What Is PAWS? What Is Its Role in Recovery?
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When you first hear the word “PAWS,” the word might make you think of clumsy lion cubs or a big, furry Saint Bernard dog. But that’s where the cuteness ends. Unfortunately, PAWS, or post-acute withdrawal syndrome, refers to the not-so-cute psychological symptoms that often set in after an addictive substance has left our systems. They can persist for months. What are the post-acute withdrawal symptom, and what does PAWS recovery look like? Let’s see what science has to say.
First, let’s clarify the difference between regular withdrawal syndrome and the post-acute withdrawal kind.
When we use a substance such as alcohol for a long period of time, our body and brain get used to it. Addiction hijacks the brain’s reward system, which relies on the feel-good neurotransmitter dopamine to steer us toward behaviors and substances that make us — yes — “feel good.” While it evolved to keep us alive by encouraging us to look for foods that taste good and to seek out romantic partners, the system is vulnerable to anything that provides instant gratification, such as drugs, gambling, or even excessive shopping.
All of these activities flood the brain with “free” dopamine, and it starts to expect the constant supply as the new normal. With time, the body also gets used to the new state of things. As a result, if the supply of dopamine suddenly stops, the body and brain stage a revolt, which manifests as withdrawal symptoms.
Unlike “acute” withdrawal symptoms, which set in around 24 hours after our last drink, peak for a couple of days, and dissipate within about a week, PAWS stages what feels like a sneak attack and can linger for months after there are no traces of the substance in our system. It’s not unique to alcohol — in fact, research shows that PAWS is associated with many different substances:
While less medically dangerous than the symptoms of acute withdrawal, the mixture of physical, mental, and emotional turmoil that PAWS can bring may be just as (if not more) distressing:
The cause of PAWS isn’t entirely clear. The brain is complex, and the simple truth is that it takes it a while to recover from the disarray caused by substance misuse. Certain genetic and environmental factors might also be at play.
Yes! Rest assured,” to “Yes! Take heart, PAWS isn’t permanent. Research shows that it might take a few weeks to several months, but most people find their way back to their former selves within about a year. As far as alcohol-related PAWS, a recent review in the Journal of Studies on Alcohol and Drugs suggests that symptoms tend to last 4-6 months.
The best way to avoid PAWS is to approach the initial withdrawal process with care by going to a detox facility — especially for those of us who’ve been drinking (or using other substances) for a long time. A gradual detox process is much more gentle on the brain and body, and it can get the recovery process off to a good start. The treatment for alcohol usually involves benzodiazepines, which have an effect on the brain similar to alcohol. These medications can be administered in a medical setting and tapered off gradually over a few days, making the recovery process much more comfortable.
In general, treating PAWS calls for a highly individualized approach, and what works for one person might not work for another. Unlike acute withdrawal, PAWS doesn’t come with distinct physical symptoms that can be addressed with medication or specific types of therapy. Basically, there’s no universal protocol for treating PAWS other than providing support and possibly treating such symptoms as anxiety, depression, and insomnia with medications
That said, here are several things that people have found helpful in overcoming PAWS:
Although it might not seem like it right now, there will be a time when PAWS will be behind you. Right now, you’re getting closer to that point every single day. It’s absolutely worth waiting for! Allow yourself to feel excited about the future and know that you’re on a journey to a more fulfilling, interesting, and meaningful life, and the weight of PAWS will start to lift sooner than you think.
1. What is PAWS?
PAWS, or Post-Acute Withdrawal Syndrome, is a set of symptoms that occur after the initial withdrawal phase from alcohol. It’s not a period but a set of symptoms. Maybe: “With PAWS, the brain and body are adjusting to functioning without alcohol, leading to various emotional and physical symptoms.
2. How long does PAWS typically last?
It can vary from person to person, but PAWS tends to last anywhere from a few months to a year or more.
3. What are some common emotional symptoms of PAWS?
Emotional symptoms of PAWS include mood swings, anxiety, anhedonia, and sometimes depression. These changes stem from shifts in brain chemistry that happen as the body adjusts to the absence of alcohol.
4. Are there physical symptoms associated with PAWS?
While PAWS is mostly known for emotional and psychological symptoms, physical symptoms can include tiredness, sleep disturbances, and fluctuating energy levels.
5. Can PAWS make it harder to concentrate?
PAWS can impact cognitive functions, leading to difficulty concentrating and memory issues. It helps to know that these symptoms are temporary and will improve as the brain heals.
6. How can I manage PAWS symptoms?
Managing PAWS involves a combination of self-care practices like maintaining a healthy diet, exercising regularly, and cultivating good sleep hygiene. Mindfulness and relaxation techniques, along with seeking support from friends, family, or support groups, are also helpful. Professional guidance from therapists or counselors can provide additional support. Most importantly, changing your relationship with alcohol by reframing how you see it can make an enormous difference.
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