13 Signs You're Suffering From Post Acute Withdrawal Syndrome (PAWS)
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13 Signs You’re Suffering from PAWS

There are many effects of addiction, most of which are readily known such as the loss of physical health, the weakened immune system, behavioral changes that make addicts more likely to resort to deviant behavior, growing disinterest in former pursuits, becoming indifferent about damaging relationships, and so on. Since most people have either experienced addiction personally or know someone who has struggled with substance abuse, most are quite familiar with what a substance abuse problem does to a person. However, there are also some aspects of addiction that are less well-known due to being less prominent. In the case of PAWS (post-acute withdrawal syndrome), it’s likely because it’s an effect that doesn’t manifest until after an addict has been in recovery for a while.

Post-acute withdrawal syndrome, which is sometimes referred to as protracted withdrawal syndrome and given the same acronym, is a condition that manifests in individuals who have gotten sober after being addicted to a mind-altering substance such as alcohol, opioids, benzodiazepines, barbiturates, and sometimes even antidepressants, most of which are substances that will alter the brain’s natural levels of dopamine and other neurochemicals.

Signs That You Have Post-Acute Withdrawal Syndrome

Commonly mistaken for depression, individuals experiencing PAWS will feel certain distinct symptoms return intermittently and are sometimes compared to mild withdrawal symptoms with traits of an affective disorder. Specifically, the following are 13 signs a person might experience when he or she is suffering from post-acute withdrawal syndrome.

1. Unstable and Unpredictable Moods

Unpredictable changes in mood, or mood swings, is probably the most common symptoms of post-acute withdrawal syndrome. In particular, it’s often reported that individuals suffering from PAWS will suddenly begin feeling depressed with no obvious reason or trigger for the feeling. Similarly, bouts of anxiety and agitation also occur as part of PAWS. In fact, the unstable moods of those with post-acute withdrawal syndrome can sometimes appear as undiagnosed bipolar disorder.

2. Anhedonia

Closely linked to depressive disorders, anhedonia is a term that’s used to describe a loss of interest in things that an individual has previously enjoyed or his or her prior pursuits. However, anhedonia typically goes much further than a loss of interest in one’s pursuits and will usually include an individual losing interest in socializing, his or her relationships, eating, sex, and other basic needs or desires. Individuals experiencing anhedonia often describe the feeling as if their pleasure circuits or ability to enjoy things has been turned off.

3. Poor Coordination and Clumsiness

Individuals who are experiencing post-acute withdrawal syndrome will often exhibit a loss of physical coordination and a general clumsiness. They will often be seen tripping or bumping into things, dropping things, or spilling drinks and food. The primary reason for the clumsiness is because these individuals aren’t paying attention to their movements; they’re distracted by their disinterest and depression.

4. Difficulty Falling Asleep

Similar to becoming clumsier due to being distracted by one’s feelings of depression, those suffering from PAWS will have much difficulty getting to sleep at night because when the lights go off and they’re lying in bed in the quiet, they’ll often begin focusing on their discontentment and the unpleasantness that’s characteristic of post-acute withdrawal syndrome.

5. Sleep DisturbancesPost Acute Withdrawal Syndrome (PAWS) Sleeping

Additionally, post-acute withdrawal syndrome will often cause sleep disturbances. This means that individuals will often have their sleep interrupted, which most commonly occurs due to the dreams that they have. These dreams will often involve some sort of event that will jar them into waking, or they’ll be dreaming about drinking alcohol or taking drugs and the cravings will cause them to wake. It’s often quite difficult to fall back to sleep as well.

6. Inability to Concentrate or Think Clearly

Many of the problems experienced by individuals suffering from PAWS — such as the inability to fall asleep and poor coordination — are caused by their wandering or racing minds. Thoughts often defer to substance abuse or other thoughts that provoke feelings of depression or disinterest, which has an adverse effect on one’s cognitive functioning. It becomes quite difficult to concentrate or think clearly for anyone experiencing post-acute withdrawal syndrome.

7. Experiencing Anxiety or Panic Attacks

If one’s thoughts aren’t causing him or her to feel depressed, the other likely scenario is that an individual experiencing PAWS will have thoughts that provoke him or her into feelings of anxiety. In some cases, this may even cause panic attacks.

8. Symptoms of Depression

Depressive symptoms are one of the most common characteristics of post-acute withdrawal syndrome. Individuals suffering from this condition will often display an overt, extreme level of melancholy from which it’s difficult for them to break free. These states may linger for minutes, hours, or days.

