Home / How to Deal With Post-Acute Withdrawal Syndrome (PAWS)


How to Deal With Post-Acute Withdrawal Syndrome (PAWS)

Many people think of alcohol and drug withdrawal as the temporary physical comfort that you experience after quitting the use of alcohol or drugs. These physical withdrawal symptoms often go away after three to seven days but with post-acute withdrawal syndrome, these psychological effects might remain for weeks or months after withdrawal and detox. If you feel frustrated or confused about your symptoms it may help to understand what it is you’re dealing with and how to go about it.

What is Post-Acute Withdrawal Syndrome (PAWS)?

In the early stages of addiction rehabilitation, psychological withdrawal symptoms from drugs or alcohol are referred to as post-acute withdrawal syndrome, or PAWS. This occurs as your brain attempts to rebalance itself without using addictive substances that it has grown accustomed to.

One of the main reasons why people get addicted to drugs and alcohol is because of endorphins. The body’s “natural painkiller” is a feel-good chemical that is released by the brain to alleviate pain and promote pleasure.

It’s unconsciously addicting and frequent use of alcohol or drugs instructs your brain to make more endorphins. So when you drink or use drugs, that’s what causes the high or relaxed feelings you experience.

However, continued drug abuse depletes your body’s natural supply of endorphins forcing your brain to rely on alcohol or other substances to create normal quantities of chemicals, many of which are connected to bodily processes. That’s why quitting the use of addictive substances throws your system into shock because your body is trying to balance itself without drugs and alcohol.

When this happens the result is the physical withdrawal symptoms that people associate with detoxing like tremors, vomiting, and others. Usually, physical withdrawal symptoms subside over a few days or, at most, a few weeks. However, PAWS symptoms may persist and can last for weeks or months.

This is because addiction leaves a chemical imbalance in the brain that causes physical withdrawal and may also manifest mental illness symptoms. Chemicals play a central role in mental health disorders such as anxiety and depression, PAWS symptoms usually begin about two to four weeks after a drug or alcohol detox, and from there it gradually gets better.

Some common post-acute withdrawal symptoms to take note of are the following:

  • Mood swings
  • Panic and anxiety attacks
  • Irritability
  • Low energy and motivation
  • Uncertainty and haziness

One of the biggest PAWS risks is relapse. Commonly due to the overwhelming feelings of depression, anxiety, boredom, or apathy. These can drive you to begin self-medicating with substance abuse as drugs or alcohol were your prior coping mechanism for these emotions.

So it’s important to remember that while using or drinking may help numb these feelings and make you feel great for a few hours, the repercussions will ultimately make mental health symptoms worse.

How do you treat PAWS?

Post-acute withdrawal syndrome is a protracted withdrawal which means that it’s the longer-term aftermath of substance abuse. The symptoms can be treated through a combination of medical and behavioral approaches such as the following:


Prescription drugs like antidepressants and anti-anxiety medications can help ease depression and reduce symptoms of anxiety that accompany PAWS. They help correct some of the chemical imbalances left over by the stimulation of neurotransmitters such as serotonin and dopamine.

Behavioral Therapy

Research shows that behavioral therapy coupled with medications is effective in helping ease mental health symptoms. Evidence-based addiction treatment like cognitive behavioral therapy helps in regulating your emotions and addresses unhealthy thought patterns that increase the possibility of a relapse. 

Support Groups

The benefits of doing rehabilitation therapy in groups such as attending 12-step groups or 12-step alternatives give each patient a sense of support and accountability in early recovery. So when PAWS symptoms are beginning to manifest and threaten your sobriety, having peers or sponsors to help guide you is critical to staying on track.

Exercise and Nutrition

The synergistic connection between the mind and body is every bit as real and critical in preventing or easing psychiatric symptoms. Research tells us that the benefits of exercise with proper nutrition help in making a positive impact on your brain and overall well-being. This is simply because when you feel good it’s easier to resist triggers that can provoke a relapse.

Mindfulness Exercises

Mindfulness practices like meditation and yoga can also help you stay grounded in moments of challenges and in this case help alleviate stress and do away with negative thoughts. Since spirituality gives you a sense of being part of something bigger than yourself and what you’re going through.


And lastly, in addition to eating well and exercising, other forms of self-care can help support and promote your sobriety. Such activities as getting enough sleep can have a huge impact on how you feel and your ability to cope with difficult situations. Hanging out with friends and family can help bring your mood up and participate in hobbies that you enjoy.

Above all else, remember that post-acute withdrawal syndrome is a normal part of recovery and not everyone will experience it. The severity of it depends on a lot of factors that differ with each person such as the depth of your addiction and your physical make-up.

Everything gets better with time and there is nothing wrong with taking each step in your own time. What matters is that you’re making progress in your recovery.

Looking for help?

Find a safe space near you so that you can freely and openly express your feelings and be guided throughout your rehabilitation journey by professionals and people who are going through the same thing. Contact R&R Recovery IOP Treatment in Huntington Beach for options, consultation, and more.

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