When a loved one completes an intensive outpatient program in Easton PA, many families begin to see the light at the end of the tunnel. They know that recovery is a long-term process, but they feel like the hardest parts — getting their loved one to recognize their problem and into treatment — are over. But what many families don’t realize is that post-acute withdrawal syndrome (PAWS) can come and go for months or years.
If your loved one is returning home from rehab or stepping down to a lower level of care, you’ll definitely want to celebrate this milestone! But it’s also important to be aware of PAWS and how to manage the symptoms if they do arise.
What is Post-Acute Withdrawal Syndrome?
Post-acute withdrawal syndrome, or PAWS, refers to a group of symptoms that linger on in recovery. During acute withdrawal, most of the symptoms are physical: nausea, increased heart rate, muscle aches and headaches. They happen because the body is adjusting to not having the substance in the body. After about a week or so, most physical symptoms taper off and the person is ready to start therapy.
When symptoms develop after the acute withdrawal stage, this is called PAWS. These symptoms are usually psychological or emotional and include drug cravings, mood swings and sleep problems. The brain needs time to heal, and this is why PAWS symptoms occur. Even though PAWS is temporary and will go away, the symptoms can be intense and become a driving factor in relapse.
What are the Symptoms of PAWS?
With so much emphasis on acute withdrawal, people often don’t realize that another set of withdrawal symptoms can occur later down the road. The symptoms of PAWS are usually psychological or emotional and include:
- Drug cravings
- Brain fog
- Irritability
- Hostility
- Mood swings
- Sleep problems
- Depression or anxiety
- Lack of motivation
- Stress sensitivity
What Causes PAWS to Happen?
Drug use changes the brain and the way it handles stress. PAWS is the brain’s way of correcting these changes and restoring chemical imbalances. While anyone in recovery can experience PAWS, it does tend to be brought on by stressful experiences or situations that remind you of your past substance use.
Dopamine and endorphins are feel-good chemicals that occur naturally in the body. They affect how your body works and how you feel. However, substance use hijacks this system by releasing an excess of dopamine. Over time, your body learns to rely on the substance for dopamine and stops producing its own.
When you quit taking the substance, your body now has low dopamine, causing symptoms like fatigue, low motivation, mood swings and anxiety. In time, your brain will heal and learn how to produce its own supply of feel-good chemicals again. But until this time comes, you may experience PAWS symptoms.
Can I Prevent PAWS from Happening?
You can’t exactly avoid PAWS, though not everyone experiences it. It is more common in those who are in recovery for an opioid use disorder or alcohol use disorder. What you can do is learn to recognize the symptoms so that you can manage them successfully. When you do this, the symptoms become less intense and less frequent, and you’ll feel more confident about navigating your recovery and preventing relapse.
Many people describe PAWS as being a rollercoaster of emotion, so it is possible for these symptoms to come out of nowhere. This is why it’s important to have effective coping strategies to use when life feels unmanageable. And remember that PAWS symptoms, like all withdrawal symptoms, are temporary and will not last forever.
How Long Do PAWS Symptoms Last?
Most of the time, symptoms last for a few days and then taper off, although this does depend on the person, the substance and the severity of the addiction. It takes about six months to two years for the brain to recalibrate and start producing its own dopamine, endorphins and other chemicals. You need these to regulate your emotions. While challenging, remember to make recovery your priority and practice healthy coping skills to reduce your relapse risk.
What are the Best Strategies for Getting Through PAWS?
There are a number of strategies that can help you work through PAWS:
- Practice self-care. Make sure to eat well, exercise, get enough rest and avoid stressful situations. Taking care of yourself gives you more energy to handle negative emotions.
- Spend time with others. Surround yourself with positive, encouraging individuals. They can offer support when your symptoms flare up.
- Follow your aftercare plan. It helps to have built-in support for when you need it. Continue going to your therapy and counseling appointments, find support groups in your area and join online communities.
- Start a journal. Track your thoughts, emotions and symptoms in a journal. You may notice that certain situations or times of the day are more likely to bring on PAWS.
- Have healthy distractions. Whether it’s your favorite hobby, a funny comedy show or a walk outside, have an array of healthy distractions at your disposal. This will help you get your mind off your discomfort.
- Give yourself grace. Recovery is a long road, and both your body and brain have to heal. While uncomfortable, PAWS is a reminder that your brain is returning to normal.
Help with Navigating PAWS
Recovery Cove in Easton, PA will walk the journey of recovery with you. We offer partial hospitalization, intensive outpatient and outpatient care in a positive and encouraging environment. We recognize that PAWS is a rollercoaster of emotions for many of our clients, but we teach essential skills and tools to help them manage cravings and work through PAWS symptoms. To learn more about our programs and services, contact us today at 484-549-COVE.
