Post-Acute Withdrawal Syndrome Timeline: An Overview

What Is Post-Acute Withdrawal Syndrome?

Post-acute withdrawal syndrome, or PAWS, is a set of symptoms that can continue to impact a person long after they have completed the normal or standard withdrawal process.

Of course, a “standard” withdrawal experience can vary in terms of the types of symptoms a person develops, how intense they become, and how long they last. Factors that can influence what someone goes through in withdrawal can include:

• Their age, gender, weight, and metabolism
• Which drug they are withdrawing from
• How long they had been abusing that drug
• How much of the drug they had been using
• The presence of any co-occurring medical or mental health concerns

In general, if you are withdrawing from alcohol, stimulants, benzodiazepines, or opioids, symptoms usually peak within a few days, then gradually subside over the following week or two. 

But if you develop PAWS, the post-acute withdrawal syndrome timeline can last for several additional months, or even years.

Common PAWS Symptoms

As with standard withdrawal, the post-acute withdrawal syndrome timeline can include a range of symptoms of varying intensity and duration. 

Examples of common physical PAWS symptoms include:

• Fatigue and exhaustion
• Overall weakness
• Dizziness or lightheadedness
• Impaired coordination
• Delayed responsiveness
• Disrupted sleep patterns
• Recurring headaches
• Muscle pain
• Gastrointestinal distress

From a cognitive and emotional perspective, the PAWS timeline can include symptoms such as:

• Ongoing drug cravings
• Anxiety and/or depression
• Mood swings
• Impaired focus and concentration
• Memory problems
• Slowed thought processes
• Problems managing stress

Post-Acute Withdrawal Syndrome Timeline

It can be difficult to identify exactly when the post-acute withdrawal syndrome timeline begins, as this experience doesn’t usually involve the onset of “new” symptoms. 

Instead, a person may be considered to be dealing with PAWS if they are continuing to experience lingering physical and/or psychological concerns more than a week or two after the acute phase of withdrawal has ended.

One of the many challenges of PAWS is that it can also be difficult to predict how much longer a person will continue to be affected by these symptoms. Usually, a person who begins to withdraw from opioids or alcohol will understand that they are in for a few unpleasant days, but they can find some peace of mind in the knowledge that the experience will likely be over relatively quickly. 

Knowing that the distress you are experiencing won’t last for much longer can help you remain positive and focused. Unfortunately, PAWS doesn’t offer this type of predictability. 

For some people, PAWS lasts for a few months after the acute phase of withdrawal. For others, it can take years before they finally feel like they’re back to full strength. Several reputable sources put the estimated duration of the post-acute withdrawal syndrome timeline at six to 24 months (or half a year to two years).

How Does PAWS Affect Recovery?

Given the potential intensity and unpredictability of PAWS symptoms, it’s not difficult to understand that they can be extremely disruptive. 

Here are a few examples of how PAWS could undermine your recovery and otherwise intrude on your efforts to build a healthier and more satisfying future for yourself and your loved ones:

• Problems with focus and concentration can make it difficult for you to devote your full attention to the therapeutic and educational components of your addiction treatment plan. Fully engaging in residential and/or outpatient treatment after completing detox can improve your ability to protect your sobriety. Being unable to reap maximum benefit from these services can increase your risk of relapse.
• Persistent drug cravings and trouble managing stress can be a difficult combination to overcome when trying to maintain your recovery. Stress is a common relapse trigger, which is why addiction treatment programs typically incorporate stress management education into their programming. If you are already struggling to resist intense urges to use alcohol or other drugs, being unable to respond to stress in a healthy manner can easily push you back into your bad old habits.
• As virtually everyone in recovery can attest, remaining sober requires a concerted effort and consistent vigilance, which can be both physically and psychologically draining. This is one of the reasons why effective recovery plans so often include nutrition and exercise components. PAWS symptoms can sap your strength and erode your motivation, making it that much more difficult for you to summon the energy you need to remain on track.

Find Detox in Atlanta Today

When you begin your recovery journey in a detoxification program, you can receive both medical and therapeutic services to protect your health and help you manage your symptoms. 

Then, when you’re ready to transition out of detox, your treatment team can help you find a trusted residential or outpatient program. These programs can help you to progress in your recovery and, if necessary, learn how to best manage your PAWS symptoms.

If you can use this type of support and you live in the Atlanta, Georgia, area, Peachtree Detox may be the perfect place for you. At our Atlanta detox center, your treatment will include an array of evidence-based services, all provided by a team of skilled and compassionate professionals. 

With a combined total of more than 60 years providing substance abuse treatment, our team is uniquely prepared to help you find your way out of the darkness of untreated addiction and put you on the path toward the healthier and more hopeful future that you deserve.

When you’re ready to get started, the Peachtree Detox team is here for you. To learn more or to schedule a free assessment, please visit our Admissions page or call us today.