Withdrawal symptoms are an unpleasant, yet inevitable, part of successfully stopping the use of drugs and alcohol. Most acute symptoms surface and subside within a matter of days or weeks. However, post-acute withdrawal syndrome (PAWS) can persist for months after an individual ceases drug or alcohol use. At Retreat of Atlanta, we guide individuals through the PAWS symptoms timeline so that they can achieve a long and fulfilling life of recovery.
What is PAWS?
Post-acute withdrawal syndrome (PAWS) is a condition characterized by persistent withdrawal symptoms. These commonly occur after the initial detox phase from substances such as opioids, alcohol, or benzodiazepines. PAWS usually includes physical, psychological, and emotional symptoms, which can persist for several months. These can make the recovery process more challenging for many individuals and even lead to relapse.
PAWS is vital to recognize as it can greatly affect a person’s ability and motivation to sustain sobriety. Thankfully, these symptoms can be managed through evidence-based therapies, holistic healing strategies, and group settings. These treatment modalities help individuals learn effective ways to manage these symptoms by instilling healthy coping mechanisms and thought processes.
Causes and Risk Factors of PAWS
Though there is no single cause of PAWS, several factors can contribute to its development. These include the severity of an individual’s addiction as well as their mental health and family history. Specific factors correlated with the development of PAWS include:
- Duration of Drug Use: Prolonged drug use can make the development of PAWS more likely.
- Dual Diagnosis: Those with co-occurring mental health disorders are at a greater risk of PAWS.
- Type of Substance: The intensity and duration of withdrawal symptoms are influenced by the kind of drug an individual has been abusing.
- History of Drug Use: Past experiences with withdrawal can increase the likelihood and severity of post-acute withdrawal symptoms.
- Insufficient Support: Support is a vital part of recovery. Those who do not have a strong support network are more susceptible to PAWS.
- Genetic Influence: A family history of addiction can put individuals at a higher risk of developing PAWS.
Signs and Symptoms of Post-Acute Withdrawal Syndrome
It is essential to be aware of the symptoms associated with PAWS, so that individuals can get the help they require throughout early recovery. Though temporary, these symptoms can be unpleasant and draining—highlighting the need for comprehensive treatment. Symptoms typically associated with post-acute withdrawal syndrome include:
- Anxiety
- Depression
- Panic Attacks
- Increased Irritability
- Cravings
- Trouble Thinking
- Memory Impairment
- Lack of Initiative or Motivation
- Mood Swings
- Fatigue
- Sleep Disturbances
- Difficulties With Fine Motor Skills
- Stress Sensitivity
- Poor Focus
PAWS Symptoms Timeline
The PAWS symptoms timeline can be influenced by the type of substance an individual has been using, how long they have been using it, and how much they use at one time. Furthermore, personal circumstances, such as family history and overall health, can play a role in the duration of PAWS. The typical phases of withdrawal are highlighted below:
- First Few Days: Acute withdrawal symptoms surface and peak during this time.
- Weeks 1-2: PAWS begins to develop. This includes persistent sleep disturbances, mood swings, fatigue, and trouble concentrating. Cravings continue and can increase in intensity for some individuals.
- Weeks 3-4: PAWS continues with anxiety and depression as well as fluctuations in overall mood and motivation. However, physical symptoms generally decrease for most individuals.
- Months 1-3: This is considered to be late PAWS. Symptoms may include lingering mental health challenges, such as poor emotional regulation, social withdrawal, and lack of motivation. Furthermore, cravings are likely still present, though their intensity has decreased.
- Months 3-6: During this time, emotional stability may improve. However, mental difficulties may linger, as well as occasional cravings.
- Beyond 6 Months: Though the majority of withdrawal symptoms should be mostly resolved, anxiety, depression, occasional cravings, and emotional sensitivity can persist. It is important to continue treatment if an individual is still struggling with these symptoms.
PAWS Alcohol Timeline
Alcohol withdrawal symptoms are notoriously dangerous and can even prove deadly when not properly monitored. Furthermore, PAWS can be particularly difficult for those in recovery from alcoholism. A typical PAWS symptoms timeline associated with alcohol withdrawal goes as follows:
- Days 1-3: This is considered the acute withdrawal phase. It includes tremors, hallucinations, delusions, nausea, profuse sweating, cravings, insomnia, anxiety, irritability, and even seizures.
- Days 4-7: Early PAWS sets in with intensified psychological symptoms and reduced physical symptoms.
- Weeks 2-4: Ongoing PAWS continues with emotional and cognitive problems such as depression, anxiety, and insomnia.
- Months 1-3: Late PAWS includes continued cravings, mental challenges, and reduced motivation.
- Months 3-6: Emotional regulation and clarity may improve while some psychological symptoms and cravings linger.
- Beyond 6 Months: Most PAWS symptoms should be diminished by this time. However, some individuals may encounter residual emotional sensitivity or occasional cravings.
How is PAWS Diagnosed?
At Retreat of Atlanta, we diagnose PAWS through a thorough clinical evaluation. This comes after or during the detox process and assesses an individual’s experiences with withdrawal, their history of addiction, and any ongoing symptoms. Our qualified staff uses both observed behaviors as well as self-reported symptoms that have persisted past the acute phase of withdrawal in order to make an official diagnosis. These symptoms may include increased depression, anxiety, mood swings, cognitive difficulties, and sleep disturbances. Following a diagnosis of PAWS, individuals are properly monitored and treated in order to help them navigate these symptoms. Our ultimate goal in treating PAWS is to help our clients establish recovery on a long-term scale.
How is Protracted Withdrawal Treated?
PAWS, also called protracted withdrawal, is treated through a combination of medication management, evidence-based interventions, and holistic modalities. These help to address the underlying causes of an individual’s addiction as well as any mental health issues. At Retreat of Atlanta, we offer the following services for those in our gender-specific detox programs:
- Medication-assisted Treatment
- Cognitive-behavioral Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Individual Therapy
- Group Therapy
- Family Counseling
- Psychiatry
- Holistic Therapy
- Dual Diagnosis Treatment
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How Do I Get Through PAWS?
The first step in successfully navigating PAWS is to seek help from a reputable detox facility. This type of programming helps individuals to undergo withdrawal in a secure, medically-monitored setting. There, compassionate staff members can administer appropriate medications and handle any challenges that may surface during the withdrawal process. Furthermore, detox programs offer a nurturing environment that promotes rest and healing.
Following detox, individuals struggling with PAWS should participate in further addiction treatment, such as inpatient rehab or partial hospitalization programming. This gives them the opportunity to continue working through the factors that have led to their addiction while cultivating vital coping mechanisms. Furthermore, support is a crucial component of a successful recovery. By participating in support groups, individuals with PAWS are able to connect with others in a judgment-free environment. This helps to reduce feelings of loneliness that contribute to the emotional distress associated with post-acute withdrawal syndrome.
Find Effective Detox in Atlanta, GA
Post-acute withdrawal syndrome can be incredibly tasking. Thankfully, help is only one call away. Retreat of Atlanta allows individuals to undergo each phase of withdrawal in a safe and transformative atmosphere. Our goal is to help each of our clients establish a firm foundation for recovery so that they can achieve a better, brighter future. To get the help you deserve today, give us a call or visit our admissions page.