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Post-Acute Withdrawal Syndrome

Withdrawing from substances such as opioids, alcohol, or benzos can be a very difficult and sometimes life threatening process. The first part of a drug detox typically takes place inside of a medically supervised environment. That is known as acute detoxification. Unfortunately, this is not where withdrawal from drugs and alcohol ends.

The second part is known as Post Acute Withdrawal Syndrome, or PAWS for short. Some of the symptoms of PAWS can be similar to those found in mood or anxiety disorders, including mood swings, insomnia, and heightened anxiety despite there being no apparent cause for it. This part of the drug and alcohol detox is marked by psychological and mental disturbances, rather than physical discomfort. Even though this sounds like it can be more manageable, these symptoms can appear out of nowhere even months into recovery, being a driving cause for relapse. This is one of the several reasons that staying in sober living is so important in early sobriety.

What does it feel like?

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PAWS can feel different for everyone. For some, they may not experience it at all. Others may feel like they are on a rollercoaster of emotions. The symptoms include mood swings, irritability, anxiety, and insomnia. Sometimes there won’t be a specific symptom to point at besides not feeling “right.”

When does it happen?

The symptoms seem to come and go but will likely be fewer and farther between as more time away from substances is gained. The symptoms will typically come on for a few days at a time but the length and severity will depend on the individual, specifically what substances were used, how much, and for how long .

With Post-Acute Withdrawal Syndrome there isn’t necessarily a specific trigger, rather it will come on randomly as one wakes up in the morning. The important piece to remember is that it only lasts a few short days. Additionally, the frequency and severity of PAWS symptoms will reduce as more time in recovery goes by. Although it can sometimes take up to two years for it to cease entirely, it is very likely that by the time that point arrived the episodes will have almost completely subsided.

How to cope with PAWS symptoms.

There are many ways to work through these uncomfortable periods, many of which are the same coping skills those in recovery are already using.

  • Work on self-care: Take this time to do things that are beneficial. Work out, eat well, go for a walk, read a book, and more. Remind yourself that you are doing your best and keep moving towards your goals.
  • Be real with yourself: Try to remember that recovery is not a sprint, it’s a marathon. There will be bad days in recovery and the key is to keep working through it. Remember the saying “this too shall pass.”
  • Interrupt the negative thoughts: When the symptoms of PAWS becomes overwhelming to the point that you feel cravings, interrupt those thoughts by doing something different. Reach out to a friend or family member, go to a twelve-step meeting, listen to music, etc.
  • When having trouble concentrating, try to break tasks up into smaller pieces. Instead of trying to accomplish something all at once, work for 30 minutes and then take a break to do something else. This can help reduce the stress of not being able to concentrate.
  • Most importantly, talk about it. Talk to someone else in recovery, such as a sponsor or peers in your sober living. Getting those feelings out to another person who understands and empathizes with what you are going through can be the most relieving thing possible.

For more information on Open Sky Recovery’s Los Angeles sober living, please visit this link or give us a call at (310) 560-3794.