What Is Post-Acute Withdrawal Syndrome?

Treatment for addiction is a strenuous, but necessary process, with many essential components involved. When it comes to recovery from substance use, individuals that suffer from addiction are likely to experience withdrawal symptoms. In severe cases, such as recovery from alcoholism, an individual may need to go through detox. To understand what post-acute withdrawal syndrome (PAWS) is, it is crucial that you understand what happens during the detox or initial withdrawal stages. 

During the first stage of drug detox (referred to as acute withdrawal), physical withdrawal symptoms are common. These symptoms can last from a few days up to nearly two weeks. These acute withdrawal symptoms may begin immediately or a short while after sudden refrain or significantly slowing down the use of a substance. Although many individuals might attempt to quit their addiction alone, they may find themselves in a more dangerous situation by doing so. 

Addiction to alcohol, as well as benzodiazepines or barbiturates, will most commonly result in a client requiring detox treatment. If detox is attempted outside of a supervised setting, the risk of life-threatening complications increases significantly. This is because these specific substances bring with them increased risks of complications, such as seizures or coma. Medical assistance is recommended and advised for all severe addiction situations. 

The Second Stage of Detox

Post-Acute Withdrawal Syndrome (PAWS), is known as the second stage of detox. Post-acute withdrawal syndrome happens as the brain tries to reset itself after active addiction. While acute withdrawal focuses on physical withdrawal symptoms, post-acute withdrawal syndrome focuses on the emotional and psychological symptoms that follow after a substance has stopped being used. Many factors play into the intensity and duration of post-acute withdrawal syndrome, such as:

• What drug was being used
• How often the drug was being used
• How much of the drug was being used
• How long the drug was being used
• Co-occurring mental or physical health conditions

The symptoms experienced with PAWS occur most often in individuals that attempt to discontinue use of:

• Alcohol
• Antidepressants
• Antipsychotics
• Benzodiazepines
• Marijuana
• Opioids
• Stimulants

Post-Acute Withdrawal Symptoms

Post-acute withdrawal syndrome is likely to last from months to years, although the intensity and frequency of symptoms are likely to reduce over time. Symptoms can be incredibly uncomfortable for the individuals experiencing them. Symptoms are typically similar from person to person, although some symptoms may reappear sporadically, which is dangerous for potential relapse. 

Some common symptoms reported in clients that experience PAWS have included:

• Depression
• Anxiety
• Irritability
• Hostility
• Lack of energy
• Fatigue
• Insomnia or other sleep issues
• Inability to concentrate
• Lack of mental clarity
• Chronic physical pain

Suggested Routes of Treatment for Substance Use Withdrawal 

There are a variety of resources that are available for individuals suffering from addiction as well as the symptoms associated with substance use withdrawal. Individuals that are affected by the distressing symptoms of withdrawal might think the only way to alleviate their symptoms is by returning to their substance of choice. To promote and sustain long-term recovery, a combination of education, support, and guidance must be offered by treatment facilities and used by those affected by withdrawal. Suggested approaches to treatment include:

• Offering education as well as seeking education regarding substance use. It is important that clients, as well as treatment professionals, acquire realistic attitudes about the recovery process. Clients should feel empowered knowing that it is normal to not feel okay during the first few months/weeks of abstinence, as well as long into recovery. Clients should be educated that withdrawal happens in the brain, and with long-term abstinence, the brain is able to reverse any changes made from long-term substance use.
• Empowering individuals to join mutual support groups. Support groups, such as Alcoholics Anonymous (AA) can significantly impact long-term recovery. These support groups are normally population-specific, meaning that there are groups tailored to specific conditions such as depression, substance use, and even grief or loss. Not only do these groups increase your support system, but they also equip clients with necessary life skills like fostering compassion and self-worth.
• Prescribing withdrawal medications if necessary. There are medications available for individuals suffering severely from withdrawal from substances. These medications may reduce uncomfortable symptoms such as sleep disturbances or anxiety, common feelings for individuals that have recently quit their substance. It is important that these medications are provided on an as-needed basis, as some of these medications themselves have the potential for abuse.
• Encouraging active but patient recovery. Engaging in physical and mental exercise can also help reduce symptoms associated with withdrawal. These exercises can also combat issues with sleep, increase positive emotional states, and reduce tension and stress. Individuals should be advised to be patient with themselves during their recovery process, and that focusing solely on their mental health and recovery is more than enough.

When it comes to recovery from alcohol or other addictions, withdrawal is a common stage that many individuals will experience. The symptoms associated with withdrawal occur in two stages, initial withdrawal and post-acute withdrawal. Post-acute withdrawal syndrome (PAWS) takes place a few days or weeks after initial physical withdrawal occurs, as PAWS is the psychological and emotional symptoms that occur with substance use withdrawal. The severity of symptoms experienced with PAWS differs from person to person, but typically includes symptoms like depression, irritability, sleep disturbances, and anxiety. Although PAWS is a common experience for those beginning recovery, there are treatment approaches that may positively impact long-term recovery and avoidance from relapse. Treatment options include promoting realistic recovery expectations, encouraging individual or group therapy, administering withdrawal medication if necessary, and being patient and active in recovery. West Coast Recovery Centers wants to help you achieve long-lasting recovery. Call us today at (760) 492- 6509.