice you can get for dealing with PAWS is to make a solid start on recovery by going to an inpatient residential rehab. There is no better place to do this than Wellbrook Recovery. Our team knows exactly what to expect from PAWS, and will be able to give you the info you need to navigate successfully through it and out the other side, towards a long, happy and prosperous recovery.

Managing Triggers That May Lead To Relapse

Identifying and managing triggers is an important part of the recovery process, especially during the post-acute withdrawal phase. A trigger is anything that reminds you of using drugs or alcohol, such as a certain place, person, or activity. Here are some tips on how to manage triggers that may lead to relapse:

1. Identify Your Triggers

The first step in managing triggers is to identify them. Make a list of situations, people, places, or activities that remind you of using drugs or alcohol. This will help you avoid these triggers and develop strategies for coping with them when they arise.

2. Avoid High-Risk Situations

Avoiding high-risk situations can help reduce your exposure to triggers. For example, if going to a certain bar makes you want to drink again, avoid going there altogether. If being around certain people makes you want to use drugs again, limit your time with them or cut ties altogether.

3. Develop Coping Strategies

Developing coping strategies can help you manage cravings and other symptoms associated with PAWS. Some effective coping strategies include deep breathing exercises, meditation, yoga, progressive muscle relaxation techniques or engaging in physical activity like running.

4. Seek Support From Others

Seeking support from others is essential during the recovery process and can be particularly helpful when managing triggers. Reach out to friends and family members who are supportive of your recovery journey or attend support groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). These groups provide a safe space where individuals can share their experiences and strategies for managing cravings and other symptoms associated with PAWS.

5. Practice Self-Care

Practicing self-care is important during the recovery process and can help mitigate some of the effects of substance abuse on the mind and body. Engage in activities that promote relaxation and stress reduction, such as taking a hot bath or practicing mindfulness meditation. Eat a healthy diet, get enough sleep, and make time for activities that bring you joy.

By following these tips, you can effectively manage triggers that may lead to relapse and stay on track with your recovery journey. Remember that PAWS is temporary and with dedication and perseverance, you can overcome this difficult stage of recovery.


Post-acute withdrawal syndrome (PAWS) can occur after quitting drug or alcohol use. It can bring physical and psychological symptoms that last for months or even up to two years, including anxiety, depression, irritability, fatigue, sleep disturbances, and difficulty concentrating.

Managing PAWS requires commitment to a recovery plan and self-care, such as eating well, getting enough restful sleep, exercising regularly, doing meaningful activities, and avoiding triggers. Natural remedies like yoga, meditation, and reducing stress levels can help manage PAWS symptoms.

Getting professional help during the post-acute phase can reduce the severity of symptoms. Identifying and managing triggers is an important part of recovery. Remember, PAWS is temporary. With dedication and perseverance, one can overcome this difficult stage of recovery.

Seeking Help and Treatment at Wellbrook Recovery

If you or a loved one is struggling with PAWS or any other symptoms of substance abuse, seeking professional help is crucial for successful recovery. At Wellbrook Recovery, we offer comprehensive inpatient residential rehab programs that are tailored to meet the unique needs of each individual.

Our experienced team of medical professionals and therapists provide evidence-based treatments that are proven to be effective in managing the symptoms of PAWS and supporting long-term recovery. We offer a range of services including detoxification, individual and group therapy sessions, holistic therapies like yoga and meditation, nutritional counseling, and aftercare planning to ensure continued success after leaving our program.

Don't let PAWS control your life any longer. Take the first step towards healing by contacting Wellbrook Recovery today. Our compassionate team is available 24/7 to answer any questions you may have and guide you towards a healthier future.


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