What Is Post-Acute Withdrawal Syndrome PAWS?

July 4, 2023 Leave a comment

Business professional in the Addiction Recovery and Mental Health industry for the past 26 years. Everyone knows that overcoming a drug or alcohol addiction is not an easy task, and is more complicated than waking up one morning and deciding to quit. Recovering from an addiction is a long and involved process, requiring near constant and ongoing diligence and understanding from both the individual and the people closest to them. All opioid drugs work by activating opiate receptors in the brain and spinal cord, which modulates perceived pain levels, induces a feeling of well-being, and produces, at high doses, a euphoric high.

These experiences were recorded 5 to 13 years after stopping antidepressants. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs), can be an effective way to manage your mood. According to American Addiction Centers, anecdotal evidence indicates that PAWS symptoms can last 2 years or longer after someone stopped drinking alcohol.

Common PAWS from Marijuana include insomnia, anxiety, irritability, headaches and other physical symptoms, such as stomach pain and changes in appetite. Not everyone will experience it and its severity depends on a lot of factors. These can include the extent of your addiction and your individual physical make-up. Reminding yourself that PAWS is temporary and gets better with time may help you get through this time. It can take several months, even years, for PAWS symptoms to fully disappear.

These changes can take months or even years to completely reverse themselves and for opiate signaling to return to normal levels.
Developing a consistent meditation practice can help you gain control over your thoughts and emotions and act more rationally in stressful situations.
Antidepressants or anti-anxiety medications can help you feel good enough to put behavioral therapy tools into practice.
In certain cases, symptoms like cravings, exhaustion, and problems with thinking can take a longer time to go away.
It’s very important for individuals and families to know about PAWS, because these symptoms can be just as powerful as acute withdrawal symptoms and often cause people to relapse.

Although it doesn’t occur in everyone, some people experience PSSD months after stopping long-term SSRI use. The PAWS symptoms of alcohol withdrawal can come and go — you might feel well one day and very uncomfortable the next. According to a 2021 study, PAWS is one of the major causes of relapse in people with alcohol use disorder. PAWS can make day-to-day tasks uncomfortable and, if a person is dealing with addiction, lead to relapses during recovery. If you or a loved one are experiencing PAWS, there are treatments to help you manage these symptoms. Be patient and give it time, as the symptoms will decrease through time in severity and occurrence as long as there is continued abstinence.

Gain as much education on symptoms of post-acute withdrawal in order to be prepared for unexpected symptoms appearing. You may go a few weeks with no PAWS, but wake up one morning after having disturbed, unrestful sleep, extreme fatigue, irritability and anger outbursts, as well as various mood swings. If you’re not prepared for it, you may find yourself at risk for relapse.

How can you support a loved one experiencing post-acute withdrawal syndrome?

You can start with five minutes a day, and gradually increase your time. Practicing meditation regularly for just a few minutes is more beneficial than attempting to sit in meditation for long periods, sporadically. When these drugs are discontinued, they could cause mood swings for months. PAWS symptoms may be more extreme if the antipsychotics are discontinued abruptly, without a taper.

Educate Yourself On Post-Acute Withdrawal Symptoms

The first withdrawal stage typically lasts for a few days up to 2 weeks. After this period, you’ll start to feel acute withdrawal symptoms almost immediately. PAWS sets in after a person stops using drugs or drinking and has completed detoxification.

Although the symptoms of PAWS can be challenging, it’s possible to manage your symptoms in a healthy way. These symptoms are common across substances — in other words, no matter which substance you used, you might experience one or more of the above. Several reviews, including a 2018 review and a 2014 review, have noted that sleep disturbances are common during cannabis withdrawal. The above-mentioned review states that there’s a lack of research on PAWS from benzodiazepines, a single dose of kudzu extract reduces alcohol consumption in a binge drinking paradigm but that it can persist for 6 to 12 months — in some cases, even years after stopping benzodiazepine use. Sometimes, your symptoms after stopping antidepressant use are part of the “rebound symptoms” — in other words, the symptoms you were trying to treat with antidepressants start coming back. Consider writing in a journal as a way to gain awareness and insight into your symptoms and document your experiences utilizing different coping skills.

Post-Acute Withdrawal Syndrome Symptoms

Instead, these symptoms fluctuate, lasting days or weeks, and are separated by periods that are symptom-free. History of drug use is the best-known risk factor for post-acute withdrawal syndrome. As with alcohol, tapering can help acute benzodiazepine withdrawal, but it is not very effective for avoiding post-acute withdrawal syndrome. This can be very difficult for patients who have taken benzodiazepines for anxiety and panic disorders, since anxiety is a common symptom of post-acute withdrawal syndrome. Symptoms of protracted benzo withdrawal can look like symptoms of other disorders such as schizophrenia, depression, panic disorders, and obsessive-compulsive disorder (OCD).

What are the symptoms of PAWS?

Unlike acute withdrawal, post-acute withdrawal symptoms are mostly psychological and emotional symptoms. In addition, certain substances are more likely to put you at risk of triggering PAWS. For example, it is estimated that 90 percent of recovering opioid users experience when its time to leave an alcoholic post-acute withdrawal syndrome, while alcohol-dependent users struggle with PAWS at a 75 percent rate. And people recovering from benzodiazepines appear to experience the full spectrum of the syndrome for longer periods of time compared to other substance users.