Withdrawal symptoms can be a significant roadblock in your efforts to leave drugs or alcohol behind. That is because the rigors of withdrawal can be as damaging to your physical and mental health as continued substance use can be. Many people—particularly those who try to give up drugs or alcohol on their own—find themselves in a kind of trap. They know they need to stop using substances. They also know that withdrawal symptoms can make it all but impossible to do so.

Fortunately, a medically supervised detoxification program at a high-quality substance use disorder facility (we humbly submit that The Aviary Recovery Center qualifies) can make it possible for you to get to the other side of devastating withdrawal symptoms. Such a program provides a safe place to weather withdrawal that is also free of the temptations that might cause you to give up. Round-the-clock medical supervision ensures you make it through the process as comfortably as possible.

For some people, however, detox does not entirely eliminate withdrawal symptoms. Instead, the psychological and emotional symptoms of withdrawal linger for weeks, months, or even years. Those who struggle in this way are dealing with post-acute withdrawal syndrome. Though the syndrome is often abbreviated to a cute acronym—PAWS—it is not at all cute for the person who is dealing with it.

A couple of quick definitions before we continue. An “acute” condition is something that is happening in the moment—like withdrawal symptoms that occur while you are actively trying to give up drugs or alcohol. Something that is “post-acute” is happening after the active period of the challenge you are facing. So, in the case of post-acute withdrawal syndrome, we are talking about withdrawal symptoms that persist well after the actual process of withdrawal has occurred.

Considering the Causes of PAWS

While you were regularly using drugs or alcohol, new pathways were being created in your brain, and existing pathways were altered. When you have developed a substance use disorder, your brain becomes used to the idea that it is going to receive a steady supply of your substance of choice. When you stop providing that steady supply, your brain makes a concerted effort to remind you that it would like you to change course and return to drug use.

All of those things cause acute withdrawal symptoms and can also lead to post-acute withdrawal syndrome. While the remarkable neuroplasticity of our brains allows for the building of new pathways to replace those created during your active substance use period, that process takes time. It is while that process is underway that you may experience PAWS.

Recognizing the Symptoms of PAWS

The symptoms of PAWS are many and may include:

Strong cravings for drugs or alcohol
Ongoing executive dysfunction
Difficulty with fine motor coordination
A lack of initiative or pleasure in activities previously enjoyed
Foggy thinking and/or difficulty with memory and focus
Feelings of anxiety or panic or symptoms of depression
Frequent mood swings
Feeling of irritability and/or hostility
Increased sensitivity to stress
Fatigue and/or sleep disturbances including insomnia, vivid dreams, and other issues
Unexplained chronic pain
A reduced libido (sex drive)

Many of these symptoms are similar—even identical—to those related to mood and anxiety disorders. Those sorts of mental health issues may be co-occurring with a substance use disorder. Your doctor or therapist will be best able to help you sort out whether you are experiencing PAWS, a mental health disorder, or both.

What to Do When PAWS Appears

Because the sorts of symptoms listed above can lead you down a path toward relapse, it is important to have an action plan in place in case you experience PAWS. Your strategies might include:

Talking about your experience of PAWS symptoms with a doctor, therapist, counselor, and/or 12-Step sponsor. Family and friends can also be supportive, but having a conversation with someone with expertise in recovery is a good idea.
Focusing on the fundamentals of self-care that support your ongoing recovery, including a healthy diet, regular exercise, restful sleep, and positive relationships.
Avoiding situations, places, and people that might be triggering because they are connected to your history with drugs or alcohol.
Knowing what activities can distract you or otherwise help you weather a flare-up of cravings. These might include writing or drawing in a journal, practicing mindfulness, doing some yoga, going for a walk, listening to your favorite music, or reaching out to a trusted friend who might meet you for a cup of coffee and a chat.
Getting in the habit of writing more things down and/or setting up reminders in your phone if you are having difficulty with focus or memory.
Remembering that PAWS is part of many people’s recovery journey, which means you are not facing the challenge alone.

Do Not Pause. Get the Help You Need Now

Located near St. Louis, Missouri, The Aviary Recovery Center provides personalized treatment for substance use disorders and co-occurring mental health disorders. We are also committed to providing ongoing support and resources as your recovery journey gets underway and challenges (perhaps including PAWS) arise. When you are ready to get the help you need to reclaim and redefine your life, we are here to help you reach your goals.