When a person suffering from opiate use disorder (OUD) stops using opioids, that person goes through acute withdrawal symptoms from about seven days to two weeks. After that period, lingering symptoms become Post-Acute Withdrawal Syndrome (PAWS). PAWS symptoms can be physical, psychological or social and can last as long as two years or even indefinitely.
Post-Acute Withdrawal Symptoms
There is no specific agreed-upon cause of PAWS. In general, it stem either from disturbances in the nervous system or deteriorated brain function from opioid use or the stress of living without opiates causes these symptoms to occur.
Unfortunately, PAWS can come and go unexpectedly. That’s why it’s often the best course of action to enlist the help of professionals to identify post-acute withdrawal symptoms and then gain the medication or coping skills necessary to heal from them.
Some post-acute withdrawal symptoms include:
- Irritability and hostility
- Depression
- Low energy and fatigue
- Withdrawal insomnia
- Fatigue
- 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
Others may experience different withdrawal symptoms, but these are the most common. People can experience PAWs whether the opioid was a prescription pain pill, heroin or even more potent opioids like fentanyl or ISO drug.
(See also How long does opiate withdrawal last?)
Tips For Living With PAWS
Recovery is an ongoing process even for those who complete a medication-assisted treatment program. Keeping up the healthy habits help a person work through about with PAWS safely and successfully. These include:
- Surround yourself with stable people who love you: An effective support system provides a solid base of encouragement, motivation, and feedback.
- Maintain a busy routine: Focus your thoughts and actions on work, family, friends, activities and hobbies. Keep a journal of your thoughts, fears, desires, and things you are grateful for.
- Eat nutritiously: A healthy diet is a great 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 have a significant positive effect. 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 growth: 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 frustrating, but by being able to relax and enjoy the good parts of life will get you through the difficult days. Believing in yourself and your ability to overcome detox is the biggest part of getting to the other side."
Medication Options for PAWS
If you or a loved one are experiencing post-acute withdrawal symptoms, the medication Suboxone may help. (See How Does Suboxone Work?).
Comfort medicines can also be prescribed as-needed. For example:
- Clonidine: can help with sweating, diarrhea, restlessness and anxiety
- Ondansetron (Zofran): can help with nausea and vomiting
- Trazodone: can help with anxiety and sleep
These medications also come with side effects and some can be habit-forming. Addiction doctors help you weigh the benefits of any medications against your symptoms and adjust until you feel your best.
If PAWS symptoms are impacting your function or quality of life, consider involving an addiction doctor to start feeling better.
Get Help with Post-Acute Withdrawals
12 Comments
20 days out of detox at home. Upset stomach pulse 125 to 1:13. Is there anything can do to get that pulse down
After 1 and a half years I’m still having adverse reactions to medications. I’m in need of back surgery but pain medications still do nothing
Do you have any suggestions about that. I have also had eye problems since stopping my pain medication that I was on for 23 years. My vision was great, I never wore glasses. It’s extremely bad now. My entire body has changed drastically, my skin has aged 20 years in a year and a half. I feel like my entire body is slowly dying, it hard to look in the mirror . Any suggestions are greatly appreciated.