Sep 6, 2013 | By Tim Stoddart

The Basics Of Post Acute Withdrawal Syndrome

Drug and Alcohol Detoxification

Detoxing from an alcohol or drug addiction is indescribably difficult. After you get through it, you’re happy knowing that the worst of the physical pain is over. Detox is no small accomplishment by any means. Unfortunately, the end of detox doesn’t necessarily mean the end to withdrawal. Most alcoholics and addicts will then experience some degree of Post Acute Withdrawal Syndrome (PAWS).


PAWS has a wide range of symptoms, and it will affect each individual differently. The severity of it will depend on the level of your addiction and how much damage was done to your nervous system during the course of your addiction. Most addicts experience PAWS immediately after detox, and the symptoms usually peak at about three to six months later. However, PAWS can last up to two years, and sometimes even much longer. PAWS tends to last the longest for the most extreme, long-lasting cases of addiction and for people over the age of 55.

There are six main symptoms of Post Acute Withdrawal Syndrome:

Difficulty with Clear Thinking –  such as trouble with problem-solving, reasoning, processing thoughts, and concentrating.

Difficulty with Managing Stress – such as trouble coping with stress or even recognizing it.

Difficulty with Managing Emotions – such as feeling extreme emotions, overreacting, depression, feeling numb, or under-reacting.

– such as insomnia, sleep apnea, sleeping too much, or not being able to keep a regular sleep cycle.

Difficulty with Physical Coordination – such as trouble with balancing, fine motor skills, hand-eye coordination, and reflexes.

Difficulty with Memory – such as short-term or long-term memory loss.

If you’re an addict in early recovery who is experiencing any of the following symptoms, you’re likely suffering from PAWS. But you aren’t powerless over the symptoms. Managing PAWS is an important part of early recovery. Here are some things that can help ease the aftershocks

Your Support System – can help you stabilize your feelings. Talk to trusted friends, your family, your sponsor, and other supportive people to help you work through your difficulties.

Protecting Yourself – from threats to your sobriety is crucial to making it through PAWS.

Proper Nutrition  – and a balanced diet that’s low in sugar, fat and caffeine will help reduce the symptoms of PAWS.

Regular Exercise –  will also help reduce PAWS and relieve tension.

Counseling, whether it is individual, group, or both, will help you cope with your problems and keep you connected to your goals in recovery.

Educating Yourself about PAWS, addiction, and recovery in every way possible will help you maintain perspective on the symptoms you’re experiencing.

Balanced Living is important for everyone. If you try your best to keep good balance and stability in your life, you’ll be better able to handle the symptoms of PAWS.

It can be extremely frustrating to experience PAWS, and it can even make you question your desire or ability to stick with recovery. It’s normal to feel that way, but it’s important to push through PAWS and realize that it will improve over time. As long as you continue to utilize different coping methods, things will get better. Sober Nation, what are some of the things that help you deal with PAWS?

9 responses to “The Basics Of Post Acute Withdrawal Syndrome

  • Lets see its feb20/2015@ 4:33am and I have just quit doing meth. I’ve been doing meth for four months straight now pretty much every day. I’m a bit worried because I can be so easily led no willpower! I have to quit otherwise I’ll be living on the streets. I have lost everything that I owned in four months. I’m getting so paranoid to the point I basically just hide out in my hotel room all day and night and do meth.If anyone has any helpful suggestions I’m listening.

    • Hey there, Richard. I am checking in with you. No doubt, you’ve probably had quite a year. How are you? We’re you able to get clean and sober, and out of that hotel room? If you are reading this, feel free to call me anytime, day or night, I’d like to know that you made it. Gabriel: 9712766853

      • Good stuff Gabe! You’re awesome and good luck Richard, its tough but recovery is possible

  • This is an excellent article. I think very few people know about PAWS symptoms and can be shocked at just how long a full recovery can really take. While it’s “risky” warning patients about what an uphill struggle things can be during/after detox, I think that setting reasonable expectations like this can make it easier to deal with the side-effects as they occur.

  • Can someone tell me is it possible to appear high even though you are no longer doing drugs. I was heavily addicted to oxycontin and have been clean for 3 months. Twice now my spouse has thought that I was using because he says I look high. My pupils are small, I seem confused, my thinking is scattered and I seem very agitated. I know 100% that I am not so why would it appear as though I am?

  • Ben Smith

    4 years ago

    Hello, good info. However, one thing I keep seeing pop up is to cut out fat for good nutrition. My understanding is that nutritional research shows now that we need some fat in our diet, especially healthy fats (olive oil, nuts, avocado,etc). In fact, some vitamins and minerals require fat to be absorbed properly. It seems like a lot of dietary advice is outdated in many forums.

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