Those who experience the re-occurring and prolonged discomfort of PAWS without understanding it can become demoralized, depressed, anxious, and prone to relapse. In early abstinence, the brain’s stores of endorphins and dopamine are severely depleted. Dopamine, the neurotransmitter that floods the brain during drug use to produce titanic highs, is also involved in the regulation of mood, and a certain amount is necessary in order to maintain a “normal” mood. The absence of enough dopamine creates a biochemically based depression. It can take between four weeks and six months for the brain to naturally manufacture enough endorphins and dopamine to replenish its inventory of these vital chemicals. Triggers could include social events, people you used to take drugs or alcohol with, or drug dealers. They could also encompass environmental triggers such as a place, smell, or object that reminds you of the time you were abusing substances.
The brain is going to take time and patience to heal once the acute withdrawal period is over, and everyone must work on their own timeline. Each person struggling with recovery will have his or her own journey to recovery.
The second stage of detox, called post-acute withdrawal syndrome , happens as the brain re-calibrates after active addiction. Unlike acute withdrawal, which consists of primarily physical withdrawal symptoms, post-acute withdrawal symptoms are mostly psychological and emotional symptoms. Post-acute withdrawal is known to last for several months, depending on the intensity and duration of drug use and alcohol addiction. Many people seek help through a medically supervised detox or by attempting to quit alone. Acute withdrawal can produce more dangerous health consequences—even life-threatening complications—if detox isn’t completed in a supervised setting. Due to the wide range of acute withdrawal symptoms that may occur, and the various addictive substances that may be used, it is always advised to seek medical assistance rather than quitting on your own. Post-acute withdrawal, whether mild or serious, is a necessary process in early recovery from alcohol or other drug dependence.
This leads to a very dangerous mental space of wanting to do something to calm their anxiety, but being too depressed and scared to reach out to others for help. This can include family, friends, counselors, health care providers, a spiritual or religious group. It’s important to strengthen your connections with people who support your recovery goals. During your recovery, establishing a healthy daily routine is recommended. Having some structure in your life will help alleviate feelings, such as boredom, that often push people towards relapse. How you will treat yourself in recovery will be the opposite of how you treated yourself in addiction.
In pre-addiction, when someone completes a task related to their survival , the limbic system creates dopamine, a neurotransmitter that leads to feeling happy, satisfied, or even euphoric. It’s the brain’s way of motivating us to do what we need to survive — it feels good. Early in recovery, the symptoms of PAWS will arrive in unexpected waves. You may wake up one morning feeling tired, run-down, and extremely irritable for no reason. Or find yourself suddenly at a loss of balance and coordination. It’s as if the stress switch is stuck in the “on” position.
- But remember, even after one year, you are still only half way there.
- Each person struggling with recovery will have his or her own journey to recovery.
- PAWS symptoms are a result of brain dysfunction while the brain readjusts to being without alcohol and drugs, and your brain chemistry gradually returns to normal.
- PAWS is also known by several similar terms, including post-withdrawal, protracted withdrawal, prolonged withdrawal syndrome, and protracted abstinence.
- There is even the option of spending time in sober living facilities after formal addiction treatment has ended.
When you do something good for yourself, your brain rewards you by emitting several chemicals that promote feelings of happiness and ease. Amanda Lautieri is a Senior Web Content Editor at American Addiction Centers and an addiction content expert for DrugAbuse.com. She holds a bachelor’s degree and has reviewed thousands of medical articles on substance abuse and addiction.
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This could be with a therapist, who will give you support and practical tips for coping, or with a friend or family member who you trust to listen to you without judgment. Understanding that PAWS can impair an individual’s recovery, we have shared four tips for dealing with PAWS below. The road to recovery may be long, but treatment can help you navigate the way. Do all you can to minimize your stress triggers, but be accepting – stress is part of life. Let trusted friends, family members, counselors, and others know about your stress triggers. Identify when these symptoms occur and what triggered them. Give your friends permission to talk with you about your mood swings and help with reality checks.
This allows people to continue with work, school, or other personal commitments without needing to take time off or explain an absence. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.
Unfortunately, for many people in recovery, the withdrawal process is not limited to this short time frame. While the body may heal in the short-term, the brain will take months, or years, to recover from severe drug or alcohol abuse. Disturbances in mental function can persist for several months or years after withdrawal from benzodiazepines. Psychotic depression persisting for more than a year following benzodiazepine withdrawal has been documented in the medical literature. The patient also experienced paranoid ideation (believing she was being poisoned and persecuted by co-employees), accompanied by sensory hallucinations. Symptoms developed after abrupt withdrawal of chlordiazepoxide and persisted for 14 months. Various psychiatric medications were trialed which were unsuccessful in alleviating the symptomatology.
