Post Acute Withdrawal Syndrome (PAWS)

Many of the problems associated with early sobriety do not stem directly from drugs and alcohol. Instead, they are associated with physical and psychological changes that occur after the chemicals have left the body. When a person uses, their brains actually undergo a physical change to cope with the presence of the drug in the body. When the drugs are removed, the brain then demands more to satisfy the desire caused by the changes. The extreme symptoms that are experienced immediately after the using has stopped is called “acute withdrawal.” Acute withdrawal, unfortunately, is not the whole story. The body makes initial adjustments to the absence of the drug, and the major symptoms ease up. However, the changes that have occurred in the brain need time to revert back to its original state (to the extent that it can). During the period of time while this is occurring, comes a variety of problems known as Post Acute Withdrawal Syndrome (PAWS).

acronym logo for post acute withdrawal syndrome

PAWS symptoms reach a peak from three to six months after the body is clean from all alcohol and/or drugs. Any use of drugs or alcohol, even in small quantities or for a short time, will effectively eliminate any improvement gained over that time, as it will keep the brain from healing. There are a variety of symptoms. Not everyone will experience all of them. Here are a few:

  • Inability to solve problems and/or think clearly/concentrate
  • Rigid, repetitive thinking
  • Memory problems
  • Emotional overreaction or numbness
  • Sleep disturbances and/or stress

It is essential to learn means of controlling PAWS, when stress levels are low, in order to be able to prevent the symptoms or be able to recognize and manage them if they occur. Here are some suggestions:

  • Talk! It is important to talk about what’s happening, to people who will listen and not criticize.
  • Set a goal -What can be done right now to improve the situation? Taking action and changing things is our choice.

Recovery is not about quitting alcohol and drugs. It is about learning to live a life that does not require mood-altering chemicals to be worth living.

Adapted from: ‘Relapse Prevention’ by Terence Gorski