Detoxing After Detox: The Perils of Post-Acute Withdrawal

Alcohol and Post-Acute Withdrawal Syndrome

However, anecdotal reports suggest that some symptoms persist for up to a decade following cessation. Dialectical Behavior Therapy Techniques for Addiction The Food and Drug Administration (FDA) confirms that benzodiazepine withdrawal symptoms can last weeks to years. If you are struggling with addiction, help is available and recovery is possible. Rehab programs are located throughout the U.S, and many offer specialized treatment that can cater to individual needs. You can use SAMHSA’s Find Treatment tool to search for treatment centers.

This condition is particularly common among individuals recovering from alcohol dependence, opioid withdrawal, and benzodiazepine withdrawal. After detox/acute withdrawal is over, the second phase of the withdrawal process kicks in. This exquisite phenomenon is known as post-acute withdrawal (sometimes referred to as protracted withdrawal).

But Post-Acute Withdrawal Syndrome (PAWS) may still occur and require management. This makes close medical monitoring and psychosocial support even more crucial for older people undergoing detoxification and PAWS. Since PAWS is not a formal diagnosis, there are no billing codes specific to PAWS treatment. But therapists and doctors treating PAWS symptoms can still bill for individual encounters. Sedative substances that powerfully impact GABA and glutamate neurotransmitter systems have the highest risk of inducing PAWS. Acute withdrawal is agonizing yet fleeting – a storm to endure before sobriety’s dawn.

Alcohol and Post-Acute Withdrawal Syndrome

Coping with PAWS and how to find help

Many state government websites will provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’ Once your state website is located, substance use resources shouldn’t be hard to find, and they should provide further phone contacts for your assistance. Similar to other drugs, these stimulant withdrawal symptoms are thought to be caused by adaptations in the brain to long-term stimulant use, and they can take several months or longer to resolve themselves. MHA Screening is an educational program intended to help inform people about options they have in getting help for mental health issues. It may suggest tools and resources that offer information, treatment services, self-help (or “DIY”) tools, and/or ways to connect with others.

During the acute withdrawal phase, individuals may experience intense physical and psychological symptoms. These can include tremors, nausea, vomiting, headaches, and severe cravings for the substance. It’s crucial to seek medical supervision during this phase, as some withdrawal symptoms can be life-threatening. In contrast to acute withdrawal, symptoms of post-acute withdrawal syndrome generally occur 2 months or more after drug cessation and are primarily psychological in nature, affecting a person’s mood, sleep patterns, and response to stress.

Who Experiences Alcohol Withdrawal Symptoms?

Reach out to a trusted healthcare provider or support group for guidance and assistance. With the right tools and support, you can overcome PAWS and continue on your path to lasting recovery. Prioritize self-care activities like maintaining a balanced diet, getting adequate sleep, and engaging in enjoyable hobbies. These practices will help you manage stress, improve your overall well-being, and reduce the risk of relapse.

Staying in recovery from addiction

  1. Symptoms of PAWS will manifest themselves after the end of acute withdrawal, but they can appear anytime within several weeks to several months after drug cessation.
  2. A person’s overall physical and mental health, as well as their genetic makeup, can influence the severity and duration of PAWS.
  3. Post-acute withdrawal is a consequence of the significant changes to brain anatomy and chemistry that take place during active addiction.

If you’re experiencing intense withdrawal symptoms, individual or group therapy is a fantastic option that we strongly recommend. Having people with first-hand knowledge to talk to will help put things into perspective and motivate you to keep going. While the acute stage of recovery involves intense physical symptoms over a period of one to two weeks, PAWS symptoms can persist, disappear and reappear for months. Often used to treat anxiety and insomnia, benzodiazepines include drugs like alprazolam (Xanax, Xanax XR), clonazepam (Klonopin), and diazepam (Valium). While effective at treating a number of symptoms, benzodiazepine withdrawal can be uncomfortable.

Support Your Recovery

By understanding the nature of post acute withdrawal symptoms and employing effective coping strategies, individuals can navigate the complexities of medical detox and recovery from drug and alcohol dependence. It’s essential to remain vigilant about mental health conditions that may arise during this time and to continue seeking support as needed. With dedication and perseverance, overcoming addiction and achieving long-term recovery is possible. These symptoms—termed post-acute withdrawal syndrome (PAWS)—were first described more than six decades ago (Satel et al., 1993). Following Segal, Kissin (1979) described several protracted alcohol abstinence syndrome cases in 1979, emphasizing their importance to relapse prevention.

These conditions can complicate the recovery process and extend the PAWS timeline. Addressing both the substance use disorder and any co-occurring mental health issues is crucial for successful long-term recovery. The acute withdrawal phase occurs immediately after an individual stops using a substance. The duration of this phase can vary depending on the specific substance and the severity of the addiction. For example, acute withdrawal from opioids like heroin may last for 7-10 days, while acute withdrawal from alcohol can last for several days to a week.