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Post-Acute Withdrawal Symptoms

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When a person suffering from Opiate Use Disorder (OUD) stops using the opioid, that person goes through acute withdrawal symptoms from about seven days to two weeks.


Even if a person is in recovery, there is a good chance that he or she will experience Post-Acute Withdrawal Symptoms (PAWS). These symptoms can be physical, psychological or social and can last as long as two years or even indefinitely.


There is no single specific agreed-upon cause of PAWS, but, in general, the causes stem from disturbances in the nervous system or deteriorated brain function stemming from opioid use, and/ or the stress of living without opiates are what cause these symptoms to occur. PAWS can come and go unexpectedly. Some of the symptoms include:


  • Irritability and hostility
  • Depression
  • Low energy and fatigue
  • Insomnia
  • Fatigue
  • Memory lapses
  • Emotional numbness
  • Anxiety
  • Increased susceptibility to emotional and physical pain
  • Intense cravings to use opiates
  • Lack of focus
  • Lack of sexual desire or the ability to experience pleasure
  • Inexplicable chronic pain


Even for those who have completed a Medicine Assisted Treatment program, recovery maintenance is an ongoing process. Keeping up the good habits of recovery can help a person work through a bout with PAWS safely and successfully. These include:


  • Surround yourself with stable people who love you.
    • A good support system provides a solid base of encouragement, motivation and feedback.
  • Maintain a busy routine
    • Focus your thoughts and actions with work, family, friends, activities, hobbies.
    • Keep a journal of your thoughts, fears, desires, things you are grateful for, etc.
    • Meditate
    • Listen to music
  • Eat nutritiously
    • A healthy diet is a good way to ward off or even reverse PAWS. Everyone is different, so there is no prescribed diet, but healthful foods promote wellness.
  • Exercise
    • Being physically active can be huge. Exercise can help produce endorphins that ease pain and make you feel better physically and emotionally. It can reverse depression, increase your energy, improve how you look physically and boost your confidence. Choose something you like and stay with it regularly.
  • Be active in your community
    • Being a positive force in your community can take the focus off yourself and put it on others.
  • Commit to personal development
    • Learning new skills, developing personal strengths and improving your knowledge can not only keep you busy, but give you a good sense of self-esteem.


“PAWS can be uncomfortable, but by being able to relax, practice, and enjoy the good parts of life will get you through the difficult days. Believing in yourself and your ability to overcome detox is what will drive you to the other side," states Isha Kothari, PA-C, Symetria Recovery's PA at our Warrenville Clinic. 


Of course, if you or a loved one are experiencing PAWS, your doctor or a recovery specialist can be a great source of help.


AnnMarie Fauske
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If you’ve been worried about a loved one, or if you’re concerned about the way you use your pain medication, we urge you to contact us as soon as possible for help. To take the first step, contact us online or call 855-993-0960  right away.

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