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Coping With Post-Acute Withdrawal Syndrome

by | Last updated May 11, 2021 at 12:11PM | Published on Feb 12, 2020 | Rehab Programs

Post Acute Withdrawal Syndrome Symptoms

Most people will start their drug and alcohol addiction recovery with a detox program. Because withdrawal from substances can be uncomfortable, dangerous, and even fatal, medical detox is essential. However, some people experience post-acute withdrawal syndrome, tampering with their recovery process, sometimes even months after their rehab. 

What is Post-Acute Withdrawal Syndrome?

Post-acute withdrawal syndrome (PAWS) is different from withdrawal. Withdrawal includes the most severe symptoms of coming off drugs and alcohol, such as severe cravings, vomiting, and even seizures. 

After withdrawal, the body and brain are still adjusting to life without substances. The result is post-acute withdrawal syndrome, a condition in which someone experiences milder (but always tricky) symptoms. These symptoms can sometimes last for months and appear without any triggers. However, there are ways to cope with PAWS and maintain long-term recovery. 

Signs of Post-Acute Withdrawal Syndrome

Post-acute withdrawal symptoms (PAWS) can continue even after six months of someone’s last dose. These come and go as waves and might require medical attention to control. The most common symptoms include:

  • Intense and persistent anxiety
  • Insomnia
  • Difficulty performing complex tasks
  • Difficulty concentrating
  • Loss of sex drive
  • Depression

Other PAWS symptoms vary based on which drugs someone was using, how long they used, and the amounts they used. For example, someone who has been using methadone and opiates for years may be more likely to experience muscle aches and cramping. In contrast, someone who used benzodiazepines is likely more prone to anxiety and panic attacks.

How Long are Withdrawal Symptoms?

The duration of PAWS is also very individualized. In some cases, it can last for several weeks. In others, it can take months. The bad news is that there isn’t an exact science to predicting how long PAWS will last since it’s so dependent on individual health and condition. 

Fortunately, however, post-acute withdrawal syndrome usually gets less intense over time. For example, while someone may struggle with PAWS for up to twelve months, they may only experience one or two symptoms (like poor concentration) towards the end of this period. 

No matter the specific symptoms, post-acute withdrawal syndrome can be a barrier to recovery and can lead to relapse. 

Coping with Severe Withdrawal Symptoms

There are some specific ways to manage PAWS without turning to drugs or alcohol. One of the most important is developing coping skills. Unpleasant symptoms can increase the risk of relapse because it seems like an “easy fix.” However, this restarts the cycle of addiction, detox, withdrawal, and PAWS.

To cope with emotional issues, developing coping skills is vital. Some practical coping skills might include journaling, art, or using DBT skills. Additionally, using these tools help in managing emotions such as depression, anxiety, and agitation.

Some ways to reduce post-acute withdrawal syndrome symptoms include:

  • Maintaining a regular sleep schedule to reduce stress levels and triggers.
  • Eating regular, balanced meals to maintain healthy hormone levels and reduce vulnerability to pain, illness, and other symptoms.
  • Practice self-care and focus on improving your overall wellbeing might help reduce cravings.
  • Seeking support and guidance whenever you feel overwhelmed by the symptoms. 
  • Exercising regularly can help reduce pain, improve sleep, and promote overall wellbeing. 
  • Keeping a log of triggers and cravings can help you be better prepared for facing them and using relapse prevention techniques. 
  • Reducing stress, avoiding high-risk situations, and keeping negative influences away can also help maintain long-term recovery. 
  • Following doctor’s instructions on medications that can help ease and manage post-acute withdrawal symptoms. 

Above all, it’s essential to be kind and gentle with yourself.  A lot of people in recovery will struggle with the psychological and emotional effects of PAWS. Being a recovering addict can be challenging; it’s important to seek addiction treatment centers that offer mental health support to help you learn how to master impulse control and recognize the risk factors of your triggers.

Treating Addiction

At Lighthouse Recovery Institute, we focus on compassion for our patients. Our staff understands that post-acute withdrawal syndrome can be a significant challenge for patients in early recovery. 

Because of this, we maintain a smaller, intimate treatment environment that allows us to give each patient the individual care and attention they deserve. We also help patients track PAWS throughout their stay to make sure that we are addressing symptoms.

We offer medication management to help reduce PAWS, address underlying medical conditions, and treat dual diagnosis disorders. Above all, we help our patients rebuild new lives in recovery, from the beginning of their treatment through each transition. We know that our patients can make it through PAWS to the other side, with lives full of joy, freedom, and success.

Seek Substance Abuse Treatment

If you or someone you know is struggling with substance abuse, don’t wait any longer. Countless treatment options can help them conquer their drug abuse and manage any withdrawal symptoms. Remember, quitting potent drugs alone can be life-threatening. It’s essential to have the support and supervision of drug addiction specialists by your side. 

At Lighthouse Recovery Institute, we believe in offering customized drug addiction treatment programs. On a case-by-case basis, we look at each program to cater to whatever your needs are to get better and walk towards recovery. From detoxification programs to group meetings and more, everyone in our team is committed to helping you win the battle of addiction. 



Molly is Lighthouse Recovery Institute’s Case Manager and Vocational Services. She has a Bachelor’s in International Relations, is a Certified Addiction Counselor, and it’s currently working towards her Master’s in Social Work. Molly’s experience allows her to provide expert knowledge about solution-based methods to help people in recovery maintain long-term sobriety.
Medical Disclaimer:

Lighthouse Recovery Institute aims to improve the quality of life for anyone struggling with substance use or mental health disorder. We provide fact-based content about the nature of behavioral health conditions, treatment options, and their outcomes. The material we publish is researched, cited, edited, and reviewed by licensed medical professionals. The information we provide in our posts is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be used in place of the advice of your physician or another qualified healthcare provider.

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