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Our Experience

We have observed that Post-Acute Withdrawal Syndrome (PAWS) is one of the leading causes of relapse in patients who do not receive proper treatment and adequate discharge planning. Therefore, it is crucial to comprehend PAWS and implement effective protective measures, as well as involve medical and clinical professionals in helping patients overcome these symptoms for long-term sobriety and recovery.


Post-acute withdrawal Syndrome (PAWS) refers to a set of symptoms that can persist for months or even years after an individual stops using alcohol or drugs. Let’s explore this phenomenon:

  1. Initial Withdrawal vs. PAWS:

    • Initial Withdrawal: After a medically supervised detox, individuals experience acute withdrawal symptoms. These can include physical discomfort such as muscle aches, nausea, headaches, and increased heart rate.

    • PAWS: PAWS occurs after the acute stage. It involves symptoms that last beyond the initial withdrawal period. These symptoms may be more psychological than physical and can include mood swings, sleep difficulties, and memory issues.

  2. Causes and Mechanism:

    • Chronic substance use can alter the brain’s molecular, cellular, and neurocircuitry related to emotions and behaviors.

    • Even after acute withdrawal symptoms subside, these changes persist, leading to PAWS.

  3. Risk of Relapse:

    • PAWS symptoms can increase the risk of relapse.

    • Recognizing and managing PAWS is crucial for long-term recovery.

Remember, seeking professional help and support during withdrawal and recovery is essential. If you or someone you know is experiencing withdrawal symptoms, consider reaching out to healthcare professionals or addiction treatment centers.


Post-Acute Withdrawal Syndrome (PAWS) occurs after the initial acute withdrawal phase when someone stops using or reduces their substance intake. Unlike acute withdrawal, which typically lasts a few days or weeks, PAWS symptoms can persist for a longer duration. Here are some common symptoms associated with PAWS:

  1. Insomnia or Sleep Disturbances: Difficulty falling asleep or staying asleep.

  2. Irritability, Aggression, and Hostility: Heightened emotional sensitivity and mood swings.

  3. Anxiety or Panic Attacks: Feelings of unease, nervousness, or fear.

  4. Depression: Persistent feelings of sadness, hopelessness, or lack of interest.

  5. Impaired Concentration: Difficulty focusing or thinking clearly.

  6. Lack of Enthusiasm or Motivation: Reduced interest in daily activities.

  7. Mood Swings: Severe fluctuations between highs and lows.


The specific symptoms can vary depending on the substance involved. For instance:


Addiction experts describe PAWS as the brain’s way of correcting those changes, specifically the chemical rebalancing and creating new neural pathways to heal itself over time.

Post-acute withdrawal syndrome can last from 12-18 months and in some extreme cases for up to 3-5 years.

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Psychology Today
Association of Intervention Specialists
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