Entering into recovery from substance abuse is a courageous journey, yet it’s often not without its challenges. While many individuals focus on the initial withdrawal symptoms, there’s another phase that can follow, known as the Post Acute Withdrawal Syndrome timeline. At Creekside Recovery Residences, we recognize the importance of understanding PAWS and providing support throughout this phase of recovery. In this article, we delve into what PAWS entails, its common symptoms, a detailed timeline, and effective treatment options.

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What is PAWS?

The Post Acute Withdrawal Syndrome (PAWS) timeline refers to a set of symptoms that can occur after the acute withdrawal phase from substance abuse has passed. Unlike acute withdrawal, which typically lasts for a week or two, PAWS can persist for weeks, months, or even years after the cessation of substance use.

PAWS can manifest differently for each individual and may vary depending on factors such as the type of substance abused, duration of use, and individual physiology.

Common Symptoms of PAWS

There are several symptoms that are common among those suffering from post-acute withdrawal. The symptoms you experience will vary depending on the type of substance you used, the duration of use, and the presence of any pre-existing conditions. Fortunately, most related symptoms can be successfully managed with long-term treatment. 

1. Mood Swings

During PAWS, individuals may experience significant fluctuations in mood, ranging from periods of depression, characterized by feelings of sadness and hopelessness, to episodes of anxiety, marked by excessive worry and tension.

Additionally, irritability and agitation may surface, leading to heightened sensitivity to environmental stimuli. Emotional numbness, where individuals feel disconnected from their emotions, can also occur, making it challenging to experience pleasure or engage with others.

2. Fatigue

Persistent feelings of exhaustion and low energy levels are common symptoms of PAWS. Despite adequate rest, individuals may struggle to regain their energy and may find even simple tasks to be overwhelming. This fatigue can impact daily functioning and diminish motivation, hindering progress in recovery efforts.

3. Insomnia or Hypersomnia

Sleep disturbances are prevalent during PAWS, with individuals experiencing either difficulty falling asleep or staying asleep (insomnia) or excessive sleeping (hypersomnia). Disrupted sleep patterns can exacerbate other symptoms such as fatigue and mood disturbances, further complicating the recovery process.

4. Cognitive Impairment

PAWS can impair cognitive function, leading to difficulty concentrating, memory problems, and impaired decision-making abilities. Individuals may find it challenging to focus on tasks, retain information, or make sound judgments, which can interfere with work, school, or interpersonal relationships.

5. Cravings

Intense urges or cravings for the substance of abuse are a hallmark symptom of PAWS. These cravings can be triggered by various cues, such as stress, social situations, or environmental cues associated with substance use. Managing cravings requires coping strategies and support to prevent relapse and maintain sobriety.

6. Physical Symptoms

PAWS can manifest with various physical symptoms, including headaches, muscle aches, tremors, and gastrointestinal issues such as nausea, vomiting, or diarrhea. These symptoms may arise as the body adjusts to the absence of the substance and can contribute to discomfort and distress during the recovery process.

7. Emotional Dysregulation

Heightened sensitivity to stress, emotional instability, and mood disturbances are common features of PAWS. Individuals may struggle to regulate their emotions effectively, leading to exaggerated responses to minor stressors or difficulty managing intense emotions. Emotional dysregulation can strain relationships and impede progress in recovery.

PAWS Timeline

Understanding the Post Acute Withdrawal Syndrome timeline provides individuals in recovery with valuable insights into what to expect throughout the various phases of the post-withdrawal period. By recognizing the evolving nature of PAWS symptoms and implementing effective coping strategies, individuals can navigate through this challenging phase of recovery with resilience and determination toward long-term sobriety and improved quality of life.

Weeks 1-2: Mild PAWS Symptoms Emerge

As individuals progress through the initial phase of acute withdrawal, characterized by intense physical symptoms such as nausea, sweating, and tremors, they may start to experience relief as these symptoms gradually diminish. However, during this time, mild PAWS symptoms may begin to surface.

These early symptoms can include subtle mood swings, lingering fatigue, and occasional cravings for the substance of abuse. While not as intense as acute withdrawal, these symptoms serve as a reminder of the challenges that lie ahead in the recovery journey.

Weeks 3-8: PAWS Symptoms Peak in Severity

During this phase, which typically spans from the third week to the eighth-week post-withdrawal, individuals may encounter the most challenging aspect of PAWS. Symptoms such as mood swings, fatigue, and cravings may peak in severity, causing significant distress and disrupting daily functioning.

Mood swings may become more pronounced, with individuals experiencing periods of intense sadness, anxiety, or irritability. Fatigue can be particularly debilitating, making it difficult to engage in activities and maintain motivation. Cravings for the substance of abuse may intensify, posing a heightened risk of relapse if not managed effectively.

Support and coping strategies are crucial during this time to help individuals navigate through these challenging symptoms.

Months 2-6: Gradual Decrease in Intensity, Intermittent Symptoms Persist

As individuals progress further into recovery, typically spanning from the second month to the sixth-month post-withdrawal, PAWS symptoms gradually decrease in intensity. While individuals may experience relief from the peak severity of symptoms, some symptoms may persist intermittently. Mood swings may become less frequent but can still occur during periods of stress or emotional upheaval.

Fatigue may improve, but individuals may still experience fluctuations in energy levels. Cravings may diminish in intensity but can resurface unexpectedly, requiring ongoing vigilance and coping strategies to prevent relapse.

Months 6-24: Significant Improvement with Residual Symptoms

Many individuals experience significant improvement in PAWS symptoms beyond the sixth-month post-withdrawal, typically extending up to two years or more. During this phase, individuals may notice a substantial reduction in the frequency and intensity of symptoms, allowing for greater stability and functionality in daily life.

However, it’s essential to acknowledge that some residual symptoms may linger, albeit to a lesser extent. While individuals may have made considerable progress in their recovery journey, occasional mood swings, mild fatigue, or fleeting cravings may still arise. Continued support, sober living, and adherence to healthy coping strategies remain crucial during this phase to maintain long-term sobriety and well-being.

Treatment Options for PAWS

• Therapy: Cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and mindfulness-based therapies can help individuals cope with PAWS symptoms and develop healthy coping strategies.
• Medication: Certain medications, such as antidepressants or mood stabilizers, may be prescribed to alleviate mood swings, depression, or anxiety associated with PAWS.
• Support Groups: Participating in support groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), provides peer support and encouragement during the recovery journey.
• Lifestyle Changes: Incorporating regular exercise, balanced nutrition, adequate sleep, and stress-reduction techniques can support overall well-being and aid in PAWS recovery.
• Holistic Therapies: Practices like yoga, meditation, acupuncture, and massage therapy may help alleviate PAWS symptoms and promote relaxation.

Contact Us to Learn More About PAWS Management

Navigating the Post Acute Withdrawal Syndrome timeline can be a challenging aspect of the recovery process, but it is a temporary phase that can be managed with the right support and strategies. At Creekside, we are dedicated to providing comprehensive support to individuals overcoming substance abuse, including guidance through the PAWS phase. By understanding the symptoms, timeline, and treatment options for PAWS, individuals can embark on a journey toward long-term sobriety and improved quality of life.

If you or a loved one are experiencing PAWS symptoms and need support on your recovery journey, reach out to Creekside Recovery Residences today. Our experienced team is here to provide compassionate care and personalized treatment to help you achieve lasting sobriety. Take the first step towards a brighter future by contacting us now.