How do I cope with Post-Acute Withdrawal Syndrome (PAWS)?

It may seem like you’re on a rollercoaster when you stop using substances. Suddenly stopping or drastically reducing your intake of alcohol or drugs can be very challenging, because your mind and body are learning to adjust to living without something you were dependent on for a long time. Withdrawal can lead to physical discomfort as well as life-threatening health conditions. But remember, you were strong before your addiction and can triumph in your recovery.

What is PAWS?

PAWS, or Post-acute Withdrawal Syndrome, refers to the more lasting effects of withdrawal that may make it very hard to stay sober. Using substances for a long time or using a heavy amount will lead to more severe PAWS symptoms. However, this is not a sign of failure. It just means you’re in recovery. PAWS symptoms show up as the brain resets from alcohol or drug use.

Symptoms of PAWS may include:[1]

• An inability to think clearly, short-term memory lapses
• Emotional outbursts, irritability, anger and mood swings
• Sleep problems such as insomnia or disturbed sleep
• Low energy, dizziness
• Coordination issues, sluggish reflexes, balance problems
• Overreaction to stress with panic attacks
• Headaches, physical aches and pains

In addition, lingering symptoms may occur based on the substance of choice.  For example, alcohol withdrawal may take 6 months to a year, while opioids can take up to 2 years. But gradually, your brain chemistry will return to normal. [2]

PAWS does go away over time

You don’t really deal with life while you’re using. For me it was almost like a shock to the system when I had to start feeling things.

While the symptoms you experience in your recovery journey may be scary—even terrifying, PAWS will go away.  It may take days, weeks, months, or years, but it gets better as time goes on.  Time and patience will help you overcome the unpredictability of symptoms that may occur.

Different people have different experiences with withdrawal. One person may experience unsettling dreams about using.  Another person may experience brain fog that feels like brain damage.  Others may experience anger problems for the first week, months, or even years of their recovery and lash out as if still addicted to alcohol or drugs. But they will be able to come out of it.

The tricky thing is that symptoms of PAWS are lingering – they come and go—but they are different for everyone.  You may feel you’re on the right track, and then a symptom appears, and you feel you are back to square one.

It will get better if you remain free from substances.  The thoughts, feelings, and sensations that go with withdrawal and PAWS are not permanent. It may seem like a long time to wait before you get better, but it will happen.

Ways to cope

For me, learning about PAWS in early recovery and being aware was helpful, so when I felt these things I knew that it was going to happen and pass.

As you make progress in your recovery, the occurrence of symptoms will be less and less as long as there is continued abstinence. Practicing healthy coping strategies for managing PAWS can help you to overcome the symptoms you may be experiencing.

People have found working on their health by exercising and eating better makes it easier to process and deal with their experiences. Others have found talking to their sponsors every day or attending anger management classes beneficial. Others may find journaling works – making lists about the consequences of using helps.

Self-care is essential in your journey. You may try positive affirmations, such as, “I am strong.” Or you may also find that getting into your spirituality and who you are as a spiritual person may help you cope. Remember to have self-compassion and take many breaks throughout the day to be good to yourself.  Practice relaxation techniques like meditation.  And take it one day at a time and try not to worry about the past or future. Put the focus on today and what you can successfully accomplish.

Talking to a mental health professional who can help you find support, therapy, or more medication may help as well. It’s crucial to avoid triggers such as people and situations that may lead to relapse. And finding support can help you heal.

There are a number of resources you can go to find support:

• If you need immediate help, you can reach the Suicide & Crisis Lifeline by calling or texting 988 or using the chat box at 988lifeline.org/chat. You can also text “MHA” to 741-741 to reach the Crisis Text Line. Warmlines are an excellent place for non-crisis support.
•  You can also find a recovery coach to talk to.

PAWS is not a life sentence. You are not alone on this journey. It’s normal to feel fear about confronting your issues. Keep your focus on getting better day by day and get support if you need it.  You will overcome Post-acute Withdrawal Syndrome by staying on track and working toward your recovery.

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