Protracted Withdrawal Symptoms (PAWS) and How to Cope

Many people think withdrawal ends after the first few days of detox. While the most intense physical symptoms often do fade, for some individuals, withdrawal lingers long after the body has cleared alcohol or drugs. This is known as protracted withdrawal symptoms or post-acute withdrawal syndrome (PAWS).

At Coachella Valley Recovery Center, we help clients and families understand what PAWS is, why it happens, and how to cope with its challenges. Recovery doesn’t stop after detox, and knowing how to manage PAWS is key to building a strong, sustainable life free from addiction.

Also Read: 

Am I Going Through Drug Withdrawal?

Why Some Signs Of Addiction Are Puzzling?

Why Drug Rehab Is The Answer?

TL;DR

• PAWS = Protracted withdrawal symptoms that can linger for weeks or months after detox.
  
• Common symptoms: mood swings, sleep problems, cravings, fatigue, and difficulty concentrating.
  
• PAWS happens because the brain is healing from chemical changes caused by addiction.
  
• Ignoring PAWS raises the risk of relapse, but coping strategies like medical care, healthy habits, mindfulness, and community support make recovery manageable.
  
• Coachella Valley Recovery Center provides personalized treatment and long-term support to help clients cope with PAWS and thrive in recovery.

What Are Protracted Withdrawal Symptoms (PAWS)?

Protracted withdrawal symptoms are ongoing physical, emotional, or cognitive challenges that persist after the acute phase of withdrawal has ended. While detox may last days to a week, PAWS can last for weeks, months, or even up to two years depending on the substance used, length of use, and individual health factors.

PAWS is especially common among individuals recovering from alcohol, benzodiazepines, and opioids. These substances alter brain chemistry significantly, and it takes time for the nervous system to rebalance once the substance is removed.

Common Protracted Withdrawal Symptoms

PAWS symptoms vary from person to person, but they often include:

• Mood changes: Irritability, anxiety, or sudden depressive episodes
  
• Sleep problems: Insomnia, vivid dreams, or poor sleep quality
  
• Cognitive issues: Memory lapses, difficulty concentrating, or brain fog
  
• Cravings: Strong and unpredictable urges to use substances again
  
• Physical discomfort: Fatigue, headaches, or lingering muscle aches
  
• Emotional instability: Feeling overwhelmed or easily stressed
  
• Sensitivity to stress: Small challenges feel unmanageable
  
• Social withdrawal: Avoiding friends, family, or responsibilities
  

These symptoms can come and go in waves. Many people feel “back to normal” one day and struggle the next. This unpredictability is part of what makes PAWS so difficult.

Why Does PAWS Happen?

Addiction alters brain pathways related to pleasure, stress, and decision-making. Substances like alcohol, opioids, and benzodiazepines create chemical imbalances that the brain must relearn to regulate without them.

During early recovery:

• Neurotransmitters are unstable: Dopamine, serotonin, and GABA levels may swing up and down.
  
• The stress response is heightened: The body overreacts to everyday stressors.
  
• Sleep cycles are disrupted: The brain needs time to restore natural sleep rhythms.
  

In short, PAWS happens because the brain is healing and healing takes time.

The Risks of Ignoring PAWS

Without support, PAWS can feel overwhelming and lead to relapse. People may believe they aren’t making progress or think they’re “broken” because symptoms return. But relapse isn’t inevitable, understanding PAWS is the first step toward managing it.

Risks of ignoring PAWS include:

• Increased relapse due to cravings and mood swings
  
• Worsening mental health conditions such as anxiety or depression
  
• Strained relationships from irritability or withdrawal from others
  
• Reduced motivation to continue treatment or aftercare
  

How to Cope with Protracted Withdrawal Symptoms

Managing PAWS requires patience, structure, and professional guidance. Here are strategies that can help:

1. Medical and Clinical Support

• Work with a doctor or addiction specialist to monitor symptoms
  
• Explore non-addictive medications that may ease sleep problems or mood swings
  
• Attend therapy to develop coping strategies
  

2. Healthy Daily Habits

• Prioritize sleep hygiene: consistent bedtime, no screens before bed, calming nighttime routine
  
• Eat balanced meals rich in whole foods to stabilize mood and energy
  
• Exercise regularly, even gentle activities like yoga or walking
  

3. Mindfulness and Stress Management

• Practice mindfulness meditation, deep breathing, or journaling
  
• Participate in therapeutic activities such as sound healing or breath work (both offered at CVRC)
  
• Reduce unnecessary stressors and give yourself grace during tough days
  

4. Community and Support Networks

• Join support groups like AA, NA, or SMART Recovery
  
• Stay connected with aftercare or alumni programs
  
• Share struggles with trusted friends or family instead of isolating
  

5. Focus on Long-Term Goals

• Recognize that recovery is a journey, not a destination
  
• Track progress to see how far you’ve come, even when symptoms flare up
  
• Work with a counselor to set achievable milestones
  

The Role of Professional Treatment in Managing PAWS

While self-care is important, professional treatment makes the biggest difference in navigating PAWS successfully. At CVRC, clients benefit from:

• Customized treatment plans tailored to their needs
  
• Dual-diagnosis expertise for co-occurring mental health issues like depression or PTSD
  
• Holistic therapies including yoga, breath work, and therapeutic outings to manage stress naturally
  
• Small census care with just 18 beds, allowing us to give each client personal attention
  
• Aftercare programs that provide ongoing support long after discharge
  

This combination of medical credibility and personalized care ensures clients aren’t left to struggle with PAWS alone.

How Families Can Support Loved Ones Through PAWS

PAWS doesn’t just affect the individual it also impacts families. Loved ones may feel confused or discouraged when symptoms resurface weeks into recovery. Here’s how families can help:

• Learn about PAWS so you know what to expect
  
• Avoid judgment or frustration when mood swings occur
  
• Encourage professional support and aftercare participation
  
• Celebrate small wins and milestones along the recovery path
  
• Stay connected through supportive communication rather than criticism
  

By understanding PAWS as a natural part of healing, families can provide encouragement instead of unintentionally pushing their loved one toward relapse.

Conclusion

Protracted withdrawal symptoms, or PAWS, are one of the most challenging parts of recovery. But with the right strategies medical care, healthy habits, mindfulness, and strong support individuals can overcome these hurdles.

If you or a loved one are experiencing lingering symptoms after detox, Coachella Valley Recovery Center offers the personalized, medically backed, and holistic care needed to manage PAWS and build lasting recovery.

FAQs About Protracted Withdrawal Symptoms (PAWS)

How long do protracted withdrawal symptoms last?

 PAWS can last anywhere from a few weeks to up to two years, depending on the substance used, length of use, and individual health. Symptoms typically become less intense over time with the right support.

Are protracted withdrawal symptoms permanent?

No. While PAWS can feel discouraging, these symptoms usually fade as the brain and body heal. Professional treatment and aftercare can help shorten the duration and intensity.

What substances are most likely to cause PAWS?

Alcohol, opioids, and benzodiazepines are most commonly linked to protracted withdrawal symptoms, though PAWS can follow recovery from other substances as well.

How can I tell the difference between PAWS and relapse?

PAWS causes symptoms like mood swings, insomnia, and cravings without returning to substance use. Relapse occurs when a person resumes drinking or drug use. Keeping track of triggers and seeking support can help prevent relapse during PAWS.

Can PAWS be treated at home?

Some self-care strategies help, but medical supervision, therapy, and structured aftercare are strongly recommended. Attempting to manage PAWS alone increases the risk of relapse.

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