Select Page

Post Acute Withdrawal Syndrome (PAWS) in Addiction Recovery | Addiction Counselor Training

by | Feb 1, 2025

Imagine you're on a journey to recovery from addiction, and you've bravely battled through the storm of detox. You're starting to see the sun peek through the clouds, thinking the worst is over, only to find yourself suddenly enveloped in a dense, unpredictable fog. This fog is Post-Acute Withdrawal Syndrome (PAWS), a lesser-known but equally challenging phase of recovery that can last months, or even years, beyond initial withdrawal.

PAWS is like the shadow of addiction; it follows the acute phase, bringing with it waves of psychological and physical symptoms that can catch you off guard. These symptoms can include mood swings, anxiety, irritability, disturbed sleep, vivid dreams, and an overall sense of feeling unwell. Unlike acute withdrawal's more predictable and short-lived symptoms, PAWS can come and go without warning, making the recovery journey feel like navigating through a maze without a map.

So, why does PAWS happen? The brain is an incredible organ, constantly adapting to its environment. When substances are introduced into the body regularly, the brain starts to adjust its chemistry and functioning to accommodate them. These substances can hijack the brain's reward system, flooding it with dopamine (a neurotransmitter associated with pleasure and reward) and other chemicals that it wouldn't naturally produce in such high quantities. Once the substance is removed, the brain struggles to regain balance, leading to the symptoms associated with PAWS.

Several factors can influence the severity and duration of PAWS, including the type of substance used, the duration and intensity of use, age at which use began, gender, physical health, and the presence of co-occurring mental health issues. Younger individuals, those with a longer or more intense history of substance use, and those with pre-existing mental health conditions may experience more pronounced PAWS symptoms.

Navigating PAWS requires patience, understanding, and a toolkit of coping strategies. Here are some steps to manage and mitigate its impact:

  1. Education: Understanding what PAWS is and recognizing its symptoms can help demystify the experience and reduce fear and frustration. Knowing that these symptoms are a normal part of the recovery process can provide reassurance.
  2. Support: Connecting with support groups, therapists, and peers who understand what you're going through can provide comfort and practical advice for managing PAWS. You're not alone in this fog.
  3. Healthy Lifestyle: Prioritizing sleep, nutrition, and physical activity can help the brain heal and reduce some symptoms of PAWS. Simple activities like walking, yoga, or any form of exercise that you enjoy can boost mood and overall well-being.
  4. Stress Management: Techniques such as mindfulness, meditation, deep breathing exercises, and journaling can help manage stress and anxiety, common triggers for PAWS symptoms.
  5. Plan for Triggers: Knowing what triggers your PAWS symptoms can help you prepare and plan for them. Identifying coping strategies in advance can make these triggers less daunting.
  6. Celebrate Progress: Recovery is a journey, not a destination. Celebrate your milestones, no matter how small they seem. Every day you navigate through the fog of PAWS brings you one step closer to clearer skies.

Remember, PAWS is a temporary and normal part of the recovery process. With the right strategies and support, you can navigate through it and emerge stronger on the other side. The journey might be long and the fog may seem dense at times, but there is hope and healing ahead. Keep moving forward, one step at a time.