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What is post-acute withdrawal syndrome (PAWS)?

PAWS is a group of symptoms that happen after acute alcohol withdrawal. It often happens when you are no longer in the hospital. PAWS can make it hard to live a healthy lifestyle. 

Who does PAWS affect?

PAWS affects people who have had long-term alcohol use. The effects are also based on factors listed below.

  • Age

  • Gender

  • Length and amount of use

  • State of health

When does it start and how long does it last?

Acute alcohol withdrawal can last from a few days to a week. PAWS begins after this. Based on the amount of alcohol you used, PAWS can last for weeks to months. Longer and heavier use of alcohol can cause more severe PAWS symptoms that can last even longer.  

What are the symptoms of PAWS?

  • Emotional outbursts or lack of emotion

  • Anxiety

  • Difficulty dealing with stress

  • Low energy

  • Having a hard time sleeping, strange dreams, and changes in sleep patterns

  • Memory problems that make it hard to learn new things

  • Trouble thinking clearly, making decisions, and solving problems

  • Problems with balance and delayed reflexes

  • Feeling dizzy

  • More accident prone

These symptoms can frustrate you and your support system.

What can I do about PAWS?

Know the symptoms and have a plan to deal with them when they happen. Below is a list of ideas that may help. 

  • Identify your support system. It can be family, friends, counselors, health care providers, spiritual or religious group. Anyone that supports your desire to stay clean and sober.

  • Stay in touch with your support system.

  • Identify emotional states that trigger your desire to use: anger, boredom, sadness, loneliness. Get more support when they arise.

  • Make a daily routine that allows time to rest and relax.

  • Try to have a routine sleep pattern.

  • Eat throughout the day. Reduced junk or processed foods and eat more healthy foods, such as fruit, vegetables, and whole unprocessed foods.

  • Exercise can help reduce stress and increase your energy.

  • Treat yourself with patience and understanding.

  • Take time to take care of your spiritual self and do things that bring you comfort.

  • Be good to yourself.

  • Give yourself time to heal. You won’t feel better right away.

A Note to Your Support System

When your loved one is going through PAWS, they may need extra support from you. Ask what you can do to support your loved one through PAWS.

References

Addictions and Recovery Organization. (2010). Post-Acute Withdrawal (PAWS). Retrieved from http://www.addictionsandrecovery.org

Carty, B. (2016, September 26). Post-Acute Withdrawal Syndrome (PAWS). Hazelden Betty Ford Foundation. Retrieved from http://www.hazeldenbettyford.org/articles/carty/post-acute-withdrawal-syndrome 

Heilig, M., Egli, M., Crabbe, J., Becker,H. (2010). Acute withdrawal, protracted abstinence and negative effect in alcohol. Addictive Biology. Apr;15(2):169-84.