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Major impairments caused by post-acute-withdrawal syndrome

August 16 | By Rachael

Every person addicted to alcohol goes through two stages of withdrawal during recovery. The acute withdrawal syndrome (AWS) and the post-acute-withdrawal syndrome (PAWS). During these phases, recovering patients witness a range of cognitive and emotionally debilitating impairments. Depending on the severity of the symptoms, alcohol withdrawal can also turn out to be life threatening in nature. However, it is necessary to endure the struggle and pain to achieve long-term sobriety.

When an alcohol-dependent person suddenly stops consuming alcohol, he embarks upon a long arduous journey and witnesses a range of symptoms due to AWS, such as intense cravings and other physical symptoms. It usually occurs between 24 hours and seven days from the last drink. The phase of AWS is generally triggered when the body attempts to adjust to the sudden absence of alcohol that it had relied on for so long.

During this phase, the desire for relief from pain induced by intense cravings can be so overwhelming that the person begins to experience the fear of death if relief does not come imminently. This is only the beginning of the ordeal for an individual who decides to quit alcohol abruptly. After the AWS stage ends, the stage of PAWS begins. This period can last up to 20 months or longer. It may take up to two years for the normal state of neurochemistry to return.

What is PAWS?

Alcohol and substance abuse cause more than just physical dependence. During the PAWS stage, the emotional and psychological symptoms of withdrawal start to dominate the person recovering from an addiction and push him or her through a “roller-coaster ride” of thoughts, feelings and reactions.

It can be quite unnerving, with rapid highs and lows of emotional and psychological turmoil that alternate in unexpected and sudden ways. Patients going through this phase often feel as if their life is careening out of control. This is the stage where a person is most vulnerable to a relapse.

Each episode of PAWS can last for a few days and the symptoms surface and retreat mysteriously without any warning and may continue to do so for a year. These withdrawal stages are a part of the journey of a person recovering not just from alcohol, but also from other substances, such as antidepressants, barbiturate, antipsychotics, benzodiazepines, marijuana, opioids and stimulants.

Symptoms of PAWS

Though each person would experience PAWS differently from the other, some of the commonly reported symptoms are:

  • Anxiety and panic attacks
  • Irritability
  • Fatigue
  • Insomnia
  • Inability to concentrate
  • Fluctuating energy levels
  • Obsessive thoughts
  • Extreme drug cravings
  • Lack of motivation and enthusiasm
  • General cognitive impairment
  • Memory loss
  • Sudden mood swings
  • Depression
  • Suicidal thoughts
  • Difficulty solving problems and thinking clearly
  • Anhedonia (the inability to feel pleasure from anything beyond the use of the drug)

Detrimental impact of PAWS

The symptoms of PAWS are largely psychological in nature and related to mood. They rarely involve physical symptoms. There is no precise tool to measure them, thus resembling a mental health condition. The symptoms are categorized according to their impact on the following areas of functioning:

  • Cognitive: Usually, thoughts may become scattered and lack coherence during the phase of PAWS. Additionally, one is likely to witness the impairment of reasoning, concentration and attention. The affected person could be distracted due to obsessive thoughts. Some may also become rigid and inflexible with their thoughts, thereby having confusing thoughts.
  • Emotional: PAWS could make a person either hyper-reactive or very passive. The affected person goes through a seesaw of emotions, such as resentment, anger, guilt, shame, etc. It has the potential to numb emotions due to which a person may be unable to bond with his or her family and friends or it could flood the person with emotions for inconsequential incidents or events.
  • Memory: This is the most noted impairment in affected people. They usually find it difficult to assimilate the latest information and retain a newly learnt skill or routine. Since the entire chunk of memory maybe missing in them, they may fail to recount the past when asked to.

Recovery road map

Withdrawal syndromes like AWS and PAWS can prove to be life-threatening in the long run. The sudden abstinence from alcohol can prove dangerous as it can cause delirium tremens (DTs) and even death in extreme cases. The ongoing support from therapists and counselors is important in reducing the intensity of this experience. Fortunately, the severity of PAWS decreases as time progresses.

If you or your loved one is fighting alcohol addiction, contact the Colorado Alcohol Addiction Help for guidance on the best facilities offering addiction treatment in Colorado. Call at our 24/7 helpline number 866-592-9261 or chat online with our counselors to know about the finest alcohol addiction treatment centers in Colorado.