Post-acute withdrawal syndrome (PAWS) is a symptom that occurs after the initial acute withdrawal stage. Although it doesn’t have intense physical symptoms, it can have intense mood-related or mental side effects. When you stop using a certain substance, you might experience withdrawal symptoms for a few days or weeks. For most people, alcohol withdrawal symptoms will begin to subside after 72 hours. If you are still experiencing withdrawal symptoms after three days, talk to your healthcare provider. Many individuals struggling with addiction also have co-occurring mental health disorders, such as depression, anxiety, or post-traumatic stress disorder (PTSD).
The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Studies show that older adults tend to experience more severe, prolonged PAWS compared to younger people withdrawing from the same substance. However, Post-Acute Withdrawal Syndrome (PAWS) is informally recognized in clinical settings and addiction medicine textbooks. The DSM-5 does recognize longer-term physiological effects from sedative withdrawal.
Renewal Center for Ongoing Recovery
All authors contributed to this study’s design, the interpretation of the data, subsequent manuscript drafts (and revisions), and final approval for submission. Dr. Bahji wrote the initial draft of the work and managed revision feedback from the other authors. The authors acknowledge the University of Calgary Health Sciences Librarians for their support in developing our search strategy. We also recognize that our work takes place on historical and contemporary Indigenous lands, including the territories of Treaties 6, 7 & 8 and the homeland of the Métis. We also acknowledge the many Indigenous communities that have been forged in urban centers across Alberta.
What is the Difference Between Acute Withdrawal, PAWS and Protracted Withdrawal?
Ultimately, understanding PAWS can help reduce the risk of relapse for individuals in recovery. When individuals are prepared for the challenges of PAWS and have the tools and support they need to cope with symptoms, they are less likely to turn to substances as a means of self-medication or escape. Furthermore, loved ones who are informed about PAWS can help create a supportive environment that promotes recovery. They can encourage their loved one to stick to their treatment plan, attend support group meetings, and engage in healthy coping strategies.
These findings were replicated in a 16-week multicenter trial against naltrexone, which found that pregabalin was well tolerated, improving withdrawal symptoms as well as naltrexone (Martinotti et al., 2010a). However, some of pregabalin’s pharmacokinetic improvements—such as quicker absorption and higher potency—have led to a concomitant increase in its abuse potential (Häkkinen et al., 2014; Schjerning et al., 2016). One reviewer (A.B.) extracted the following data from included studies, while another (D.C.) confirmed the extracted data for accuracy. In addition, we supplemented the electronic database searches with manual searches of all eligible articles’ reference lists and previous reviews for additional studies.
- Dr. Bahji also received financial support from a 2020 Research Grant on the Impact of COVID-19 on Psychiatry by the American Psychiatric Association and the American Psychiatric Association Foundation.
- Emotional turbulence, cravings, fatigue…relapse tempts those struggling with PAWS.
- A urine test can help doctors rule out withdrawal from specific drugs or combinations.
Furthermore, as most extant AWS studies are limited to acute withdrawal treatment, further research remains needed regarding the post-acute withdrawal abstinent period (Williams & Mc-Bride, 1998). If symptoms of PAWS become overwhelming, seeking assistance from a mental health professional or addiction specialist may be necessary. They can provide valuable resources and support for managing withdrawal syndrome effectively. These protracted withdrawal symptoms can significantly impact an individual’s ability to maintain abstinence, making it crucial to develop effective coping strategies. Detoxing from addictive substances is a crucial step in overcoming substance abuse, but it can be just the beginning of a long journey toward recovery.
Consuming regular, balanced meals throughout the day can also help stabilize mood and energy levels, which are often affected by PAWS. By maintaining stable blood sugar levels, individuals can reduce the likelihood of experiencing intense mood swings or fatigue, making it easier to manage PAWS symptoms. Aftercare and ongoing support are essential components of a comprehensive PAWS management plan. These services help individuals maintain their recovery progress, prevent relapse, and build a strong support network.
Stress-reduction techniques are essential for managing the emotional and psychological symptoms of PAWS. Mindfulness meditation and deep breathing exercises can help calm the mind and reduce anxiety. Fatigue and low energy are common, as the body adjusts to functioning without the substance. People may feel physically exhausted, even after adequate rest, and struggle to maintain their usual level of activity. PAWS refers to symptoms of substance withdrawal that last past, or develop after, the initial withdrawal period. The duration can vary from person to person, and the substance involved may play a role.
Detoxing After Detox: The Perils of Post-Acute Withdrawal
While these acute withdrawal symptoms generally subside within a week, recovery is rarely immediate. Instead, individuals often transition into a post acute withdrawal period, where symptoms like mood swings, fatigue, and cravings may persist for months, creating what is known Is marijuana addictive National Institute on Drug Abuse NIDA as a protracted withdrawal experience. In the days and weeks after you stop drinking or quit substance abuse, you may experience acute withdrawal symptoms. It is the second withdrawal stage, often called post-acute withdrawal symptoms (PAWS). Post-acute withdrawal, whether mild or serious, is a necessary process in early recovery from alcohol or other drug dependence.
While acute withdrawal symptoms generally resolve in a few weeks, PAWS symptoms can last for a few months or up to a year. While physical symptoms tend to resolve in two or three weeks, the chemicals in the brain take much longer to rebalance themselves. This manifests in a series of psychological withdrawal symptoms that can be stressful to deal with. Post-Acute Withdrawal Syndrome, or PAWS, refers to a number of withdrawal symptoms experienced following the acute withdrawal phase of recovery. Tracking your triggers, managing stress, and taking care of your basic needs might help keep your symptoms in control.
Alcohol withdrawal symptoms range from mild but annoying to severe and life-threatening. Over time, however, the body builds a tolerance to alcohol, and a person may have to drink more and more to get the same feeling. Meanwhile, the brain is producing more and more neurotransmitters, making a person further imbalanced.