Post-Acute Withdrawal Syndrome: What Is It and How Long Does It Last?

After the perils of detox, a person early in sobriety may still have feelings of depression, anxiety, insomnia, loss of interest in things they previously enjoyed, and/or an inability to concentrate. These problems, coupled with strong drug cravings, may be overwhelming to someone early in sobriety, but they do get better over time.
According to the Semel Institute for Neuroscience and Human Behavior, Post-Acute Withdrawal Syndrome, or PAWS, affects about 90 percent of recovering opioid users and 75 percent of recovering alcohol and psychotropic abusers. The intensity and duration of PAWS symptoms vary based on how often and how much a person has used mind-altering substances, but seem to have the greatest impact on those with a long-term history of opioid use. A 2015 Psychology Today article entitled “Detoxing after Detox: The Perils of Post-Acute Withdrawal”, explains that “in early abstinence, the brain’s stores of both endorphins and dopamine are severely depleted” and “the absence of enough dopamine creates a biochemically based depression”. There is no specific timeline for the cessation of symptoms and the duration is dependent upon the individual’s using history and physiological makeup, but it is generally accepted that PAWS can last anywhere from a few weeks up to about one year. The brain needs time to heal and naturally replenish its supply of endorphins and dopamine, and this process will be different for each individual.
It is important to be aware that PAWS symptoms will diminish overtime. In early sobriety, it may be helpful to realize that the symptoms do not reflect the reality of one’s life, but are simply the residual effects of past drug use. University of Wisconsin Health lists several ways a person may cope with PAWS symptoms, including the development of a support system, making a daily routine that allows for rest and relaxation, developing a routine sleep patterns, reducing junk or processed foods, exercise, and, most importantly, giving yourself time to heal. Recovery is a process that takes time. The damage to our mental and physical health from drugs and alcohol will not leave us immediately, but by recognizing the symptoms of PAWS and developing healthy coping skills to handle these symptoms when they occur, we may feel more at ease and capable of continuing on the road of recovery.
 
 
 

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