Post-Acute Withdrawal Syndrome

Many of the problems associated with early sobriety do not stem directly from psychoactive substances. Instead they are associated with physical and psychological changes that occur after the substances have left the body. When a person regularly uses psychoactive drugs, the brain undergoes physical changes to cope with the presence of drugs in the body. When the drugs are removed from the body, the brain craves the drugs that it has become accustomed to and as the brain attempts to rebalance itself without the presence of psychoactive drugs the person often experiences feelings of confusion, pain, and discomfort. The symptoms that are experienced immediately after stopping drug use are called acute withdrawal. But often the symptoms do not stop at acute withdrawal. After the body makes initial adjustments to the absence of drugs, the changes that have occurred in the brain still need time to revert back to their original state. During this period, a variety of symptoms known as Post-Acute Withdrawal Syndrome (PAWS) begin to occur. In the book Uppers, Downers, All Arounders, published by CNS Productions, authors Darryl Inaba and William Cohen define PAWS as “a group of emotional and physical symptoms that appear after major withdrawal symptoms have abated” (Inaba & Cohen, 2011).

According to Inaba and Cohen, PAWS is a result of damage to brain neurons combined with the psychological stress of living a drug and alcohol free life (Inaba & Cohen, 2011). The symptoms of PAWS typically last six to 18 months but sometimes can last up to ten years. The major symptoms of PAWS include sleep disturbances, memory problems, inability to think clearly, emotional overreaction or numbness, problems with physical coordination, and a hi...

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...hat relapse does not become an option. I have always believed that with knowledge come choices and this motto is especially helpful in situations where choices seem limited like they do during PAWS. Treatment centers should implement mandatory education about PAWS which includes teaching about the reasons and the symptoms of PAWS, the length of time a person can expect to be at risk of experiencing PAWS, the high risk of relapse potential that exists during PAWS, and how to recognize, manage, and control the symptoms of PAWS as soon as they appear so that relapse does not occur and continued recovery prevails.

Works Cited

Gorski, T. T., & Miller, M. (1986). Staying Sober: A Guide for Relapse Prevention. New Providence, NJ: Independence Press.

Inaba, D. S., & Cohen, W. E. (2011). Uppers, downers, all arounders. (7th ed.). Medford, OR: CNS Productions, Inc.