Breaking free from substance dependence is a huge accomplishment, but withdrawal doesn’t always end with detox. For many, post-acute withdrawal syndrome (PAWS) creates persistent symptoms that linger for weeks or months after stopping substance use. PAWS affects mood, cognition, and overall well-being, making recovery more challenging without the proper support. At 12 South Recovery, we recognize that withdrawal isn’t just physical—it has deep psychological and emotional effects.
What Causes PAWS?
PAWS occurs because of long-term changes in brain chemistry due to prolonged substance use. Drugs and alcohol alter neurotransmitter activity, impacting the brain’s ability to regulate mood, stress, and cognitive function. When the substance is removed, the brain struggles to restore balance, leading to persistent withdrawal symptoms.
Several factors contribute to PAWS, including:
- The type of substance used (alcohol, opioids, benzodiazepines, stimulants, etc.)
- The duration and intensity of substance use
- Underlying mental health conditions
- Personal health and lifestyle factors
- The effectiveness of treatment and relapse prevention strategies
Understanding these causes helps in creating an effective plan for managing PAWS and reducing its impact on daily life.
Symptoms of Post-Acute Withdrawal Syndrome (PAWS)
PAWS manifests in various ways, often affecting emotional stability and cognitive function. Unlike acute withdrawal, which causes intense but short-lived physical symptoms, PAWS symptoms can fluctuate over time. Some of the most common symptoms include:
Emotional and Psychological Symptoms
Many individuals experience heightened emotions, often shifting between depression, anxiety, and irritability. Stress sensitivity increases, making it harder to cope with everyday challenges. Feelings of hopelessness or mood swings are common, sometimes leading to relapse if not addressed.
Cognitive Impairments
PAWS can make concentrating, remembering things, or processing information difficult. Many people describe feeling mentally “foggy” or struggling with decision-making. These cognitive issues can be frustrating, especially for those trying to rebuild their lives after addiction.
Sleep Disturbances
Insomnia, vivid dreams, and frequent awakenings at night are common in PAWS. Sleep irregularities can worsen mood instability and contribute to overall fatigue, making daily responsibilities more challenging.
Physical Symptoms
Although PAWS is primarily psychological, physical symptoms such as fatigue, headaches, and body aches can persist. Some people experience changes in appetite, body temperature regulation issues, or unexplained discomfort.
How Long Does PAWS Last?
The duration of PAWS varies widely. Some people only experience mild symptoms for a few weeks, while others struggle for months. Several factors influence how long PAWS lasts, including the substance used, the person’s overall health, and the effectiveness of their treatment plan.
In general:
- Short-term PAWS: Symptoms gradually fade within a few weeks.
- Moderate PAWS: Symptoms persist for several months but improve with time.
- Long-term PAWS: Some individuals may experience mild PAWS symptoms for a year or more, mainly if they used substances that significantly altered brain chemistry.
While PAWS is temporary, it can feel overwhelming. That’s why having the right strategies can make all the difference.
Managing PAWS: Practical Strategies for Recovery
Dealing with PAWS requires patience, commitment, and a structured approach. While symptoms can be frustrating, there are effective ways to manage them and stay on track with recovery.
Professional Addiction Treatment at 12 South Recovery
PAWS is best managed with professional support. At 12 South Recovery, we offer:
- Medical detox to help safely remove substances from the body under professional supervision.
- Residential treatment that provides a structured environment for healing and long-term recovery.
- Mental health care to address co-occurring disorders and emotional well-being.
Developing a Stable Routine
Recovery thrives on consistency. Establishing a structured daily routine can help regulate mood and energy levels. Prioritizing healthy habits such as regular sleep, balanced nutrition, and physical activity supports brain healing and reduces PAWS symptoms over time.
Therapy and Mental Health Support
Therapy plays a critical role in managing PAWS. Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) teach coping mechanisms for emotional instability, stress, and cravings. Group therapy and peer support programs provide encouragement and accountability, making it easier to stay motivated.
Medication-Assisted Treatment (MAT)
In some cases, non-addictive medications can help alleviate PAWS symptoms. Doctors may prescribe medications for anxiety, depression, or sleep disturbances, but these should always be used under medical supervision to avoid dependency.
Stress Reduction Techniques
Since PAWS can make individuals more sensitive to stress, learning how to manage it effectively is essential. Meditation, mindfulness, deep breathing exercises, and light physical activity can help reduce anxiety and improve overall well-being.
Contact 12 South Recovery Today
PAWS is a real and challenging part of addiction recovery, but it doesn’t have to derail your progress. With the right tools, support, and professional care, it’s possible to manage symptoms and regain stability. If you or a loved one is experiencing PAWS, 12 South Recovery is here to help. Our team of addiction specialists provides expert treatment and mental health support to guide you through recovery. Contact us today to learn more about our programs, or share this article with someone who may benefit from it.
