Unsuspecting newcomers reach landmark time periods in their recovery process only to be met with the return of severely uncomfortable cravings and symptoms of withdrawal. Up to two years later, the cravings and withdrawal symptoms can suddenly strike. Despite the presence of important recovery factors, like therapy, meetings, and being of service, the painful reminders of an addiction past show up. What causes this haunting sensation? The answer is PAWS, Post Acute Withdrawal Syndrome. A sorely misunderstood phenomena in early recovery, PAWS is critical to learn about.

paws post acute withdrawal syndrome

Why it is important to understand PAWS?

Without PAWS education, the sporadic onset of withdrawal symptoms can be a blindside. Expecting the return of mental discomfort can reduce the shock and often the disappointment. Recovery is a day-at-a-time process. When those days start adding up without the presence of cravings or withdrawal, a person can start to have some real hope that they are going to make it. Withdrawal is the most vulnerable time for relapse. Recovery is once more put at risk months into recovery when PAWS strikes and withdrawal is felt again. Understanding PAWS is the difference between relapse prevention and relapse.

 Signs and Symptoms of PAWS

  • Depression
  • Cravings
  • Cognitive dysfunction and impairment
  • Obsessive behavior
  • Emotional irregularities
  • Difficulties sleeping (insomnia, oversleeping, disturbed sleep, night terrors, “using dreams”)
  • Sensitivity to stress, pain
  • Panic
  • Anxiety
  • Drop in motivation or initiative 

What to do during PAWS?

This too shall pass. Experiencing PAWS is uncomfortable and triggering, but it is not a permanent state. If you think you are going through a period of PAWS, reach out to your support system. Stay closely connected with your sponsor, therapist, and family members to keep yourself accountable and supported.

Most importantly, remember all the hard work you have done so far. PAWS may make recovery feel like you are at the beginning again. Your sober time has not disappeared! Stay committed to your life in recovery.


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