For many people contemplating addiction treatment, the thought of withdrawal gives them pause. Although specific symptoms depend on the substance being abused, a person’s overall health, and the length of their addiction, withdrawal is often associated with uncomfortable symptoms such as sweating, chills, headaches, abdominal upset, sleep disturbances, loss of appetite, and rapid heart rate. 

Generally, the most intense withdrawal symptoms last a few days or weeks and gradually taper off as a person becomes more confident in their recovery. However, it’s also possible for a person to experience a prolonged withdrawal period that is known as post-acute withdrawal syndrome (PAWS). 

Even though PAWS is not officially recognized as a disorder by the Diagnostic and Statistical Manual of Mental Disorders, this is a condition you should take seriously. If you ignore the symptoms of PAWS, you could be increasing your risk of relapse. 

The Difference Between Acute Withdrawal and PAWS
Acute withdrawal is what happens during detox. The physical and psychological discomfort a person experiences during this time occurs because the abused substance is leaving the body so the healing process can begin. When you seek professional addiction treatment, a medically managed detox provides 24/7 monitoring to prevent complications and offer emotional support during acute withdrawal. 

PAWS is a type of secondary withdrawal that occurs after a person’s acute withdrawal symptoms have faded. It is most often experienced by people who are in recovery from an addiction to alcohol, opioids, or benzodiazepines (benzos). Individuals who have co-occurring mental health disorders such as anxiety and depression are also at risk. 

How to Cope with PAWS
Depending on the substance being abused and the length of a person’s active addiction, PAWS can last between six months and two years. However, PAWS can be successfully managed. 

Here are some tips that can help you keep PAWS from derailing your recovery efforts: 

• Look for a pattern. PAWS symptoms such as mood swings, trouble concentrating, and fatigue tend to come in waves. They are often triggered by stress or being around people or places you associate with your addiction. Keeping a journal can help you determine what your personal triggers are and what symptoms are most disruptive. 
• Be patient with yourself. Bouts with PAWS are temporary in nature—typically lasting just a few days and decreasing in intensity as you move forward with your recovery efforts. Reminding yourself that these feelings won’t last forever can make the condition easier to handle.
• Keep moving. Exercise helps regulate your mood and keeps stress in check. This makes it easier to cope with the cravings that can be associated with PAWS.
• Eat well. Nutritious meals that keep your blood sugar stable will help you avoid mood swings and make it easier to manage any cravings triggered by PAWS. 
• Practice good sleep hygiene. The sleep disturbances associated with PAWS are understandably frustrating, but keeping a consistent bedtime, eliminating caffeine in the afternoon and evening hours, removing distractions from your bedroom, and creating a soothing evening routine can make it easier to get the rest that your body needs. 
• Adjust your schedule. If you’re finding it hard to focus, create a schedule that lets you accomplish your most difficult tasks when your energy levels are highest. Allow plenty of time for breaks. 
• Turn to your support system. Mutual support 12-Step groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) can help you feel less alone when dealing with PAWS. Supportive friends, family, and spiritual leaders can also help by keeping you accountable.
• Know when to seek professional help. If lifestyle challenges alone aren’t enough to keep PAWS symptoms in check, additional counseling and/or medication may be needed. Antidepressants are often used to treat the symptoms of PAWS because they help stabilize serotonin levels. Be honest about your struggles with your care provider so you can create a plan to help you move forward.

PAWS Is Nothing to Be Ashamed Of
Sometimes, people who experience PAWS believe that it’s an indication they’re not “cut out” for recovery or that they don’t have the willpower necessary to be successful. This couldn’t be further from the truth. 

PAWS is an indication that your brain is recalibrating itself and attempting to restore normal functioning after a prolonged period of active addiction. It’s not a reflection of your character or a sign that you’re not taking your recovery efforts seriously. 

Help Is Available
If you’re struggling with PAWS, St. Joseph Institute for Addiction can help. We provide a full continuum of care for graduates of our residential addiction treatment center to ensure they have the support they need to continue to progress in their recovery efforts. Our relapse prevention and continuing care services include ongoing counseling support, alumni gatherings, retreat programs, online educational resources, and the Trac9 relapse prevention tool. Contact us today to discuss how we can help you determine the best way to move forward.