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Recalibrating the Brain During Recovery: PAWS

Addiction takes a significant toll on the mind and body. Detoxing from drugs and alcohol can be very dangerous and sometimes even fatal. Detox should be done under the supervision of medical professionals in a safe environment. Unfortunately, detoxing the substances from your body is not the end of withdrawal symptoms for many in recovery. After detox, most people experience acute withdrawal symptoms that include physical discomfort. These symptoms can include muscle aches, headaches, cramping, and nausea. Acute withdrawal symptoms, such as increased heart rate, can be very dangerous to a person’s health and can lead to life-threatening situations if detox is not completed with medical supervision. The next phase of withdrawal is post-acute withdrawal syndrome (PAWS), which focuses on the mind’s recalibration.

What is Post-Acute Withdrawal Syndrome?

Post-acute withdrawal syndrome, or PAWS, involves symptoms that are psychological and emotional. PAWS continues to display in those in recovery after acute withdrawal symptoms have stopped. Recovering from addiction to alcohol, antidepressants, antipsychotics, benzos, marijuana, and opioids makes you more likely to experience post-acute withdrawal syndrome. Other addictive substances may cause PAWS, as well. 

Addiction changes the chemical balance in the brain, and it needs time to correct and heal. During substance use, the brain’s reward center is activated and adjusts to the presence of the drug of choice. People also begin to rely on drugs or alcohol to cope with stressors in their lives. The brain needs time to recalibrate to function properly without the substance present. Psychological and emotional symptoms that present from PAWS are the brains way of healing from active addiction. 

The experience of PAWS during recovery can lead many to relapse. Similar to feeling physical withdrawal, people will want to stop experiencing it by using drugs or alcohol. It is important to acknowledge these symptoms to begin treating them and learning to cope.   

Common Symptoms of PAWS

Many describe this phase of withdrawal as a roller coaster ride of symptoms. In the early stages of PAWS, symptoms can change minute to minute. The longer they continue in recovery, the frequency of symptoms will diminish. The intensity of PAWS will vary for each person depending on their medical history, co-occurring disorders, the substance that was abused, and the duration of addiction. Triggers can include stress or reminders of drug or alcohol use, such as people they used with or places they used. The most common symptoms experienced with post-acute withdrawal syndrome are listed below.

  • Irritability 
  • Foggy thinking 
  • Depression 
  • Anxiety 
  • Hostility 
  • Cravings 
  • Memory issues 
  • Mood swings 
  • Fatigue 
  • Inability to manage stress 
  • Insomnia or other sleep disturbances 
  • Limited focus 
  • Lack of initiative 

How Long Does PAWS Last?

The length of time a person will experience post-acute withdrawal syndrome varies. PAWS is temporary, but some may struggle with it longer than others. Some people in recovery may only experience a few weeks, some may only experience it for a few months, and some may struggle with PAWS for up to two years. Symptoms typically only last for a few days at a time. The ebb and flow of PAWS can last anywhere from 6 months to two years as the brain recalibrates and finds a chemical balance without drugs or alcohol. Symptoms can be managed through continuous efforts in recovery. Work with your doctors and therapists to find proper coping mechanisms. Practice self-care, rely on your support system, and remember that PAWS is temporary. You will get through this as your journey in recovery continues. 

If you or a loved one struggles with addiction or has relapsed, get help at Archstone Behavioral Health, located in Lantana, Florida. Our drug and alcohol rehab center offers a full continuum of care to treat addiction and co-occurring mental health disorders. Archstone’s levels of care begin with detox and continue well beyond your stay at our facility with aftercare planning and alumni programs. We will support you through every step of your recovery. If you are affected by PAWS, our team will work with you to find the right treatments and coping mechanisms to help you avoid relapse. If you are ready to start your journey to recovery, call Archstone Behavioral Health at (561) 264-4961!

Sources:

https://americanaddictioncenters.org/withdrawal-timelines-treatments/post-acute-withdrawal-syndrome
https://www.hazeldenbettyford.org/articles/post-acute-withdrawal-syndrome
https://www.psychologytoday.com/us/blog/some-assembly-required/201505/detoxing-after-detox-the-perils-post-acute-withdrawal