Not progressing as fast as you’d hoped? Post-acute withdrawal symptoms

In the worst cases, PAWS can be debilitating and lead to a return of drinking or drug addiction or substance abuse as a coping mechanism. Many symptoms are similar to depression, bipolar disorder, or anxiety disorders and can be treated with medications or psychotherapy. While avoidance of post-acute withdrawal syndrome isn’t possible, you can effectively manage your symptoms.

paws alcohol

Although post-acute withdrawal syndrome can be a very challenging process while the brain and body begin to heal and reorient itself to life without the use of alcohol or other drugs, help is available. There are many outpatient treatment programs available to guide you through the post-acute withdrawal phase during recovery to prevent relapse. Contact a treatment provider today to learn more about the various rehab options. Infants born to mothers who used substances of dependence during pregnancy may also experience a post-acute withdrawal syndrome. While post-acute withdrawal syndrome has been reported by those in the recovery community, there have been few scientific studies supporting its existence outside of protracted benzodiazepine withdrawal. Because of this, the disorder is not recognized by the Diagnostic and Statistical Manual of Mental Disorders or major medical associations.


The first stage is characterised by much more physical symptoms which can be very severe, even life-threatening, but which usually start to ease off after a week or two. So if you are dependent on drinking this is a really important time to get some help. If you feel you need a drink when you wake up in the morning, get shakes when you are not drinking, then look here for your local specialist providers. There are two stages of alcohol withdrawal; the acute withdrawal phase and the post-acute withdrawal phase. The first phase, the acute stage, can last several weeks after stopping drinking; however, PAWS can last up to two years.

paws alcohol

Post-Acute Withdrawal Syndrome occurs when someone who has consumed a large amount of a drug over a long period, decides to quit. PAWS can often be the cause of people relapsing into their addictions. Slowly reducing the amount of alcohol consumed may seem like a possibility for some people to stop using alcohol; however, it can be hard to maintain the results after quitting.

Cymbalta (Duloxetine) Withdrawal

Avoid situations, including triggers, that may initiate a craving to use, or situations that are anxiety-provoking, such as loud or crowded places. This will help reduce the trigger of or exasperation of post-acute withdrawal symptoms. While it is possible to cope with post alcohol withdrawal syndrome without medical help, getting back to the premorbid functioning levels is the most efficient with the assistance of a medical professional. If co-occurred mental disorders are left untreated, they can trigger they can still manifest in person during recovery time. Sobriety is not just a destination to arrive at after quitting alcohol, going through detoxification, and attending a rehab program; sobriety is a lifelong journey.

  • The symptoms they are experiencing – trouble sleeping, memory and attention problems, irritability and mood swings, anxiety, and cravings – can be mistaken for signs of depression.
  • While clinicians working at the rehabilitation centers often notice signs of protracted withdrawal syndrome, it is hard to keep track of all patients who stopped abusing alcohol.
  • If insomnia is a problem, limit the amount of caffeine used before bedtime and try to establish a sleep routine by going to bed at the same time every night and waking up at the same time each morning .
  • People will still be uncomfortable with the emotional and mental symptoms, which might lead to relapse.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. As time goes on, you will experience PAWS symptoms less and less, and eventually, the symptoms will disappear completely. And while the outfit is an important step to looking and feeling eco sober house your best, Jared also doesn’t underestimate smell. Style is such a personal thing,” he told British GQ in June 2021. “It’s a lot more than what someone is wearing. There are quite a few people who I think have excellent style not just through their clothes but through their personality, their energy and the positivity they emanate.”

Stress Management

SINCE THEN, this PAWS alcohol withdrawal scale has been in use in many hospitals and rehabilitation centers to better prepare them for treating patients undergoing alcohol detoxification. PAWS is a condition that can arise after someone has taken a lot of a drug over a long period and decides to stop. After the initial acute withdrawal symptoms have passed, people may experience post-acute withdrawal symptoms that last from one year to five years, depending on the treatment or lack of treatment received.

We’ll look at why it’s so important to work with your doctor when stopping Xanax. If a loved one is experiencing PAWS, you can show support by reminding them that you’re there for them and encouraging them to reach out to you for help. In other words, PAWS could occur because your brain’s chemicals are beginning to regulate and return to their earlier state. The above-mentioned review states that there’s a lack of research on PAWS from benzodiazepines, but that it can persist for 6 to 12 months — in some cases, even years after stopping benzodiazepine use. A 2020 study looked at experiences of PAWS after stopping antidepressants based on self-reported symptoms on an internet forum. These experiences were recorded 5 to 13 years after stopping antidepressants.

