What Is Post-Acute Withdrawal Syndrome (PAWS)?

Post-acute withdrawal syndrome (PAWS) is a set of symptoms that can occur after quitting alcohol or drug use. These symptoms can persist for several months to two years. 

Unlike the acute withdrawal symptoms that occur in the first few days or weeks after stopping drug or alcohol use, PAWS is more psychological and emotional.

Understanding the Two Stages of Withdrawal: Acute and Post-Acute

When a person with a substance use disorder (SUD) stops taking drugs, they go through two stages of withdrawal.

Acute Withdrawal (Detox)

Acute withdrawal is the first stage of detox. During this phase, you will likely experience physical withdrawal symptoms like shaking, nausea, or sweating.

In addition to physical withdrawal symptoms, acute withdrawal can also cause emotional distress and intense cravings. Once the acute withdrawal phase is over, individuals typically transition to the second withdrawal stage.

Post-Acute Withdrawal

The second phase of detox is post-acute withdrawal syndrome. During this phase, you will likely experience a collection of psychological and mood-related symptoms that occur as the brain recovers from the effects of active addiction.

People also refer to PAWS as prolonged withdrawal syndrome, post-withdrawal syndrome, or protracted withdrawal syndrome. Despite the discomfort, it’s important to know that PAWS is temporary. Over time, the symptoms will begin to fade, and individuals will start to feel better.

Symptoms of PAWS

PAWS can manifest in a variety of ways and can differ from person to person. Some common symptoms of PAWS include:

• Mood swings and irritability
• Anxiety and panic attacks
• Depression
• Insomnia or other sleep disturbances
• Lack of energy and motivation
• Difficulty concentrating and making decisions
• Cravings for drugs or alcohol

Furthermore, these symptoms can occur at any time during the PAWS period and can last for several days or even weeks.