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What is Post-Acute Withdrawal (PAW) Syndrome?


Did you know that you can still suffer from symptoms of your drug addiction even in sobriety? Often, when people think about drug addiction, they only think about the symptoms that occur while using. However, it is the sobriety-based symptoms that make recovery more difficult. Recent studies indicate that the symptoms of post-acute withdrawal (PAW) are associated with damage to the brain. These symptoms emerge during sobriety which contributes to many cases of relapse.

If you have suffered from drug addiction for a long time, your brain has most likely suffered from damage from the toxic effects of the chemicals you were using. These symptoms are called Post-Acute Withdrawal. PAW can be more severe for some clients than others. There are certain conditions that can actually damage and aggravate PAW symptoms.

PAW is caused by the combination of damage to the brain and nervous system (bio), difficulty thinking clearly and managing feelings and emotions, and problems with relationships (social). Together, PAW is a bio-psycho-social syndrome.

The recovery process can cause a great deal of stress and often people in recovery to not have the tools needed to manage stress without using drugs and alcohol. The two factors that influence the severity of PAW are:

  • The severity of the brains dysfunction caused from the addiction
  • The amount of psycho-social stress experienced in recovery

Symptoms of Paw peak in intensity over three to six months after abstinence begins. The good news is that these symptoms go away in time if treatment is received. Recovery from damage to the nervous system requires six to 24 months of treatment with the assistance of a health recovery program.

In long term recovery, you will learn how to manage the symptoms of PAW. During intervals where you experience PAW symptoms, you must seek the support of your treatment program. Often symptoms of PAW result in the increase desire to use drugs and alcohol.

Symptoms of Post-Acute Withdrawal

  • Inability to Think Clearly– You have difficulty organizing your thoughts and solving simple problems. You often do not understand what is going on.
  • Difficulty Remembering Things– Your brain recognizes what is happening in the moment but has trouble storing those memories due to damage to your long term memory.
  • Emotional Instability– You may suffer from emotional overreaction where little things set off big reactions or you may be emotionally numb where it feels like you cannot feel anything.
  • Sleep Disturbances– You may have trouble sleeping restfully. Symptoms of insomnia like difficulty falling asleep. When you do fall asleep, you do not feel rested.
  • Physical Coordination Issues – Feelings of clumsiness and trouble with hand-eye coordination. This can cause you to feel accident prone.
  • Stress Sensitivity- During periods of high stress, symptoms of PAW get worse. These are especially aggravated by night with lack of sleep.

How long does the Post-Acute Withdrawal last?

All substances have different effect on the body so it is hard to determine when the symptoms of PAW will last for each individual. All substances have different effects on the body and it also varies depending on the level of abuse.

In early recovery, it is easy to be discouraged. You may feel disappointed to still be having symptoms of drug use even during sobriety. However, substance abuse affects each person differently and eventually your symptoms will pass. Have faith that this new lifestyle is one that is better for your health and for your love ones.

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