A clinician might also recommend talk therapy or a rehabilitation program. If certain situations, people, or activities bring you stress and no joy, consider letting them go. If your plate is full, try to avoid adding unnecessary responsibilities to the mix. After all, if you’re currently experiencing fatigue and nausea, skipping meals and sleeping too little will only make you feel worse. The duration of PAWS can depend on a range of factors, including the substance you used and how frequently you used it, as well as your support system.

paws alcohol

Tracking your triggers, managing stress, and taking care of your basic needs might help keep your symptoms in control. Therapy and support groups can help you cope with the mental and physical stress of PAWS. Many people are familiar with the physical symptoms of alcohol withdrawal, but PAWS typically has more eco sober house boston of an impact on a person’s mental well-being. PAWS is a significant threat to someone’s recovery because of its severe side effects. Bob Carty, director of clinical services at Hazelden in Chicago, agrees that knowing what the protracted withdrawal symptoms are is important to learn how to manage them.

Risk Factors for Post-Acute Withdrawal Syndrome (PAWS)

Some report that they not only more easily stressed, but can become overwhelmed by even slightly stressful situations. Treatment experts believe that this hypersensitivity to stress can exacerbate all the other post-acute withdrawal symptoms. One German study found that long-term alcohol use tends to inhibit the effects of certain chemicals in the brain and those effects remain diminished weeks after abstinence. This resulted in an increased craving for alcohol and increased feelings of anxiety during protracted withdrawal. It is important to remember that symptoms of post-acute withdrawal syndrome come and go. Most people do not experience excessive fatigue or anxiety for months or years on end without a break.

The condition gradually improves over a period of time which can range from six months to several years in more severe cases. Match with a licensed therapist and get convenient care from anywhere. Practice positive self-talk, including reminding yourself that what you are experiencing is normal and that “this too shall pass.” Be gentle with the thoughts you have, and be patient with yourself. Have a confidential, completely free conversation with a treatment provider about your financial options. Neither nor AAC receives any commission or other fee that is dependent upon which treatment provider a visitor may ultimately choose.

Complicated alcohol withdrawal syndrome is defined as withdrawal hallucinosis, withdrawal-related seizures, or delirium tremens. Vertava Health offers 100% confidential substance abuse assessment and treatment placement tailored to your individual needs. That said, there are some general factors that could increase a person’s chance of developing post-acute withdrawal syndrome symptoms. Many people report mental discomfort and feeling a rollercoaster of changing emotions.

For instance, a substantial proportion of individuals with mental health issues use alcohol self-medication to cope. In this case, the underlying mental health issues would be the cause of PAWS. Another alternative is to go through an outpatient detox process. These programs demand participants visit the detox center daily throughout the treatment to monitor their dosages and withdrawal symptoms from alcohol and other highly addictive substances. People may continue with their jobs, schooling, or other personal activities without having to take time off or explain an absence by doing so. These programs require individuals to visit the detox center daily throughout the process to check on medications and withdrawal symptoms.

Content is reviewed before publication and upon substantial updates. Effects of this syndrome may then continue for anywhere from 2–3 months to several years. There are anecdotal reports of individuals who continue experiencing prolonged withdrawal for the rest of their lives, though this appears to be extremely rare. Similar to other drugs, these stimulant withdrawal symptoms are thought to be caused by adaptations in the brain to long-term stimulant use, and they can take several months or longer to resolve themselves. Post-acute withdrawal syndrome is separate and distinct from the acute phase of withdrawal, which typically occurs in the first two weeks after drug cessation. In 2015 Dr James Maldonado discovered a way to predict the possibility of PAWS occurring in a patient.

Learning healthy coping strategies for managing PAWS is one of the best ways to overcome the discomforting symptoms that may appear. Benzodiazepines, such as Xanax, Ativan and Klonopin, are known for having common PAWS, including intense anxiety, panic attacks, irritability, and severe sleep disturbances, including insomnia. Get professional help from an addiction and mental health counselor from BetterHelp via phone, video, or live-chat. Post-Acute Withdrawal Syndrome, or PAWS, is a persistent occurrence of withdrawal symptoms that can last for months after a person gets sober.

Some people in protracted withdrawal experience dizziness, slow reflexes, coordination problems and trouble with balance. People who experience stumbling and clumsiness during prolonged withdrawal can appear to be intoxicated when they are in fact abstinent. People experiencing protracted withdrawal will many times not have the ability to solve even simple problems due to their inability to think clearly. They report difficulty concentrating and sometimes it’s because they find it hard to think about anything but the fact that they are not drinking or using drugs. Jennifer Fifield is a Senior Web Content Editor at American Addiction Centers and an addiction content expert for,, and She holds a bachelor’s degree in Broadcast Journalism and a master’s degree in Health Promotion Management.

Think of the withdrawal syndrome as the brain’s way of correcting the chemical imbalances suffered during active addiction. Acamprosate has been found to be effective in alleviating some of the post acute withdrawal symptoms of alcohol withdrawal. Carbamazepine or trazodone may also be effective in the treatment of post acute withdrawal syndrome in regards to alcohol use.

There might be a specific medication that would alleviate a symptom, or there might need to be a series of medications to ease the discomfort. There also might be lifestyle changes that patients can make, such as changing to a healthy diet and exercise, which help ease symptoms and calm stress levels. The exact post acute withdrawal symptoms experienced will depend on the particular addiction, and the time the person abused drugs or alcohol. After a person detoxes from alcohol, they may want to consider entering an inpatient rehab center for further support.