Have you heard that “it ain’t over till it’s over”? Well, with many health issues, it isn’t even over when it’s over. Post-surgery patients need follow-up appointments. Thousands of people who recover from COVID-19 retain long-haul symptoms that may persist for months. And among people who have successfully detoxed from substance use disorder, over 75 percent battle post-acute withdrawal syndrome (PAWS).
Acute and Post-Acute Withdrawal
Initial, or acute, withdrawal is what most people think of as “withdrawal” from addiction. Patients in this stage become visibly ill as the body reacts to the absence of a substance it long depended on to feel “normal,” usually giving full rein to whatever physical effects the drug had muted. (For example, withdrawing from anything sedative typically means that normal body functions kick into high gear, triggering increased heart rate, diarrhea, heavy sweating, shaking or cramping muscles and insomnia.) Other typical drug-withdrawal symptoms include vomiting, severe nausea, panic attacks and desperate cravings for the drug. Occasionally, a patient will become suicidal or suffer seizures or organ failure, so it’s never advisable to attempt withdrawal without medical supervision.
Unpleasant though it is, acute withdrawal rarely lasts more than a week or two. Once it passes, however, the patient still has multiple recovery issues to deal with. These issues frequently include protracted, or post-acute, withdrawal, with such symptoms as:
- Decreased ability to experience pleasure
- A sense of emotional numbness
- Difficulty concentrating, making decisions or controlling emotions
- High sensitivity to familiar drug-use triggers
- Sleep problems
- Chronic pain, fatigue, restlessness or depression
- Increased sensitivity to stress
Post-acute withdrawal syndrome occurs when post-acute withdrawal symptoms persist for some months after detox (or begin several weeks or months later). If you’re experiencing PAWS, your brain’s neurotransmitters are having temporary difficulty recalibrating for the new, healthier “normal.”
How Long Will It Last?
The question, “How long does PAWS last?” rarely has a simple answer, even for doctors evaluating individual patients. Most cases resolve within a 6–24-month window, but some people continue to experience symptoms for much longer. (And in any case, even a short period of time feels endless to anyone who just wants a painful situation to pass.) Nor is PAWS typically a matter of “here one day and gone the next”: it’s likelier to come and go, becoming less frequent and intense over time.
Duration, as well as symptoms, can be affected by:
- Type(s) of drugs involved
- Length of addiction period
- Patient gender, age and/or body type
- Overall physical and mental health of patient
The best way to deal with PAWS is to take it day by day, as with sobriety itself. Don’t obsess over “Will this ever end?”: that’ll just make the symptoms (and relapse temptations) worse. Manage your life to reduce symptoms, which will likely also reduce overall duration.
How to Cope with PAWS
- Make an advance plan for dealing with common PAWS symptoms.
- Eat healthy, and get plenty of exercise and sleep. Taking care of physical health will make you less vulnerable.
- Do everything you can to manage and reduce stress in your life. Avoid taking on major responsibilities, and occupy yourself with productive activities you enjoy. Maintain a consistent daily routine. Take a break whenever you start to get tired.
- Use prayer, meditation or yoga to further calm your mind.
- Minimize your contact with negative people, especially anyone who may be inclined to tell you to “snap out of it.” Surround yourself with supportive, patient people who will encourage you to keep going when you feel you can’t bear another hour of sobriety.
- Continue therapy and stay active in a peer support group.
- When you have an episode, note what triggered it and what circumstances were involved. Use this information to guide additional coping plans.
- If your symptoms are severe, ask your doctor about medication to reduce cravings or mood swings.
- Keep reminding yourself that however it may feel at the moment, this won’t last forever. By seeing it through, you will become stronger for permanent recovery from addiction.
With You for the Long Haul
At Cumberland Heights, we know that recovery is a lifelong journey that only begins with physical detox. Our Aftercare Community is for clients who have just completed treatment, alumni who have stayed clean 30 years and everyone in between. Whether or not PAWS is a problem for you, you’ll benefit from ongoing support.
For questions about Aftercare, call (866) 899-5501. For general questions about Cumberland’s services, or to request help for yourself or a family member, use the form on our Contact Us page.
