Post Acute Withdrawal (PAW) is a cluster of symptoms that occur in recovering addicts and alcoholics. PAW symptoms usually begin to occur between seven and fourteen days after the acute period of withdrawal, and usually peak between three and six months after the start of abstinence.
Post-Acute Withdrawal (PAW) Syndrome is also referred to as:
- The protracted withdrawal syndrome,
- Chronic brain toxicity,
- Long-term neuropsychological impairment
- Long-term neurocognitive impairment
Acute withdrawal (AW) is comprised of mostly physical symptoms that occur as a result of stopping the use of a drug after the addict has develop tolerance and dependence.
- Tolerance means that the body adapts to the constant use of large quantities of the primary drug of choice. As a result it takes more and more of the drug to experience the desired effect from taking the drug.
- Dependence means that the body learns to function normally with a high dose of the drug. When they stop taking the drug they experience symptoms of acute withdrawal.
Symptoms of Acute Withdrawal (AW) includes shakes, vomiting, chills, muscle soreness and cramps, headaches, diarrhea or constipation, extreme skin sensitivity, sensitivity to light, and more. PAW begins to emerge as AW symptoms begin to subside.
PAW is a bio-psycho-social syndrome that results from the combination of damage to the nervous system caused by alcohol or drugs and the psychosocial stress of coping with life without drugs or alcohol.
PAW symptoms can be divided into the following six groups or clusters:
- Difficulty Thinking Clearly: PAW causes recovering people to have difficulty recognizing and solving usually simple problems, making decisions, concentrating, understanding abstract concepts, and stopping rigid and repetitive ways of thinking.
- Difficulty Managing Feelings: PAW creates the tendency to vacillate between emotional overreactions or emotional numbness;
- Difficulty Remembering Things: PAW causes people to have difficulty remembering what they learn and understand. The memories tend to fade after several hours something. It’s as if the memories are not shifted from short-term memory to long-term memory.
- Difficulty Sleeping Restfully: PAW causes sleep disturbances. Many recovering people have difficulty falling asleep and sleeping restfully. Their sleep is fitful; they awaken many times during the night, and do not feel rested after sleep.
- Problems With Physical Coordination: Recovering people often have difficulty with hand-eye coordination and controlling fine muscle movements. They also have problems with balance and can easily feel dizzy and disoriented.
- Stress Sensitivity: Recovering people tend to be stress sensitive. This means that a low level of stress can cause an exaggerated reaction on their brain and nervous system. Living in high stress, which is necessary in facing the challenges of early recovery, cause the problems with managing thoughts, feelings, memory, and sleep to become even more severe.
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