Aftershocks: Post Acute Withdrawal Symptoms (PAWS)

January 13, 2012

Psychological withdrawal is referred to as PAWS

Withdrawal is a two part process, where physical withdrawal is followed by a psychological withdrawal. Psychological withdrawal is referred to as post acute withdrawal symptoms (PAWS). Post acute withdrawal is also accompanied by a few physical symptoms. It is important to go to a substance abuse treatment program after a drug /or alcohol detox to decrease the risk of relapse related to post acute withdrawal symptoms.

First Part of Withdrawal: Detox

Different substances will produce different withdrawal symptoms. Each substance requires different lengths of time to completely leave the body. A medically supervised detox is suggested for the addict who wants to stop using substances. The physical withdrawal symptoms occur when the substances leave the addict’s body.  Alcohol and/or drug detox can be physically strenuous on the body and sometimes deadly. Common withdrawal symptoms are:

• Sweating
• Racing heart
• Palpitations
• Muscle tension
• Tightness in the chest
• Difficulty breathing
• Tremor
• Nausea, vomiting, and diarrhea

A medically monitored detox program will help the addict remain comfortable during the withdrawal process. A quality drug and alcohol detox facility will have a team of doctors and nurses who provide 24 hour supervision addressing the physical symptoms as they arise. Detoxing from substances alonewithout a follow up plan of substance abuse treatmentputs the addict at risk for relapse.

After an alcohol and drug detox regimen, the addict’s body will be exhaustedand post acute withdrawal symptoms will begin.

Second Part of Withdrawal: PAWS

Post acute withdrawal symptoms (PAWS) are just as important to address as the physical detox process. PAWS mimics feelings related to physical detox, however it is psychological as well as physical. This part of the process comes in episodes that last a few days at a time. PAWS patterns can remain present for up to two years. The feelings associated with these episodes range from good to bad, occurring within the same week or even within a span of a few hours. Physical symptoms that accompany PAWS will vary. Many of these symptoms are the body and brain’s response as they attempt to adjust back to a healthy level of functioning. No physical danger is present with PAWS other than the potential for relapse. Symptoms of PAWS:

• Mood swings
• Anxiety
• Irritability
• Tiredness
• Variable energy
• Low enthusiasm
• Variable concentration
• Disturbed sleep

The psychological and emotional detox can be more difficult than the physical component of drug and alcohol detox. The addict has grown accustomed to using substances in place of dealing with uncomfortable feelings. These painful feelings put the addict at greater risk for using substances again. Management of symptoms without using substances is the goal of treatment to decrease the risk of relapse.

Quick Tips for Managing PAWS

The cycle of addiction makes it difficult for an addict to change behavioral patterns. Instant gratification, poor sleep habits and poor diet are a few of the characteristics of an addict’s life. The unhealthy pattern of living needs to change, especially when dealing with post acute withdrawal symptoms. Some quick tips for managing PAWS are:

1. Don’t panic and be patient. The episode will pass.
2. Educate yourself on self care and changing unhealthy patterns such as: sleep schedule, diet, exercise, etc.
3. Find holistic remedies such as: acupuncture, massage, talk therapy, support group (AA/NA), etc.
4. Don’t dwell on symptoms which can make them worse.
5. Attend a substance abuse treatment to gain relapse prevention skills to cope with PAWS.

At first, the onset of PAWS can be discouraging for an addict who is attempting to maintain recovery. Understanding that this is a normal phenomenon and accepting the process makes dealing with PAWS bearable.  The benefit of attending a substance abuse treatment program  is that it gives the addict time to learn how to manage post acute withdrawal symptoms in a safe environment before returning home.

Substance Abuse Treatment Decreases the Risk of Relapse

Many addicts will complete an alcohol and drug detox program and go home unaware of post acute withdrawal symptoms. When PAWS occurs, the addict may feel that they have to use substances to fix the uncomfortable feelings. This is an automatic response that the brain produces out of habit from the cycle of addiction.

A substance abuse treatment program provides a safe environment for an addict providing time to adjust to living without using and learn how to manage PAWS. A multidisciplinary team of doctors, nurses, and therapists in a rehab facility will provide additional support for the addict. A comprehensive addiction treatment program will offer the addict educational lectures, relapse prevention groups, and individual counseling where the addict will learn coping skills for dealing with post acute withdrawal symptoms and triggers that contribute to continued substance abuse.

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Page Links

• Substance Abuse and Addiction
  

  Drug Detox Centers
  Everyone who wants to stop active drug addiction must go through drug detox first. Drug detox can be painful and dangerous and should always be followed by treatment.

  Alcohol and Drug Relapse Prevention
  Relapse prevention for both alcohol and drug abuse is a core component of addiction treatment. There are warning signs and tools that can help prevent relapse.

  Drug Addiction Treatment
  Learn what drug addiction is, what withdrawal symptoms can be, and what quality drug addiction treatment prgrams should offer.