For many people, the distress of withdrawal is a significant obstacle on the path to recovery. Thankfully, with proper care, you can usually get through the most difficult parts of withdrawal in a relatively short amount of time. Unfortunately, some people also experience what clinicians refer to as post-acute withdrawal syndrome, or PAWS. In today’s post, we answer a variety of questions about PAWS, including how long does post-acute withdrawal syndrome last?
What Is Post-Acute Withdrawal Syndrome?
Post-acute withdrawal syndrome is a set of persistent symptoms that last long after the expected time frame for withdrawal from alcohol or another drug.
Typically, withdrawal is an intense but relatively brief experience.
- In most cases, withdrawal symptoms peak within a few days after a person stops using the substance to which they had become addicted.
- Symptoms then usually become increasingly less intense over the next few days, before finally dissipating.
- Depending on a variety of individual factors – including which drug the person has been abusing – the entire withdrawal process rarely lasts longer than 10-14 days.
Unfortunately, the answer to the question, “How long does post-acute withdrawal syndrome last?” is that PAWS can persist for multiple months or even years. We’ll discuss this in greater detail a bit later in this post.
Who Is at Risk for PAWS?
Given that PAWS can last for such an extended period of time, it’s understandable to wonder who is most likely to go through this experience. According to UCLA’s Semel Institute for Neuroscience and Human Behavior, post-acute withdrawal syndrome is most common among people who have become addicted to one of the following substances:
- Alcohol
- Opioids (such as heroin, morphine, fentanyl, and most prescription painkillers)
- Benzodiazepines (a category that includes anti-anxiety medications such as Ativan, Xanax, Klonopin, and Valium)
The Semel Institute reports that opioid users have the greatest risk, with about 90% experiencing some level of PAWS. Experts estimate that the prevalence of post-acute withdrawal syndrome among people who are recovering from addictions to alcohol or benzodiazepines is about 75%.
What Happens During PAWS?
“Normal” withdrawal from alcohol, opioids, and benzodiazepines can involve both physical and mental distress. When the process shifts to the post-acute phase, most symptoms are psychological, though a few important physical impairments can also occur.
The following are examples of common PAWS symptoms:
- Anxiety and irritability
- Depression
- Panic attacks
- Anhedonia (inability to experience joy)
- Diminished ability to learn and remember
- Problems focusing or thinking clearly
- Lack of energy, motivation, and initiative
- Impaired coordination
- Continued drug cravings
- Increased sensitivity to stress and pain
The impact of post-acute withdrawal syndrome may not be limited to the person who is directly experiencing the symptoms. The effect that PAWS has on a person’s mood and mindset often leads to conflicts with friends, family members, and romantic partners.
How Long Does Post-Acute Withdrawal Syndrome Last?
Now, let’s fully address the answer in the title of this post: How long does post-acute withdrawal syndrome last?
As is also the case with a standard withdrawal timeline, the duration of a person’s experience with PAWS can be influenced by several factors. These factors can include:
- The individual’s age, weight, and metabolism
- Which drug they had been abusing
- How long they had been abusing this drug
- How much of the drug they had been using
Research indicates that post-acute withdrawal syndrome is the result of substance-related structural and functional changes in the brain. So the length of time that a person experiences PAWS symptoms will primarily depend on the extent of the damage and the rapidity with which the brain can repair itself.
Unfortunately, there’s no accurate way to determine exactly how long a person will continue to live with post-acute withdrawal syndrome. At a minimum, symptoms usually last for at least six months. At the other end of the spectrum, some people have reported PAWS symptoms as long as two years after they had ended their substance abuse.
Can PAWS Be Treated?
Treatment for PAWS is similar to treatment for addiction itself. Ideally, it should be customized to reflect each person’s unique needs. Therapy can be helpful, and medication may also be beneficial (especially if the individual’s PAWS symptoms include anxiety or depression).
The therapeutic component of treatment for PAWS can help people learn to manage their symptoms in a healthy and productive manner. Dialectical behavior therapy (DBT), which promotes skills such as mindfulness and distress tolerance, may be helpful for someone who is living with PAWS. Cognitive behavioral therapy (CBT), which can help people replace negative thought patterns with healthier ways of thinking, can also be beneficial.
Also, continued participation in a 12-step group or another form of ongoing support can help people make (and maintain) the lifestyle changes that will minimize their symptoms and increase their ability to cope.
Find Addiction Treatment in Worcester
If you have been struggling with an addiction to alcohol or another substance, Lake Avenue Recovery is here for you. Our alcohol and drug rehab center in Worcester, Massachusetts, offers multiple outpatient treatment options to help people end their substance abuse and build a foundation for successful recovery. While you are with us, you can expect to receive personalized services and comprehensive support within a safe and respectful environment.
To learn more about how Lake Avenue Recovery can help you, or to schedule a free assessment, please visit our Contact Us page or call us today.