9. Thoughts of Suicide or Suicide Attempts

When the depressive symptoms of post-acute withdrawal syndrome progress to the point when an individual begins having suicidal ideations or have made an attempt at suicide, the individual should be directed to a professional in order to get help for the condition. Thoughts of or attempts at suicide should always be taken seriously.

Post Acute Withdrawal Syndrome (PAWS) Cravings10. Strong Drug Cravings

Perhaps the most expected symptom of PAWS, cravings are extremely common and will sometimes persist for years after an addict has gotten sober. Cravings become most problematic when they either trigger either symptoms of post-acute withdrawal syndrome or put an individual at risk of a relapse.

11. Increased Sensitivity to Stress

As part of post-acute withdrawal syndrome, individuals often become extremely sensitive to stress and situations that might provoke feelings of stress. Not only do individuals experiencing PAWS become stress more easily, but they become increasingly affected by even the least stressful situations, appearing to blow them out of proportion and become easily overwhelmed.

12. Increased Sensitivity to Pain

In addition to becoming more sensitive to stress and anxiety, individuals experiencing post-acute withdrawal syndrome with frequently exhibit increased sensitivity to physical pain. Even the most negligible injuries feel much more painful to them because their capacity for pain has been heightened due to PAWS.

13. Intensified Emotions or Feelings of Numbness

Intense emotion is another symptom that’s common of post-acute withdrawal syndrome. Individuals with PAWS will often exhibit the most extreme level of any given emotion, whether that means becoming overly excitable when happy or excessively confrontational when angry. On the other hand, the opposite extreme is also possible; similar to anhedonia, individuals suffering from post-acute withdrawal syndrome may feel unable to experience any emotion at all, instead feeling empty or numb inside.

Palm Beach Institute Makes Sobriety Accessible and Attainable for Anyone In Need

Post-acute withdrawal syndrome is very underdiagnosed due to its similarities to a number of other mental and emotional disorders. However, it’s important to know that there are many resources available to help individuals who are experiencing symptoms of PAWS. If you or someone you love would like a free consultation, call the PBI today at 855-960-5456. Our specialists can help anyone in need find the treatments and programs they need to beat a deadly substance abuse problem. Don’t wait; call PBI to begin the journey to sobriety as soon as possible.


3 Responses to “13 Signs You’re Suffering from PAWS”

  1. I have been in recovery from xanax for 2 months a week ago I drank 8oz of beer the day after I felt like I was back in withdrawal..please help did beer set me back?

    • probably so, xanax works just about the same as alcohol, only on steroids…u gotta fight it through Rawls. I hope all is well.

  2. Stone Crandall

    PAWS is basically ur body adjusting. It’s completely normal. I abused opiates for years and I was able to stop by removing myself from the toxic surroundings I was in. My habit was around 20-25 30mg ocycodone Roxocit daily. My withdrawal symptoms would start roughy 12 hours after my last pill. Timing is very important when starting the detox process. What I mean by that is take your last dose at a time where ur withdrawal symptoms will begin in the middle of the night. For example, my symptoms began roughly 10 hours after taking my last pill so I took that last pill around 5-6pm. By doing this, I would wake up involuntary around 4am and I would be wide awake. This meant the first stages of withdrawal symptoms were about to begin. (Yawning, watery eyes, sneezing, etc). As soon as you wake up, take ur Suboxone strip and try to go back to bed immediately but this is easier said than done. I would take .5 mg of xanax and we us usually be back to sleep within 15 mins. While your sleeping you will most likely perspire a lot and go thru a few t shirts which is normal. When you wake back up around 9-10 or even 11ish you will feel completely fine. You shouldn’t be going through any withdrawal symptoms because the suboxone is in your body working. Drinks lots of water. Urinate frequently and always take suboxone on an empty stomach. The more you sleep while on a suboxone, the easier the process is. ALSO, SUBOXONE IS AN AID TO ASSIST YOU AND MAKE THE DETOX PROCESS EASIER. THERE IS NO NEED TO STAY ON SUBOXONE. Physical withdrawal symptoms are gone after the 3rd or 4th day. THERE IS NO NEED TO STAY ON A SUBOXONE REGIMENT. My habit was absurd and I’m lucky I’m still alive. I was heavily addicted to 30mg oxycodone and I never kept a daily ledger but it was safe to say I would ingest anywhere between 20-25 “blues” a day. I detoxed with the help of only two 8mg strips of Suboxone, some xanex for the anxiety, and OG Kush marijuana. I know so many friends who have gotten off opiates but are now addicted to suboxone and it’s bc Dr’s are keeping their patients on these suboxone regiments and IMO its criminal. What aide is going to help you get off off a suboxone addiction?


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