If a member of your family has an addiction to drugs or alcohol, there is help available. And while your family member may be doing all they can to stay sober, there is the possibility of what is known as Post Acute Withdrawal Syndrome (PAWS). Here is more about this condition and what you need to know in order to be supportive and understanding.

What is PAWS?

Post-Acute Withdrawal Syndrome can happen after a person has sought treatment for things like alcohol or drugs. This happens after an addiction when the brain re-calibrates. When this happens there are a few symptoms that are typical. These include:

  • Emotional outbursts or lack of emotion
  • Irritability and hostility
  • Anxiety
  • Lack of libido
  • 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 thing
  • Inexplicable chronic pain

What Physical and Psychological Issues Triggers PAWS?

There is a variety of triggers that can exacerbate Post Acute Withdrawal Syndrome. These are those that either trigger the condition or make the experience worse.

  • Acute emotional issues that arise during the first year or years of recovery
  • The type of substance used
  • What kind of support was provided by professionals
  • The length of time and amount of substance that was used
  • Co-occurring physical and/or mental health conditions

There are other examples that are helpful in determining what may cause PAWS.


One thing that can trigger PAWS is the habits the person is used to. These habits and the loss of them sometimes maximizes symptoms like anxiety and cravings. For instance, a person who has an addiction to alcohol may miss the habit of being around friends at a club or bar.

Homeostatic Adjustment

Certain drugs cause changes in our brain. The drug causes endorphins and neurotransmitters to release and when that is taken away, it can take time for the brain to readjust. This often creates feelings of cravings, fatigue, and a variety of psychological signs during Post Acute Withdrawal Syndrome.


When a person stops using their drug of choice it is psychologically stressful. It can lead to withdrawal symptoms or relapse while the person tries to live their life without alcohol or drugs.

Physiological Adaptations

There are physical withdrawal symptoms that may manifest during PAWS. For example, those who take opioids and have an addiction can experience symptoms such as stomach cramps, nausea, and diarrhea. This can take a few weeks to revert to normal although the typical time is around 14 days. Other areas are affected such as heart rate, digestive system, and even hormones.

How Long Do the Symptoms Last?

Post-Acute Withdrawal Syndrome lasts different lengths of time depending on various factors, including the drug of choice.

For example, someone addicted to cocaine may experience struggles to stay sober for around four weeks or so. Yet, someone with an addiction to methamphetamine may experience long-term issues and struggles. Right in the middle of the two is an addiction to opiates where the struggles for sobriety last between weeks and months depending on various factors related to the individual.

Of course, all of this depends on the individual as well. These examples are just that – everyone’s struggle is different and some may react with longer struggles or hopefully a shorter length of time of their struggle. Some are right in the middle where they experience symptoms periodically And in a best-case scenario, some do not experience any symptoms of PAWS at all after recovery.

How is PAWS Treated?

The symptoms of Post Acute Withdrawal Syndrome are mainly emotional and psychological. This means that support from family, friends, and medical professionals is important.

Patients should do the following:

  • Keep in touch with the support system they have like the aforementioned friends, family, and medical professionals
  • Get good rest
  • Eat healthily
  • Exercise
  • Identify the triggers that create a desire to use such as loneliness, boredom, or being sad
  • Have patience with yourself
  • Celebrate your accomplishments

The support system should do the following:

  • Celebrate accomplishments
  • Encourage the help of support groups
  • Encourage patience
  • Be supportive and understanding even if it is hard to do so

Professional support personnel encourages the patient by:

  • Education on what to expect for both recovery and withdrawal
  • Assess potential co-occurring disorders, which may emerge or re-emerge
  • Help patient find natural sleep methods
  • Help patient manage impulse control
  • Celebrate accomplishments
  • Encourage healthy eating and exercise
  • Take symptoms reported seriously

Sometimes a medical professional may prescribe certain medications like naltrexone which help reduce cravings.

When a Family Member is Coping with PAWS

Keep in mind that your family member is going through an emotional rollercoaster. They may have mood swings, feel tired, have brain fog, and feel depressed. The same advice for them goes for you – be patient and understanding. These symptoms will start to decrease after a time period and while that time period varies, things do get better.

Of course, PAWS may reintroduce itself expectantly. But by knowing what is going to happen, you can help your family member and provide the support they need during this time.