+39 0536 62968 (Lago della Ninfa) | +39 339 65 23 405 info@deepice.com PRENOTA LA TUA LEZIONE ORA

During acute withdrawal, the body is healing from the substance misuse. The effects can be life threatening, and it is important to undergo acute withdrawal with medical supervision. With aggressive prevention and recognition, mortality rates decrease to 1-4% . 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.

paws alcohol

The brain then makes changes to avoid permanent or recurrent inhibition. These changes cause the nervous system to become overactive and easily excitable when the drinking stops 3. Anhedonia is losing interest in things that you previously enjoyed doing, sometimes https://sober-house.net/ described as having your ability to feel pleasure turned off. In extreme cases, anhedonia can extend to losing interest is pursuing basic needs, like eating. One study was specifically conducted to determine if PAWS should be included in the DSM-IV.

Post-acute withdrawal symptoms typically last between 1 and 2 years; however, the severity and frequency of symptoms tend to dissipate as times goes by without the use of addictive substances. Post-acute withdrawal syndrome occurs after the acute withdrawal stage and is a natural occurrence as the brain slowly returns back to normal over a period of time. As one’s brain chemicals begin to regulate, their post-acute withdrawal symptoms may fluctuate as the individual’s brain attempts to seek a healthy equilibrium. PAWS is the brain’s way of correcting chemical imbalances that it suffered from during active addiction. PAWS tends to occur more commonly and intensely among individuals with alcohol, Benzodiazepine, or Opioid addictions. Infants born to mothers who used substances of dependence during pregnancy may also experience a post-acute withdrawal syndrome.

Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Sometimes they can become overly excited and excessively angry over small matters, then go into a stage of not feeling any emotions at all. Authors of the Johns Hopkins study concluded that their findings were “consistent with the concept of a protracted withdrawal syndrome.” Benzodiazepines, such as Xanax, Ativan and Klonopin, are known for having common PAWS, including intense anxiety, panic attacks, irritability, and severe sleep disturbances, including insomnia. To understand Post-Acute Withdrawal Syndrome , one must first understand the 2 stages of detox or withdrawal symptoms.

Common Post-Acute Withdrawal Symptoms

If you or a loved one are experiencing PAWS, there are treatments to help you manage these symptoms. Although these withdrawal symptoms eventually go away, it is essential to understand them and learn how to cope with them, as they can sometimes cause someone in recovery to relapse. Recovery experts say that patients abstaining from alcohol and opiate-based painkillers will typically experience post-acute withdrawal from six to 24 months.

paws alcohol

If you know what to expect, you won’t be caught off-guard the next time the situation arises. It’s a series of questions that can give the doctor a better idea of how severe the addiction is and helps predict the acuteness of PAWS.


Acquiring coping skills can help someone in recovery effectively deal with PAWS symptoms. Cognitive therapy is a great way to learn skills that can change negative thinking patterns and create more positive thoughts 1. A support system can also consist of friends, family, and perhaps a religious or spiritual group. However, the support system must only include those who want to help the recovering individual stay sober. This support system will ideally help them to cope with PAWS symptoms 8. PAWS can last a couple of weeks and may stick around for months or years.

  • Animations controlled by the interface include videos, GIFs, and CSS flashing transitions.
  • Much of what people are taught in addiction treatment is geared towards helping them successfully navigate the challenges of PAWS.
  • The Hazelden Betty Ford Foundation has addiction and mental health facilities in 8 States throughout the United States.

As a result, you should continue to practice self-care techniques that help you remain calm, motivated, and focused on recovery. Withdrawal symptoms can be uncomfortable, painful, and even life-threatening without proper medical attention, so professional detox is such an important step in the recovery process. While most withdrawal symptoms subside after two weeks, some linger past the typical timeline. In a person with an addiction to benzodiazepines, for example, lasting withdrawal symptoms can stem from functional changes to the neuroreceptors in the central nervous system. Up to 15% of people who have taken benzodiazepines long term experience PAWS. Much of what people are taught in addiction treatment is geared towards helping them successfully navigate the challenges of PAWS.


When you stop using a certain substance, you might experience withdrawal symptoms for a few days or weeks. There are multiple addictive substances that, when abused and detoxed, can result in PAWS. For example, 90% of people recovering from opioid addiction experience PAWS to some extent, as do 75% of people recovering from alcohol and psychotropic drug abuse 2. Treatment is generally administered over an extended period of time because the symptoms of PAWS can continue for months or years. Acamprosate, a drug commonly used to help recovering alcoholics, has been found to be somewhat effective in managing some PAWS symptoms. Most patients undergo psychotherapy as well, in the form of behavioral therapy, group therapy, or both to learn to cope with the symptoms.

paws alcohol

There are many outpatient treatment programs available to guide you through the post-acute withdrawal phase during recovery to prevent relapse. Contact a treatment provider today to learn more about the various rehab options. Acamprosate has been found to be effective in alleviating some of the post acute withdrawal symptoms of alcohol withdrawal. Carbamazepine or trazodone may also be effective in the treatment of post acute withdrawal syndrome in regards to alcohol use.

How to Recognize PAWS

Typically, the brain recalibration process takes anywhere from six months to two years before the brain once again naturally produces endorphins and dopamine. These programs require individuals to visit the detox center daily throughout the process to check on medications and withdrawal symptoms. This allows people to continue with work, school, or other personal commitments without needing to take time off or explain an absence. Mild withdrawal symptoms may occur within the first six to 24 hours after one’s last drink.

Stress Management

Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Practice positive self-talk, including reminding yourself that what you are experiencing is normal and that “this too shall pass.” Be gentle with the thoughts you have, and be patient with yourself. Have a confidential, completely free conversation with a treatment provider about your financial options. Try to remember “this, too, shall pass.” The symptoms are part of your recovery journey and proof that you’re making progress. If insomnia is a problem, limit the amount of caffeine used before bedtime and try to establish a sleep routine by going to bed at the same time every night and waking up at the same time each morning . Review the events that precede a flare-up of your PAWS symptoms, and think about how you reacted.

Prediction of Alcohol Withdrawal Severity Scale

Regardless of the addictive substance used, PAWS are typically the same for most individuals in early recovery from substance use disorders . Disturbances in mental function can persist for several eco sober house review months or years after withdrawal from benzodiazepines. Psychotic depression persisting for more than a year following benzodiazepine withdrawal has been documented in the medical literature.

One unexpected protracted withdrawal symptoms for many recovering addicts is an increased sensitivity to stress and stressful events. Some report that they not only more easily stressed, but can become overwhelmed by even slightly stressful situations. Treatment experts believe that this hypersensitivity to stress can exacerbate all the other post-acute withdrawal symptoms.

As the symptoms of acute withdrawal in early abstinence begin to diminish and stabilize, the symptoms of post acute withdrawal begin to appear, usually between seven and 14 days into sobriety. But, the phenomenon also known as protracted withdrawal syndrome or simply prolonged withdrawal is not without some controversy. Consider writing in a journal as a way to gain awareness and insight into your symptoms and document your experiences utilizing different coping skills. It is also a healthy way to express yourself and your feelings/emotions.