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.

For more information or to be connected with a treatment program near you, visit our admissions page today.

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.

Outpatient rehab can last several months depending on what type of program you attend. Most people transition from inpatient rehab into an outpatient rehab program. This helps them maintain their recovery skills as they continue their treatment program.

In addition, sober living programs provide an additional level of accountability for those in outpatient rehab. Creekside Recovery Residences offers sober living programs for those in outpatient rehab.

What Are the Different Types of Outpatient Rehab Programs?

Different types of outpatient rehab programs vary in levels of care. Simply put, this means that some programs are more intensive than others. It is best to step down from each higher level of care to the next as you gradually build the skills needed for long-term recovery.

Partial Hospitalization Program (PHP)

Most people go from residential treatment to a partial hospitalization program (PHP). Furthermore, the programming in PHP is similar to residential treatment. As a result, you get a mix of individual and group sessions along with experiential therapy and psychoeducational classes on mental health, life skills, and addiction.

However, unlike residential treatment, you don’t live in a facility during your PHP program. But, you still get about six to eight hours of programming per day, five days per week. After that, you can move on to an intensive outpatient program.

Intensive Outpatient Program (IOP)

Intensive outpatient programs (IOP) continue your treatment with a less restrictive schedule compared to PHP. You still get a significant amount of treatment and support, however, you can attend an IOP program while resuming everyday responsibilities. For instance, many IOP programs occur during the evening, allowing you to work full-time during the day.

Most IOP programs last three to four hours per session, four to five days per week. Some rehab programs offer IOP during both the daytime hours and evening so that you can choose which time is best for you. After IOP, you can continue with regular outpatient programs.

Outpatient Program (OP)

Following PHP and IOP programs, you can continue with a regular outpatient program. This is the most flexible type of rehab program because you get to choose what is right for you. This could be meeting with a therapist weekly, bi-monthly, or monthly. You can also participate in group or family therapy sessions on a similar schedule.

Most sessions during regular OP will last about an hour. In addition, there are now several virtual options for outpatient rehab. Virtual outpatient rehab provides greater accessibility and flexibility to those in recovery from addiction.

How Long Do Outpatient Rehab Programs Last?

Different types of outpatient rehab programs last different amounts of time. Furthermore, you need to consider the total length of time as you progress from one type of program to the next. Therefore, outpatient rehab programs typically last at least 60 to 90 days from PHP to regular outpatient programs.

Lastly, you might be in regular outpatient therapy for several months or even years. That is because outpatient therapy is a tool to help you navigate everyday life as you build your recovery skills.

In addition, outpatient therapy helps to treat common underlying causes of addiction which is often a co-occurring mental health disorder. According to the Substance Abuse and Mental Health Services Administration (SAMSHA), “More than one in four adults living with serious mental health problems also has a substance use problem.”

What’s the Difference Between Inpatient and Outpatient Rehab?

The primary difference between inpatient and outpatient rehab is where you live during treatment. Throughout inpatient rehab, also called residential treatment, you live within the treatment facility. That way, you can stay safe from any relapse triggers during early recovery.

On the other hand, during outpatient rehab, you can live at home, with family, or in a sober living program. This allows you to resume some of your everyday responsibilities while in treatment. For additional support, you can consider a sober living program throughout outpatient rehab.

How Do Sober Living Programs Differ From Residential Treatment?

The key difference between sober living programs and residential treatment is that during sober living, you have more freedom to leave the home. But, during residential treatment programs, you won’t be able to leave the facility throughout your program. Of course, some exceptions may apply, like medical or psychiatric appointments, for instance.

However, this doesn’t mean that during sober living, you can come and go as you please. For example, while you can go to an outpatient program, work, or school, you might need to return to the sober living home right away. In addition, you will likely have a curfew and randomized drug testing as well as required programming within the home.

Which Type of Rehab Program is Right for Me?

Overall, you need to consider where you are in your recovery to determine which type of rehab program is right for you. The whole process, from inpatient to outpatient rehab, can last a long time, and it’s best to go in succession from higher to lower levels of care.

Additionally, many treatment programs require that you step down from one level of care to the next. Depending on the severity of your addiction and your treatment history, you might be able to start at a lower level of care. However, most treatment providers like to know that you have made progress before you advance.

Regardless of which type of outpatient rehab program you are in, you can choose a sober living program for additional support and structure.

Begin Outpatient Rehab and Sober Living Today

Creekside Recovery Residences provides sober living programs for those in outpatient rehab. You can remain in sober living no matter how long your outpatient rehab will last. In addition, some people continue sober living after active treatment as they get back on their feet in recovery from addiction.

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Posts in category: Long-Term Recovery

Post Acute Withdrawal Syndrome Timeline