Identification and Evidence-Based Treatment of Post Acute Withdrawal Syndrome

Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs), can be an effective way to manage your mood. When people are equipped with the conscious awareness of what the obstacles are and where they are located, many are able to find their way through them successfully. Active addiction precipitates a massive increase in the activity of the sympathetic division of the autonomic nervous system. The sympathetic division of the ANS is activated under circumstances of perceived threat and sets in motion the chain of survival-focused physiological responses that prepare the body for “fight or flight” (or to freeze). Behavioral health treatment for alcohol problems is often (but not always) covered by insurance. In the United States, most states have low-cost or free rehabilitation programs for those who are uninsured.

What exactly is post-acute withdrawal syndrome?

There are anecdotal reports of individuals who continue experiencing prolonged withdrawal for the rest of their lives, though this appears to be extremely rare. Seeking treatment at a detox or rehabilitation center can increase the chance of a successful recovery. It can also lessen the risk of relapse because of medical support and supervision.

Often, symptoms are triggered by stress or brought on by situations involving people, places or things that remind the individual of using. Many people in recovery describe the symptoms of PAWS as ebbing and flowing like a wave or having an “up and down” roller coaster effect. In the early phases of abstinence from substance use, symptoms can change by the minute. As individuals move into long-term recovery from alcohol or drug dependence, the symptoms occur less and less frequently. As challenging as it is, post-acute withdrawal is a necessary process that everyone in early recovery must go through, as the brain and body begin to heal and reorient to life without the use of alcohol or other drugs. If you are thinking about quitting drinking, talk to your healthcare provider.

Structure and routine are critical for people in early recovery because it helps to reduce stress, increase predictability, and provide a sense of control over one’s life. A structured routine should include regular sleep patterns, healthy eating habits, and scheduled activities. When family members and friends understand PAWS, they can provide Motives and Side-Effects of Microdosing With Psychedelics Among Users PMC more informed and effective support to their loved ones in recovery.

General PAWS symptoms

Despite an older treatment trial showing some positive data for amitriptyline for mood, the clinical measures used were problematic, and side effects and safety profile limit its utility. Finally, there is no evidence that melatonin and other agents (homatropine, Proproten-100) show PAWS symptoms. These symptoms affect many people in the early phases of abstinence from numerous substances, but they occur in an extremely high percentage of those with histories of long-term opioid use.

Drugs, brains, and behavior: the science of addiction. 2018

Recovering from substance addiction involves learning to cope without the influence of drugs or alcohol. This adjustment can unmask underlying behavioral and process addictions as alternate unhealthy coping mechanisms. In general, the more severe the substance abuse, the more likely PAWS will occur and the longer it will last. Sedative drugs like alcohol, benzodiazepines and opioids have a very high likelihood of causing PAWS. In addition to reducing the risk of relapse, understanding PAWS can also help individuals develop a greater sense of self-efficacy and control over their recovery. When they know what to expect and have the tools to cope with challenges, individuals may feel more empowered and confident in their ability to maintain their sobriety and build a fulfilling life in recovery.

Family therapy and couples counseling can also be beneficial for strengthening relationships and improving communication skills. Dr. Lembke notes, “Addiction and PAWS can strain relationships, so it’s essential to work on rebuilding trust and fostering healthy connections with loved ones.” Journaling and engaging in creative outlets, such as art or music therapy, can also be effective stress-reduction techniques. Experts recommend engaging in at least 30 minutes of moderate-intensity exercise most days of the week. This can include activities such as walking, jogging, swimming, or cycling. The absence of the substance can lead to feelings of sadness, hopelessness, and a lack of interest in previously enjoyable activities.

Acute withdrawal symptoms lasts around 3-7 days for shorter acting substances like opioids, or 7-14 days for long-acting substances like alcohol and benzodiazepines. Symptoms of post-acute withdrawal syndrome are caused by the body recalibrating after depending on substances for so long. An identity crisis of sorts as the mind relearns how to cope and function without its former fuel. By incorporating a variety of enjoyable activities into daily life, individuals in PAWS recovery can create a well-rounded self-care routine that supports their physical, mental, and emotional wellbeing. Remember, self-care is not a one-size-fits-all approach, and what works for one person may not work for another.

Aftercare services, such as outpatient therapy, 12-step programs, online sober communities, and sober living homes, can provide individuals with the support and resources they need to maintain their recovery and cope with PAWS symptoms. Engaging in these services can help individuals build a strong support network, develop healthy coping strategies, and address any underlying mental health concerns that may be contributing to their substance use disorder. The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes.

Understanding these risks highlights the importance of undergoing detox in a medically supervised environment. While detoxification is challenging, it’s a pivotal step toward overcoming addiction and reducing the likelihood of long-term substance-related symptoms in recovery. Benzodiazepines include drugs like diazepam and alprazolam elicit profound physical dependence when taken continuously. This means withdrawal symptoms frequently emerge even after appropriate prescribed use. Overall, heavy, chronic substance abuse predicts more severe, persistent PAWS symptoms.

1. As challenging as it is, post-acute withdrawal is a necessary process that everyone in early recovery must go through, as the brain and body begin to heal and reorient to life without the use of alcohol or other drugs.
2. Sedative drugs like alcohol, benzodiazepines and opioids have a very high likelihood of causing PAWS.
3. Different substances can have varying effects on the brain and body, and the duration of PAWS may depend on the specific substance used.
4. Sleep disturbances are prevalent, with individuals experiencing insomnia, vivid dreams, or altered sleep patterns.
5. The acute withdrawal phase typically involves intense physical symptoms as the body begins to adjust to the absence of an addictive substance.

Detoxification and substance abuse treatment. 2016

Often, there is no diagnostic test for withdrawal, as with opioid withdrawal. A urine test can help doctors rule out withdrawal from specific drugs or combinations. Alcohol is a sedative drug and works, in part, by activating gamma-aminobutyric acid (GABA) receptors in the brain.