Post-Acute Withdrawal Syndrome (PAWS) is a term used to describe the symptoms after acute withdrawal from alcohol or drugs. It can last for years, and about 50% of people with an addiction will experience it, although every person experiences not all symptoms. This condition is often referred to as protracted withdrawal.
Symptoms include cravings, trouble sleeping, anxiety, depression/sadness, mood swings, feeling as though life is difficult to cope with, and many more.
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. This makes it vital that those suffering from it get treatment. Many symptoms are similar to depression, bipolar disorder, or anxiety disorders and can be treated with medications or psychotherapy.
Post Acute Withdrawal Syndrome is not unique to addiction issues. All drugs and alcohol, even medications, affect the brain. When a person withdraws from any substance or stops using a medication they have been taking for an extended period, their brain changes as it adjusts to no longer having those substances in their system.
The exact post acute withdrawal symptoms experienced will depend on the particular addiction, and the time the person abused drugs or alcohol.
Opioids may produce muscle aches, dilated pupils, insomnia, watery eyes, and runny nose. Nicotine use can cause headaches, shaking, and irritability and alcohol abuse can bring about fatigue, nausea, and vomiting. Cocaine addiction can cause tremors and loss of appetite.
There are many more examples. The list will be different for each person because everyone’s body and brain respond differently to the chemicals they have used.
Must Read: Benzos and Alcohol
Alcohol Detox: Timelines Post Acute Withdrawal Syndrome
Recovery from substance abuse a unique experience for each person. The path to recovery varies from person to person. Recovery is dependent on the individual, the amount of alcohol consumed, and how long they drank excessively. Individuals may suffer from Post-Acute Withdrawal Syndrome (PAWS) for up to two years after sobriety.
It is critical to realize that each individual has a different recovery rate. People who are experiencing PAWS will require continual treatment to alleviate their symptoms throughout a long-term strategy.
The Effects of Alcohol on the Brain
Excessive drinking affects the brain’s chemicals, which results in altered neurotransmitter activity by enhancing GABA and reducing glutamate. This process produces an individual who is calm and cheerful while consuming alcohol.
Excessive alcohol consumption can lead to alcohol dependence if the brain stops producing enough GABA and creates too much glutamate. When this occurs, the body will require more significant amounts of alcohol to maintain the impact, resulting in addiction. The length of time it takes to recover from an addiction increases as prolonged and severe the habit becomes.
The Alcohol Withdrawal Timeline has three phases of alcohol detoxification, starting with mild symptoms and progressing to moderate symptoms, then severe symptoms known as Delirium Tremens (DTs).
Timeline for Alcohol Withdrawal Symptoms
The first day without drinking is usually the most difficult, but some people experience only minor physical symptoms. Mild withdrawal causes cravings, nausea, vomiting, nervousness, headaches, and sleeplessness as indicators. At the third stage, which may range from 24 to 48 hours, physical symptoms such as heart arrhythmia, fits, delirium, hallucinations, and a higher body temperature can occur.
The most severe paws symptoms, which occur in the third stage over 48 to 96 hours, are intense itching; compulsive and hazardous behavior; sadness and worry; epileptic seizures with tremors; disorientation; panic attacks, and delirium as some of the psychological symptoms.
The symptoms and timeline of alcohol withdrawal will vary based on their age, how long they have abused alcohol, and how much alcohol was consumed before beginning treatment. While each stage of the detox bears a unique set of symptoms, most people will experience intense alcohol cravings at some time while some have more dangerous health consequences.
Different Strategies for Alcohol Detoxing
Some people may detox without quitting drinking entirely, but this is not a suggested approach unless only minor withdrawal symptoms exist. Alcohol withdrawals can be severe and even deadly in some cases. The first step in breaking free from alcoholism is detoxing. After acute detox, it’s important not to drink alcohol to avoid shocking one’s system and raising the risk of seizures.
Some individuals may believe that reducing the quantity of alcohol consumed is a feasible technique to quit drinking; nevertheless, keeping the benefits after quitting can be difficult. It may be possible for some people to avoid the symptoms of acute alcohol withdrawal. Still, even months after quitting drinking, they may continue to feel down and negative if their bodies’ damaged biochemistry isn’t repaired.
The alcoholic may not realize they have mental disorders and cognitive impairment unless it is appropriately treated by mental health professionals and behavioral health experts. If the person does not recognize that they have an issue with alcohol, they are more likely to relapse when they can’t figure out why they don’t feel better after quitting drinking and addiction treatment.
Inpatient and Outpatient Alcohol Detoxing Programs
The preferred approach for alcohol detox is an in-patient treatment program, and this will give individuals proper treatment, emotional support, and constant monitoring to assist them in their recovery process. An alcohol detox program will help people get the nutrition and hydration they need and strategies for coping with alcohol withdrawal symptoms and prevent relapse.
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.
Must Read: Is Xanax Addicting?
Post Acute Withdrawal Symptoms
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. The symptoms during the recovery journey are usually intermittent and can be cyclical. PAWS can often be the cause of people relapsing into their addictions.
