Understanding Post-Acute Withdrawal Syndrome (PAWS)

Written by:
Picture of South Meadows Recovery
South Meadows Recovery
Our methodology:

At South Meadows Recovery, we employ a personalized, evidence-based approach to empower anyone to overcome addiction, regardless of their circumstances.

Blog Categories:
Sad Woman in a Dark Room

Post-Acute Withdrawal Syndrome (PAWS) is a lesser-known but significant aspect of addiction recovery, often overshadowed by the more immediate and intense symptoms of acute withdrawal. This condition emerges after the initial withdrawal phase and can persist for months or even years. PAWS poses unique challenges to individuals in recovery, influencing their physical, emotional, and cognitive wellbeing.

The Nature of Post-Acute Withdrawal Syndrome

PAWS represents a collection of symptoms that occur after the acute withdrawal stage of dependency on substances such as alcohol, prescription medications, or illicit drugs. Unlike acute withdrawal, which is characterized by physical symptoms like sweating, shaking, and nausea, PAWS primarily impacts an individual’s emotional and psychological state.

Symptoms can include mood swings, anxiety, depression, sleep disturbances, and ongoing cravings. The unpredictable and prolonged nature of these symptoms often complicates the recovery process.

Causes of Post-Acute Withdrawal Syndrome

The root of PAWS lies in the brain’s adjustment to the absence of the abused substance. Prolonged substance use alters the brain’s chemistry and functioning. When the substance is removed, the brain struggles to regain balance, leading to the various symptoms associated with PAWS. Factors like the type of substance used, duration of abuse, and individual health conditions can influence the severity and duration of PAWS.

Post-Acute Withdrawal Syndrome: Diagnosis and Management

Diagnosing PAWS can be challenging, as its symptoms overlap with other mental health conditions. A thorough evaluation by a healthcare professional is essential to distinguish PAWS from other potential issues. Once diagnosed, managing PAWS requires a comprehensive approach. This includes continued support from healthcare providers, engagement in therapy, lifestyle changes like regular exercise and a healthy diet, and possibly medication to address specific symptoms like depression or anxiety.

Coping with PAWS

Coping with PAWS is a critical part of the recovery journey. It involves building a strong support network, including therapists, support groups, and loved ones. Developing new coping strategies and stress management techniques is also vital. Maintaining a routine, practicing mindfulness, and engaging in activities that promote physical and mental health can provide stability and improve overall wellbeing.


Post-Acute Withdrawal Syndrome is a complex and challenging aspect of recovery from substance abuse. It requires awareness, understanding, and a multifaceted approach to management. Individuals facing PAWS should seek ongoing support and embrace a holistic approach to their recovery. With the right tools and support, overcoming PAWS and moving towards a healthier, substance-free life is possible.