Post-Acute Withdrawal Syndrome PAWS: What to Expect After Detox

The brain’s reward system is turned on its head, and its natural ability to cope with stress is undermined. For those who use opiates or opioids—from medically prescribed pain medications to heroin—the brain adjusts by decreasing its natural production of endorphins while increasing the number of opioid receptors. This increases sensitivity to pain and makes it much harder to experience pleasure in the absence of using.

Presentation of PAWS

After the acute withdrawal stage, some uncomfortable symptoms may linger. Although PAWS can be challenging, there are ways to manage the symptoms and successfully avoid using the substance again. The symptoms of protracted withdrawal can come and go over time depending on triggers. In general, though, PAWS is recorded as lasting a few weeks to a few months after stopping use. Some sources report that PAWS symptoms for morphine users usually start between 6 to 9 weeks after the acute withdrawal phase and persist until 26 to 30 weeks.

Although the symptoms of PAWS can be challenging, it’s possible to manage your symptoms in a healthy way. According to the research, these symptoms can endure weeks or even months after discontinuing use. Sometimes, your symptoms after stopping antidepressant use are part of the “rebound symptoms” — in other words, the symptoms you were trying to treat with antidepressants start coming back. A 2020 review noted evidence that SSRIs might be more likely to cause PAWS than other antidepressants, with paroxetine being most likely to produce PAWS symptoms.

Symptoms of Alcohol Withdrawal: Timeline and Signs of Danger

This article discusses alcohol withdrawal, its symptoms, and potential complications. It also provides an overview of the alcohol withdrawal timeline process and when to discuss your drinking with your healthcare provider. Enjoyable activities can also serve as healthy coping mechanisms during times of stress or when experiencing PAWS symptoms. By focusing on pleasurable pursuits, individuals can distract themselves from cravings or negative emotions, reducing the risk of relapse. These side What Is Angel Dust Side Effects, Use, and Risks effects can fluctuate in intensity over time and may come and go in waves. It’s essential for individuals experiencing PAWS to have a strong support system and coping strategies in place to manage these symptoms effectively.

Who Experiences Alcohol Withdrawal Symptoms?

1. These experiences were recorded 5 to 13 years after stopping antidepressants.
2. This adjustment can unmask underlying behavioral and process addictions as alternate unhealthy coping mechanisms.
3. This chronic stress response continues during post-acute withdrawal, receding and effectively resetting only gradually over time.
4. You can use SAMHSA’s Find Treatment tool to search for treatment centers.

People who drink daily or almost every day should not be left alone for the first few days after stopping alcohol. Withdrawal symptoms can quickly go from a bad hangover to a serious medical situation. Learning the symptoms of dry drunk syndrome as well as a few strategies to better cope can help you or someone you love to move past this stumbling block toward lasting recovery. This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services.

From these, we excluded 1,416 records during the title and abstract screening phase, leaving 592 full-text articles for review. Subsequently, 16 treatment studies met the inclusion criteria (Figure 1). Fourteen were pharmacological trials, whereas two were nonpharmacological intervention studies.

It’s essential to remember that progress is not always linear and that setbacks are a common part of the journey. Physical symptoms of PAWS can be distressing and may interfere with daily functioning. Sleep disturbances are prevalent, with individuals experiencing insomnia, vivid dreams, or altered sleep patterns. Many individuals report difficulty concentrating, feeling mentally “foggy,” and struggling to focus on tasks.

Emotional turbulence, cravings, fatigue…relapse tempts those struggling with PAWS. By shining light on this murky phenomenon, we can navigate towards calmer waters. However, PAWS can often disrupt sleep patterns, leading to insomnia or other sleep disturbances.

This means that after relapse, some PAWS symptoms may resurface upon withdrawing again. Mild, intermittent substance use can induce acute withdrawal, but may not cause the deeper neuroadaptations that drive PAWS. Someone who only used prescription opioids briefly at low doses may get through acute withdrawal with no PAWS.

People who experience severe withdrawal symptoms or DTs may require hospitalization or intensive care unit (ICU) treatment during alcohol. People with alcohol use disorder should be monitored by a medical professional when withdrawing from alcohol. Moderate to heavy drinkers can also benefit from medical supervision in the acute withdrawal stage.

PAWS has been a relatively neglected topic (De Soto et al., 1985), and few recent scientific studies support its existence. Consequently, the notion of PAWS remains highly controversial (Satel et al., 1993). However, these studies have not formally emphasized the notion of PAWS (Potgieter et al., 1999).