Addiction recovery is a lifelong journey that involves far more than simply stopping substance use. While the initial detox period addresses the physical withdrawal symptoms, many individuals experience a lesser-known but equally challenging phase known as Post-Acute Withdrawal Syndrome, or PAWS.
Understanding PAWS is critical for anyone in recovery, as well as their loved ones and support systems. Knowing what to expect and how to manage it can make all the difference in staying on the path to long-term healing.
What Is PAWS?
Post-Acute Withdrawal Syndrome refers to the lingering symptoms that persist after the acute withdrawal stage. Unlike the early withdrawal period, which typically lasts days to a couple of weeks and is marked by physical symptoms like nausea, sweating, or tremors, PAWS is primarily psychological and emotional.
It can begin weeks or even months after detox and may come and go unpredictably. PAWS is a natural result of the brain adjusting to life without the substances it had become dependent on.
Common Symptoms of PAWS
PAWS symptoms can vary in intensity and duration but often include:
- Mood swings or irritability
- Anxiety or panic attacks
- Depression or emotional numbness
- Difficulty concentrating or memory problems
- Fatigue or low motivation
- Sleep disturbances, including insomnia or vivid dreams
- Strong cravings for the substance previously used
These symptoms can feel frustrating or discouraging, especially when someone expects to feel “better” after detox. But experiencing PAWS is normal—and temporary.
What Causes PAWS?
Long-term substance use alters the brain’s neurochemical balance, especially in areas related to mood regulation, decision-making, and stress response. Even after the substance is removed, it can take the brain months to restore its natural rhythms and functionality.
PAWS is essentially the brain recalibrating itself—rebuilding damaged pathways and learning to function without the artificial stimulation or sedation of drugs or alcohol.
How Long Does PAWS Last?
There’s no one-size-fits-all timeline for PAWS. For some, symptoms may fade within a few weeks. For others, they can linger for several months or longer, especially if the individual used substances heavily or over a long period.
PAWS symptoms tend to come in waves. Someone might feel stable and confident one week, then suddenly experience a resurgence of anxiety or depression the next. This fluctuation can be confusing, but it’s not a setback—it’s part of the healing process.
Managing PAWS: Strategies for Coping
The key to getting through PAWS is having a plan, staying connected, and treating yourself with patience and compassion. Here are some helpful strategies:
1. Stick to a Routine
A regular schedule for sleep, meals, physical activity, and recovery-related appointments can give your body and brain the consistency they need to heal.
2. Practice Mindfulness and Stress Management
Deep breathing, meditation, journaling, or gentle movement like yoga can help regulate your nervous system and reduce anxiety.
3. Get Professional Support
Working with a therapist or attending recovery support groups (like NA, AA, or SMART Recovery) can provide tools and accountability during this phase.
4. Avoid Triggers
Steering clear of environments or people tied to your past use helps reduce the likelihood of relapse, especially during emotionally vulnerable periods.
5. Be Kind to Yourself
Recovery isn’t linear. Experiencing PAWS doesn’t mean you’re failing—it means your brain is doing the hard work of healing. Give yourself credit for every step forward.
Final Thoughts
PAWS can be one of the most challenging parts of recovery because it often arrives after the visible signs of withdrawal have passed. But it’s also a sign of progress—a marker that your body and mind are transitioning toward true, lasting wellness.
Being informed about PAWS gives you power. Power to prepare. Power to cope. And most importantly, power to stay committed to your recovery goals.
If you or someone you love is experiencing symptoms of PAWS, support is available.