Ask any recovering addict and they will tell you the recovery process is no easy task. One of the most challenging components of recovery is post-acute withdrawal syndrome or PAWS. PAWS is not well-known outside of addiction and recovery circles, but those seeking treatment will need to get familiar with this syndrome if they want to increase their odds of successful sobriety.
What is PAWS?
Withdrawal is something most addicts experience when they stop using. Withdrawal can be broken down into two basic steps. The first is acute withdrawal, which usually lasts approximately 1-2 weeks after the substance is stopped. Acute withdrawal is primarily characterized by physical withdrawal symptoms that often resemble the flu.
The second step is post-acute withdrawal, which occurs after acute withdrawal is over and may last up to two years. Post-acute withdrawal encompasses physical and psychological symptoms and may be very difficult to overcome without preparation and professional support. Post-acute withdrawal symptoms often peak at around six months and can be severe enough to derail the recovery process.
Symptoms of PAWS
While most people in recovery experience somewhat different symptoms during acute withdrawal, the symptoms of PAWS tend to be relatively similar and include:
- Sudden, intense mood swings
- Depression and anxiety
- Inability to think clearly or concentrate
- Variable energy levels
- Inability to experience pleasure (anhedonia)
- Sleep disturbances or insomnia
- Acute sensitivity to stress
- Problems with physical coordination
- Obsessive thoughts
Episodes of PAWS may strike at any time and without warning. Over time, the episodes become less frequent, with much longer positive periods in between.
Why does PAWS Occur?
There are a number of possible reasons behind post-acute withdrawal syndrome:
- Because the body has adapted to functioning with drugs or alcohol in the system, it must re-learn to function without the substances, particularly when dealing with stress
- Because substances were used to numb emotions, when emotions are felt once again, they can be overwhelming
- The stress of recovery impairs brain function, which can exacerbate the symptoms of post-acute withdrawal syndrome
- Nutritional deficiencies that occurred during substance abuse can affect the body’s ability to function properly
- A mental illness that was present but undetected during the substance abuse now becomes more prevalent in the early stages of recovery
Because PAWS is a fairly standard step in the recovery process, it is important to learn what it is and how to deal with it. If it is not addressed, the uncomfortable symptoms can lead to a relapse. The good news is that episodes of PAWS usually only last a few days and if you employ effective coping strategies, you can ride out the difficult days until the good days return. Some coping strategies might include:
- Practice self-care so you are strong enough to handle episodes when they arise
- Maintain a balanced diet so nutritional deficiencies become less of an issue
- Prepare yourself for dealing with stress by practicing positive stress management
- Exercise daily to keep your body in shape and improve your mental well-being
- Seek the support of others to help you through the difficult days
- Remember the symptoms of PAWS are temporary and better days are ahead
Post-acute withdrawal syndrome is a challenging part of the recovery process and one that often requires professional help to overcome. If you are struggling with the symptoms of PAWS, you are not alone. Contact West Coast Recovery Centers at 442-333-6199 to get your questions answered and get the professional support you need.
Relapse Prevention Skills
Relapse is a very real and ongoing concern for those in recovery. Relapse is often seen as a single event, the act of using or drinking once again. This is commonly known in recovery circles as “physical relapse.” However, relapse is actually a process that contains many stages. By addressing relapse in its earliest stages, you are more likely to prevent physical relapse and maintain your new life of sobriety.
Stages of Relapse
The events leading up to a physical relapse may be weeks, or even months, in the making. The three stages of relapse are:
Although you are not actively thinking about using at this time, your emotional state could be leading up to those thoughts and urges in the future. Common symptoms of emotional relapse include:
- Anger and intolerance
- Unhealthy reactions to stress
- Poor judgement or loss of control
- Disturbed sleep or poor eating
- Isolation from others
If emotional relapse is left unaddressed, it can lead to mental relapse. This stage includes:
- Thinking the people and places involved with previous using
- Glamorizing or being nostalgic over the using period
- Figuring out how to use so family and friends won’t know
- Hanging out with the people who used with you
When relapse arrives at the mental stage, occasional thoughts about using will gradually become a steady stream. At this point, it is much more difficult to turn away completely and prevent physical relapse from occurring.
This is the point where the person in recovery uses the drug or alcohol. Recovery reaches an abrupt halt and must begin all over again. It is much easier to avoid relapse during the emotional stage, than to try to recover from the physical relapse after it has occurred.
Preventing relapse in the early stages requires you to know how to identify the triggers that could lead you to use over time. When you know your trigger, you can take healthy steps to avoid them. While triggers vary somewhat from person to person, some of the most common triggers include:
- Overconfidence that takes the focus off of the recovery process
- Unrealistic expectations of recovery that can lead to disappointment and defeat
- Self-pity or depression that take much of the satisfaction out of the recovery process
- Lack of self-care that can leave you tired, hungry and less able to cope with urges
- Isolation from others, rather than seeking out support from a sponsor or group members
Recovery is something you must focus on every day to prevent a physical relapse and remain on the healthy road to sober living. There is no place for complacency in the recovery process. Instead work on developing habits that will help you stay on track:
- Attend 12-step meetings regularly
- Continue with counseling or group therapy sessions
- Maintain daily self-care, including exercise, healthy eating and sufficient sleep
- Find effective relaxation techniques and use them regularly to manage stress
- Develop hobbies you enjoy that will fill the time you used to spend using
- Write about your recovery progress so you have something to turn to when cravings strike
- Remain honest with family, friends and your sponsor to prevent opportunities to use
The good news is that after about four years of sobriety, your risk for relapse becomes considerably lower. To learn more about preventing relapse or get the addiction support you need, contact West Coast Recovery Centers at 442-333-6199.