PAWS symptoms can include: Inability to think, hostility anxiety, chemical imbalances, Memory problems, Emotional overreactions or numbness, Sleep disturbances/insomnia, Depression and fatigue, Anxiety and panic, Physical coordination problems, Stress sensitivity as part of the unexpected symptoms.
Predicting PAWS
In 2015, Dr. James Maldonado developed a method to forecast the risk of PAWS in a patient. 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.
It’s a series of inquiries that may help the doctor better assess how severe the addiction is and how soon PAWS will occur.
Not Just Alcohol
Abusing alcohol, opiates, antidepressants, marijuana, or benzodiazepines can all induce protracted or sustained withdrawal symptoms in people who are allergic to them. Some medicines might create long-lasting or persistent withdrawal symptoms after the acute stage is over. The healing process might take months or even years. The most remarkable approach to aid the recovery is to avoid stressful circumstances and locations that might cause a bad emotional reaction.
A person must be prepared for the possibility of PAWS. According to research, 70% to 90% of patients will experience symptoms of PAWS. They are generally only mild, but people may feel them so strongly that they believe they are going insane on rare occasions. People will still be uncomfortable with the emotional and mental symptoms, which might lead to relapse. These symptoms won’t last forever if treated appropriately.
Frequently Asked Question And Answers on Alcohol Post Acute Withdrawal Symptoms
Q. How can I tell if someone is experiencing Post Acute Withdrawal Symptoms?
A. Symptoms of Pare not always easy to recognize because they resemble the original problem, often with variations in intensity. The most noticeable difference between post-acute withdrawal syndrome and relapse is that the body has returned to its pre-addiction state while PAWS is still in the withdrawal phase.
Q. What are the dangers of not seeking treatment for PAWS symptoms?
A. Because the symptoms of post-acute withdrawal syndrome at their core can constantly be threatening to relapse, it’s essential that someone experiencing PAWS seek medical supervision and supportive care. Medical professionals determine what medications or therapies might alleviate physical withdrawal symptoms and help lessen the intensity of PAWS symptoms, which significantly increases one’s chances of becoming sober.
Q. How long does acute withdrawal syndrome paws last?
A. There is no set timeline for how long PAWS lasts because everyone is different and experiences common paws symptoms differently. Paws symptoms could dissipate after a few weeks or persist for years, and some people have been known to experience them nearly a year after their last drink.
Q. What is the connection between post-acute withdrawal syndrome and relapse?
A. Despite neither being fully sober nor experiencing intense cravings after addiction recovery, some patients will feel strong urges to drink again in the initial stages of recovery from active addiction. This is because PAWS can cause a patient to become frustrated or discouraged with their lack of progress. Some even experience intense depression and other symptoms. The more the body adjusts, though, the more noticeably different each cycle of PAWS will feel.
Q. Do all alcoholics experience paws symptoms?
A. No one knows for sure whether non-addicted people going through PAWS experience it in the same way. Most research has been conducted on alcohol-dependent subjects. However, some studies have indicated that even when people can successfully detox without medical supervision, they will still experience PAWS withdrawal process in some capacity.
Q. How do you treat post-acute withdrawal syndrome?
A. There is no surefire treatment for post-acute withdrawal syndrome as every person is different, and the symptoms vary significantly from subject to subject. Treatments for medically supervised detox that have been used with some success include medications, lifestyle changes, and therapies such as acupuncture.
The basis of post-acute withdrawal syndrome treatment for most people is a combination of medication and therapy. 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.
Q. What is the difference between post-acute withdrawal syndrome and major depressive disorder?
A. One of the most common misconceptions about PAWS is that it is an extension of depression or a depressive episode that has been prolonged by months instead of days. However, when someone is amid PAWS, they are not feeling depressed or sad. 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. When they occur simultaneously as depressive symptoms, it makes them even more challenging to tease apart.
Common symptoms tend to last about six months and then subside. People who enter into and recover from a depressive episode, on the other hand, may or may not feel well for considerably more extended periods.
Q. Is it possible to be feeling better after overcoming an alcohol addiction but still have cravings?
A. Yes! Many people experience cravings months, even years after they have stopped drinking. This does not mean that someone is destined to relapse, however. Cravings are normal and happen more often for people in early recovery or who are restarting drug use following a period of abstinence (e.g., jail). These cravings usually decrease over time as someone becomes acclimated to life without alcohol and as their brain balances itself out (neurofeedback).
Q. How can I know if what I am feeling is PAWS or major depressive disorder?
A. It may be helpful to keep a log of symptoms so that you can look back and see how often different symptoms occur and when they begin. This will help you determine if there is a pattern of PAWS or if your symptoms are more likely to indicate that you are experiencing depression. If you feel like your mood is low and impacting daily functioning and affecting your mental health, we recommend talking with someone who can help sort through what you’re feeling and make a diagnosis so you can receive medical assistance the soonest.
