Dealing With Withdrawal – PAWS in Drug Recovery

Dealing With Withdrawal | Transcend Recovery Community

PAWS is not typically an acronym for a recovery-related animal petting project – rather, it stands for the all-too-real and common post-acute withdrawal syndrome/symptoms, aftershocks of recovery that are felt within your body after the acute stage of dealing with withdrawal is over. Post-acute withdrawal is best described as the reason why early recovery is so difficult to get through, and it accounts for the roller coaster emotions most people go through.

We’ll talk about how PAWS works, why it happens, how it differentiates itself from the acute withdrawal that anyone who struggled with drug dependence will have experienced, and the ways in which you can alleviate the symptoms and keep them from ruining your chances in early recovery, and beyond.

Detailing The Symptoms Of PAWS

PAWS has more general symptoms than acute withdrawal, which is more specific to the type of drugs you take and the severity of your addiction. Typically, the symptoms you will commonly see in a case of PAWS include:

  • Severe mood swings and irregular thinking
  • Anxiety
  • Depression and depressive thoughts
  • Anhedonia (the inability to feel pleasure or joy)
  • Restlessness/sleeplessness
  • Irregular sleeping cycles
  • Cravings
  • Diminished cognitive ability

You’ll feel worse all around when dealing with withdrawal, with a lower self-esteem, constant second-guessing, mood swings that cause you to feel free and empowered by your sobriety in one moment, and utterly crushed by the prospect of dealing with life completely sober in the next. However, these symptoms are intermittent, and will pass within two years, disappearing and surfacing over the course of this early recovery period.

Acute And Post-Acute Withdrawal

Acute withdrawal is a series of symptoms exhibited by the body due to drug dependence. This is part of a greater system of coping within the body, wherein elicit substances become less and less effective over time due to continued and frequent usage. This is called tolerance. At a certain point of tolerance, the body has become so accustomed to a specific regular dosage of drugs that stopping causes the body to go into a sort of state of shock.

This shock is the withdrawal period, and its symptoms are different from one drug to the next. Active drug users sometimes cycle their intake to prevent extreme tolerance and, as a result, prevent more extreme effects when dealing with withdrawal. Others who lack that knowledge risk increasingly taking more and more of their drug to achieve a high until they either overdose, or are forced through a very unpleasant series of symptoms while dealing with withdrawal.

Post-acute withdrawal occurs shortly after the initial acute withdrawal is over, and the symptoms are a lot more universal, and far less severe. Just as dealing with withdrawal is a normal part of dependence, post-acute withdrawal is also very common, and can be considered a normal part of addiction recovery in general. It can also partially explain the tumultuous journey many go through during early recovery – although it is not completely to blame.

Early recovery is always an awkward period, as it marks the adjustment between a life of addiction and a life without drugs. Not only are there chemical changes in your body and brain caused by months or years of drug use, but you also have to account for the immense stress of reintroducing yourself into normal living, meeting all new people, cutting off old contacts, learning to cope with stress in new ways, getting into new hobbies, learning how to take care of yourself properly and in a healthy manner, and discovering what it means for you specifically to be sober. Sobriety is a life-changing experience, and you have to like who you become.

Dealing With Withdrawal

Withdrawal itself is countered depending upon:

  • The severity of the withdrawal, and for that matter the addiction itself
  • The substance/s a person is addicted to, which changes the symptoms of the withdrawal
  • The age and general health of the person

Typically, the safest way to go about dealing with withdrawal is in a medical setting. A residential sober housing community may help you get setup and provide the medical oversight necessary to ensure that you go through withdrawal in a safe, non-dangerous way. Withdrawal can kill you, especially if your vice happens to be alcohol. Usually the symptoms are much less severe than death, but they remain dangerous enough to warrant having someone look after you while you go through them.

Withdrawal itself does not last long. Acute withdrawal may last anywhere between a few days and a few weeks depending on the substance or substances you’re dealing with. Heroin and other prescription opiates will typically put you down for about two days, with heavy flu-like symptoms, nausea, fever and extreme lethargy.

Benzodiazepines can result in paranoia or anxiety, and may result in seizures over the course of recovery, making medical supervision necessary. Withdrawal can last weeks.

Cocaine and other stimulants will lead to restlessness and jitters while dealing with withdrawal for a week following abstinence, after which symptoms will drop.

