When a person with a substance use disorder gets clean, their body and mind go through many changes. Usually, there is a short detox process that helps people start their journey to recovery. This process makes it easier for a person to cope with immediate and painful withdrawal symptoms such as body aches, diarrhea, and fever. Once this period is over, it’s easier to focus on recovery. However, many people experience something called PAWS (post acute withdrawal syndrome) after they have been clean and sober for months, and sometimes even up to 18 months after they initially get sober.

What is Post Acute Withdrawal Syndrome?

Many people who don’t struggle with addiction make assumptions that simply aren’t rooted in addiction science. There’s a belief that once the drug is removed from an addicted person’s life, everything easily falls into place for them. This is what is called wishful thinking. The truth is that after the initial phase/acute withdrawal period, a second, more subtle phase of withdrawal often kicks in.

While not as intense as acute withdrawal, post-acute withdrawal can be pretty uncomfortable to deal with, especially if you haven’t been educated on its causes.

Many people who used their drug of choice long-term, or used opioids heavily, experience this second phase of withdrawal.

PAWS and the Brain

Post-acute withdrawal occurs because long-term drug or alcohol use causes changes to your brain chemistry, causing your brain’s reward system (which creates the “feel good” feelings when you get high) is malfunctioning. When you use drugs, it overproduces a chemical called dopamine. But often the brain can’t keep up with the demand for this chemical when you’re getting high.

Your brain may temporarily have a surge of feel-good chemicals when you get high, but when you quit using, there aren’t very many chemicals left. Think of your brain like a car that needs gas (dopamine) to function. If you drive your car super fast for a few hours, there may not be enough gas when you’re going the speed limit. You need to fill up again.

The brain needs to rest and rejuvenate to readjust. You may be left with a deficit of dopamine, temporarily. This deficit can increase your sensitivity to pain and make it difficult for you to feel “good” in early recovery.

PAWS Symptoms

While each person’s experience of PAWS can be different, they all tend to have similar symptoms that can vary in intensity.

PAWS can make people get fatigued quickly, and interrupt sleep, memory, concentration and attention span. Mood changes can include fluctuations in mood, anxiety, irritability, anger, and depression.

These moods will come and go, but if you experience any of them intensely or they are overwhelming, you may want to seek the help of a therapist to help you cope with them.

Almost everyone in early recovery will experience PAWS to a certain extent as the brain and body begin to heal from their addiction.

Getting Help for Substance Use

Are you or somebody you love ready to stop using drugs and try a new way of life in recovery? Get the help you need. Give us a private call at 877-450-1880 to learn more about your options.