What is Post-Acute Withdrawal Syndrome?

Post-Acute Withdrawl Syndrome (PAWS) is a common disorder among people with substance abuse disorders. It is a set of prolonged withdrawal symptoms and a key sign of relapse. The symptoms of PAWS can occur from a few months to years after being sober. When or how PAWS begins cannot be predicted but depends on the substance used, how it was abused and for how long it was used.

PAWS manifests itself in numerous ways but can also materialize discreetly. While it is important to remain physically sober it is also critical to be emotionally healthy as well. If your emotional well-being is neglected it makes the risks of PAWS and relapses more probable.

Some symptoms of PAWS include:

Stress Sensitivity

Those in early recovery tend to struggle with taking control of their stress. For those suffering from PAWS, it is important to remember their coping skills from treatment. While you may have spent a good amount of time building addictive behaviors it is time to utilize the healthier coping skills you learned in recovery.

Sleep Disturbances

Another symptom of PAWS is problems sleeping. Maintaining a proper sleep schedule is the norm for a healthy lifestyle. There are also many easy remedies to sleeping disturbances such as creating a routine, exercising or listening to calming music before bed. If you notice significant changes in your sleep pattern this is a sign of PAWS.

Memory Problemsmemory

Just as stress is a common symptom of PAWS so is problems with memory. These two are usually linked as they tend to feed off of each other. Some people become forgetful and in turn internalize this as stress while for others the side effect of stress tends to be memory loss. The two go hand in hand and can indicate the sign of PAWS.

Impaired Concentration

Lack of concentration is another common symptom and a major red flag of someone faltering in recovery. Not being able to focus might drive one to use again in order to find clarity. This is usually a telltale sign someone is struggling with their recovery.

Emotional Overreactions or Numbness

A common feeling among those who struggled with substance abuse is feeling overwhelmed by too many emotions or feeling deprived of emotions. Once in treatment, they are taught how to cope and showing signs of emotional mood swings is a major sign for PAWS. Some may overreact to the smallest of details while others tend to be unfazed about something that can be deemed extremely emotional. This drastic contrast is a symptom of PAWS and usually a sign that relapse will soon follow.


Cravings stem from triggers that drive you to cope using your addictive habits. Most former addicts common triggers include a particular place, person, thing or emotion. These are also often a mix of anxiety or depression which lead to thoughts of relapse. Understanding your triggers is the first step to getting them under control. For help on triggers read our blog on How to Tame Addiction Triggers.

According to the PostAcuteWithdrawal.org, 91% of addicts surveyed experienced PAWS and it can happen at any time. Just because you have been in recovery for a long period of time doesn’t mean you are off the hook from experiencing PAWS.

What to do if you have PAWS

Suffering from PAWS is quite a challenge and most often ends in a relapse. To better your chances here are a few things you should do:

  • Stay Active and Eat Healthy
  • Be Positive
  • Avoid Triggers
  • Talk to someone in addiction
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