Alcohol can lead to tremors and seizures, nausea, and even death in very severe cases of alcoholism. This is why it’s important to have medical supervision and consider weaning off drinking instead. This may be safer depending on the severity of your addiction. If you’re in doubt, it’s important to consult a physician directly, or enroll in residential treatment before attempting to go through your withdrawal symptoms alone.

At the end of the day, dealing with withdrawal is something most people have to handle, and PAWS is no different. Although it’s such a common condition described by most people going through recovery, it is not officially recognized it yet. Talking to your therapist or your psychiatrist can help you gather more information specifically towards what sort of symptoms you may be tackling over the course of the next two years, as these symptoms typically vary from one addiction to another depending on the health of the person and their substances.

PAWS is a natural part of recovery, and one you must push through. However, the above tips will greatly help you deal with the symptoms of both acute and post-acute withdrawal without further tempting you into a relapse. With a little luck and a lot of effort, you’ll feel your mood normalize in time.

The Use of Psychotropic Drugs in Substance Abuse Treatment

The Use of Psychotropic Drugs in Substance Abuse Treatment | Transcend Recovery Community

Addiction treatment often includes medication, including psychotropic medication. Even though you might expect anti-anxiety or anti-depressants to treat only mental illness, they are also used to facilitate the process of withdrawal from addiction and sobriety.

Psychotropic medication can alleviate many psychological symptoms, which is why they are commonly used not only for depression, anxiety, and other mental illnesses, but also to alleviate the discomforts of addiction treatment. They can help alleviate conditions such as an inability to concentration, sleeplessness, paranoia, hallucinations, manic states, moodiness, or depression. These drugs can significantly improve mood, health, well-being and quality of life for individuals who suffer from these conditions as well those who are having a challenging time with the beginning stages of their recovery.

Along these lines, there are many recovering addicts who find that there are in fact mental illnesses lying beneath their addictions. As their addiction wanes and as they begin to physically improve, they may experience anxiety, states of depression, moodiness, or other symptoms, such as those described above. In these cases, psychotropic medication might also be useful and prescribed as a part of their addiction treatment.

There are a variety of antidepressants that are used for different psychological disorders, depending upon a person’s needs and circumstances. For example, MAOIs (Monoamine Oxidase Inhibitors) were the first class of anti-depressants to be developed. They increase levels of norepinephrine, serotonin, and dopamine by inhibiting an enzyme called monoamine oxidase. TCAs (Tricyclic Antidepressants) work by increasing the levels of norepinephrine as well as serotonin, but to a lesser degree. SSRIs (Selective Serotonin Reuptake Inhibitors) increase the levels of serotonin, which can ease depressive symptoms. SSRIs are incredibly effective, but they do come with risks. They can cause suicidal thoughts and even attempts at suicide. SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) are a new class of anti-depressants. They differ from SSRIs in that they increase levels of both serotonin and norepinephrine in the brain. They have similar side effects to SSRIs as well.

In addition to anti-depressants, there are also anti-anxiety medications. One of the most common anti-anxiety drugs used in drug treatment is benzodiazepines. They have been very effective in treating alcohol withdrawal syndrome. The risk with benzodiazepines, however, is that they are highly addictive and have severe withdrawal symptoms. And for this reason, researchers are exploring other forms of treatment for the alcohol withdrawal process. The benefit to benzodiazepines is that if a recovering addict can take them as prescribed, they usually pose the risk of addiction and instead, the medication greatly facilitates their alcohol detox process. However, if an addiction does develop, the withdrawal process from benzodiazepines can be severe.

Other types of medication used to aid the psychological withdrawal experience include anti-seizure and mood stabilizing drugs. It’s important to know that you can be actively involved in the conversation with your doctor about what drug you’re using, the symptoms you’re experiencing and whether or not it’s working in your life. Perhaps knowing the traits of an ideal drug would help. These include:

  • Do a good job of reducing or eliminating symptoms.
  • Be safe in that the side effects are not harming or dangerous.
  • Not interact with other drugs, making them ineffective.
  • Not produce additional side effects.
  • Be convenient to use, such as a pill a day or with meals.
  • Be inexpensive.

If you are in the early stages of your recovery and you are experiencing significant psychological side effects, talk to your doctor, therapist, or drug counselor. There are ways to manage the psychological discomforts that come with addiction treatment.


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