Post-acute withdrawal syndrome, or PAWS, can occur after alcohol detox.

What is PAWS?

Post-Acute Withdrawal Syndrome, or PAWS, refers to a number of withdrawal symptoms experienced following the acute withdrawal phase of recovery.

While the acute stage of recovery involves intense physical symptoms over a period of one to two weeks, PAWS symptoms can persist, disappear and reappear for months.

The emotional and mental distress caused by PAWS can be tough to handle, but if you’re aware of the causes and prepare yourself for the symptoms, you’ll be well-equipped to face them head on.

Addiction, Recovery, and PAWS

Both acute and post-acute (PAWS) withdrawal symptoms exist because the body has to make adjustments for the sudden absence of the substance, whether it’s alcohol, opiates, marijuana or stimulants.

While physical symptoms tend to resolve in two or three weeks, the chemicals in the brain take much longer to rebalance themselves. This manifests in a series of psychological withdrawal symptoms that can be stressful to deal with.

According to UCLA’s Semel Institute for Neuroscience and Human Behavior, PAWS symptoms are experienced by roughly 9 in 10 recovering opiate users and 3 in 4 recovering alcohol users.

Fortunately, knowing what to expect and having a strong support group can help in approaching PAWS with a proactive and positive mindset.

PAWS Symptoms

There are several symptoms that can be experienced during post-acute withdrawal. Not everyone will experience all of them, and they often come and go. Symptoms include:

  • Aggressive behavior
  • Cravings
  • Anxiety
  • Mood swings
  • Depression
  • Fatigue
  • Insomnia
  • Inability to focus
  • Low libido
  • Memory lapses
  • Suicidal thoughts

How Long Does PAWS Last

While acute withdrawal symptoms generally resolve in a few weeks, PAWS symptoms can last for a few months or up to a year.

It’s important to remember that the symptoms are not persistent. They will come and go. You’ll find that certain situations, environments and other factors may play a role in when you experience PAWS symptoms.

As time goes on, they’ll show up less frequently. Eventually, they’ll disappear entirely.

Dealing With PAWS

Know what you’re dealing with. Knowledge is power. Learn to recognize the symptoms as part of the recovery process. Knowing what to expect will help you immensely.

Pay attention to the different situations that may bring about withdrawal symptoms. These are called triggers. Write them down, keep them with you, and always remind yourself that what you’re feeling is nothing more than your brain rewiring itself.

Get physical. Physical activity is your best friend. Hit the gym or go for a run. You don’t have to do anything too strenuous. A relaxed walk or easy hike will get your blood pumping and help you clear your head.

Remember, exercising releases endorphins, which will help counteract the negative thoughts and emotional you’ll encounter with PAWS.

Don’t go at this alone. Build a strong support system. Tell your friends and family what you are going through. Send them this article and ask them for support and understanding while you go through this process.

If you’re experiencing intense withdrawal symptoms, individual or group therapy is a fantastic option that we strongly recommend. Having people with first-hand knowledge to talk to will help put things into perspective and motivate you to keep going.

Remember, this is a normal part of the recovery process. The emotional and mental hurdles of PAWS are a temporary setback. Expect them, embrace them, and know that you’ll soon be free of them.

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Editor – Camille Renzoni
Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. 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 providers.