Those who have used psychoactive substances for longer, more often, and at higher doses are more likely to experience PAWS, and the symptoms will be more intense than those whose drug use was lighter. Stimulant drugs such as cocaine and amphetamine provide some of the clearest evidence that PAWS is a true medical condition, and not simply an extension of acute withdrawal. Similar to alcohol’s mechanism of action, benzodiazepines such as diazepam or alprazolam are GABA receptor activators, and their chronic use also causes the brain to adapt by switching to a hyperexcitable state. Withdrawal symptoms are very common with this class of drugs, even in patients who take them strictly as directed and under a doctor’s supervision. The symptoms of post-acute withdrawal tend to involve more emotional and psychological aspects of withdrawal, unlike during acute withdrawal.
When someone abuses drugs or alcohol for a prolonged period of time, their mind becomes reliant on these substances to produce certain chemicals to function correctly. Once the drugs have been detoxed from the body, the brain will take time to correct the chemical imbalances and relearn to function without the assistance of drugs or alcohol. Enduring the physical symptoms of drug or alcohol withdrawal can be uncomfortable. Symptoms such as muscle aches, increased heart rate, nausea and vomiting are all common during the detox process.
The Symptoms Of Post
PAWS may be caused by the imbalance of neurotransmitters in the brain. You’ll go for weeks without any withdrawal symptoms, and then one day you’ll wake up and your withdrawal will hit you like a ton of bricks. And if you’re not prepared for it, if you think that post-acute withdrawal only lasts for a few months, or if you think that you’ll be different and it won’t be as bad for you, then you’ll get caught off guard. The first stage is the acute stage, which usually lasts at most a few weeks. During this stage, you may experience physical withdrawal symptoms. But every drug is different, and every person is different.
It’s also strongest one to two weeks after their initial acute withdrawal symptoms have passed. The good news is that PAWS becomes increasingly less intense over time. For most recovering alcoholics, PAWS lasts between one and two years. Though it can be upsetting, PAWS is a normal part of the recovery process from unhealthy dependence and addiction. It is important to be aware of the symptoms of prolonged abstinence from substance abuse, because some of these negative symptoms can be discouraging to recovering individuals and tempt them to return to drug use. Long-term symptoms of opiate withdrawal are commonly reported in individuals recovering from opioid addictions.
Think of the withdrawal syndrome as the brain’s way of correcting the chemical imbalances suffered during active addiction. Although withdrawal symptoms are uncomfortable, they typically end after two weeks at most, especially when a medical professional oversees the detox process. However, some drugs can lead to prolonged or protracted withdrawal, lasting for months and sometimes up to a year. People who consume a large amount of an intoxicating substance for a long time are more likely to develop this condition, which is called post-acute withdrawal syndrome . After detox/acute withdrawal is over, the second phase of the withdrawal process kicks in. This exquisite phenomenon is known as post-acute withdrawal .
However, since the mostly psychological and emotional, ongoing support from a therapist, a recovery group, family and friends is an essential part of reducing the stress of post-acute withdrawal syndrome. The overall duration of PAWS can be challenging to predict since it can fluctuate based on length of abuse, the frequency of substance abuse, amount of drugs or alcohol consumed, and an individual’s health. It is crucial to create a support system that includes an individual who can help recognize when someone is experiencing PAWS symptoms. This person may be a counselor or mental health professional 8. Avoid situations, including triggers, that may initiate a craving to use, or situations that are anxiety-provoking, such as loud or crowded places.
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In many ways, the symptoms that occur in stage one are similar to a normal hangover. While these initial symptoms may not appear serious in nature, they are just the beginning. Health experts define heavy alcohol use as more than three drinks per day for women and four drinks per day for men.
Symptoms were completely relieved by recommending chlordiazepoxide for irritable bowel syndrome 14 months later. Another case report, reported similar phenomenon in a female patient who abruptly reduced her diazepam dosage from 30 mg to 5 mg per day. She developed electric shock sensations, depersonalisation, anxiety, dizziness, left temporal lobe EEG spiking activity, hallucinations, visual perceptual and sensory distortions which persisted for years. These alcohol withdrawal symptoms and timeline will vary from person to person depending on his or her age, how long the individual abused alcohol, and how much alcohol was consumed before beginning the detox.
Stopping alcohol use cold-turkey or attempting to recover from drug addiction is not recommended. Due to the severity of PAWS symptoms, people often feel as if they have to use to make the symptoms go away. When you are in a treatment center, working with substance use specialists will offer you methods and medication to combat PAWS symptoms. PAWS is a significant threat to someone’s recovery because of its severe side effects. PAWS symptoms are extremely uncomfortable and typically affect a person’s mental health and physical health.
The amount of time PAWS sticks around for generally depends on how long, how much, and how often someone uses an addictive substance 7. Benzodiazepines include drugs like Valium and Xanax and work similarly to alcohol. However, those who use benzodiazepines seem to be at an extremely high risk of developing PAWS symptoms that can last for years 2.