Understanding PAWS in Des Plaines: Why Your Loved One’s Treatment Is Working

The information in this article is intended for educational purposes only and does not constitute medical advice. If your loved one is experiencing withdrawal symptoms or considering treatment, please consult a qualified healthcare professional for guidance specific to their situation. Treatment outcomes vary based on individual circumstances and goals.

If your loved one is months into treatment and you’re seeing mood swings, sleeplessness, or intense cravings, you may be watching Post-Acute Withdrawal Syndrome (PAWS). It’s a second wave of symptoms that emerges after acute withdrawal ends, and it can persist for months after treatment begins.

These new symptoms aren’t a sign of failure. They’re a sign that your loved one’s brain is adjusting to life without opioids. 

This guide explains what PAWS recovery in Des Plaines looks like, why it happens, how long it lasts, and how Symetria Recovery supports patients through every stage. If your loved one is enrolled in our Intensive Outpatient Program in Des Plaines, or is considering it, this article is for you.

What Is Post-Acute Withdrawal Syndrome (PAWS)?

PAWS stands for Post-Acute Withdrawal Syndrome. It’s a widely used clinical term for a recognized pattern of symptoms that can continue after acute withdrawal ends. While PAWS is not a formal diagnosis in the DSM-5, the symptoms it describes (e.g., mood instability, sleep disruption, cravings) are well-documented in the medical literature on protracted opioid withdrawal. 

Opioids profoundly alter the brain’s reward and emotional regulation systems. When your loved one stops using opioids, the brain doesn’t immediately return to baseline. It moves through a slower recalibration process, and PAWS is what your loved one feels day after day during that recalibration. 

A peer-reviewed study published in Frontiers in Pharmacology documents these lasting neuroplastic changes in brain circuits that control stress and emotion after opioid use. Your loved one might blame themselves for symptoms that linger for months. The research shows those symptoms are a predictable neurological consequence of opioid use, not a personal shortcoming.

Understanding what PAWS is helps Des Plaines families recognize that these symptoms are neurological. They reflect a brain that’s healing, and they respond to evidence-based treatment.

Recognizing PAWS Symptoms in Your Loved One

PAWS symptoms vary from person to person and can fluctuate in intensity. One week, your loved one may feel relatively stable. The next symptoms return with new force. This unpredictability is one of the most challenging aspects of PAWS recovery in Des Plaines and one of the most important to understand. 

Research documents the following as common PAWS symptoms in opioid recovery: 

• Mood instability, including anxiety, depression, or irritability
• Sleep disturbances, including insomnia or vivid dreams
• Difficulty with concentration and mental clarity
• Intense, unpredictable cravings
• Persistent fatigue, even with adequate rest
• Heightened sensitivity to stress
• Reduced ability to experience pleasure

These symptoms can feel overwhelming in the moment, and they’re a normal sign of neurological healing. Seeing these symptoms as part of recovery, not a sign of failure, is one of the most powerful shifts a family can make. 

How the Brain Recovers During PAWS

PAWS has a strong neurobiological basis. The symptoms your loved one experiences aren’t a matter of willpower or mindset. They’re driven by real changes in the brain’s chemistry and circuitry, even as they show up in mood, sleep, and emotional regulation. 

Opioids flood the brain’s dopamine system, creating an artificial and powerful sense of reward. Over time, the brain adapts. It produces fewer of its own feel-good neurotransmitters because it expects the opioid to do that job. When opioid use stops, those natural reward pathways don’t spring back immediately, and you might notice changes in your loved one’s mood as the system rebuilds. 

The brain needs time to get back to managing mood, pleasure, stress, and sleep on its own. That process is what’s behind PAWS recovery in Des Plaines. 

Peer-reviewed research backs this up. Researchers studying the brain’s extended amygdala during opioid withdrawal and prolonged abstinence have documented lasting neuroplastic changes in the circuits that control stress and emotional regulation. Those changes last well beyond acute withdrawal.

A 2023 Neuropharmacology review found that protracted opioid withdrawal produces a lasting low emotional state, including reduced ability to feel pleasure and a blunted response to everyday rewards. Researchers describe this as the brain slowly resetting the systems that opioids disrupted.

How Long Does PAWS Recovery Last?

PAWS recovery doesn’t follow a single timeline. Several factors shape its course:

• Substance type
• Length of use
• Individual brain chemistry
• Co-occurring mental health conditions
• Quality of ongoing treatment support

Many people see meaningful improvement within six to 12 months when they stay engaged in treatment, though timelines vary widely based on individual factors. Some experience milder, intermittent symptoms for a year or longer. 

Staying engaged in treatment during this period matters. The 2024 SAMHSA Federal Guidelines for Opioid Treatment Programs note that short-term withdrawal management alone is associated with high recurrence and overdose risks. Medications for Opioid Use Disorder (MOUD) reduce mortality and improve recovery outcomes when patients take them as part of a long-term treatment plan.

Continuing MOUD through PAWS keeps your loved one safer. Tolerance drops quickly during any break from opioids, which is why uninterrupted treatment is one of the most important factors in preventing overdose during recovery. This same principle is why many patients benefit from continuing treatment well beyond the acute phase, with outcomes improving significantly beyond 12 to 15 months.

How Symetria Treats PAWS in Des Plaines

PAWS recovery in Des Plaines unfolds inside ongoing treatment. At Symetria Recovery, we combine medication-assisted treatment with unlimited counseling, psychiatric care, family counseling, and on-site pharmacy services. Our clinical team conducts a comprehensive evaluation to assess your loved one’s medical needs, mental health, and social circumstances, and we build a treatment plan around their full situation. 

The Symetria Method® combines MOUD with unlimited counseling and psychiatric care, all delivered on an outpatient basis. Your loved one can maintain employment, housing, community commitments, and family responsibilities while in treatment.  For example, a patient who works a full-time shift can attend an early-morning dosing visit, head to work, and return for a counseling session in the late afternoon, without choosing between recovery and a paycheck.

This is what we mean when we describe Symetria as a system of care rather than a program. A program runs on rules and timeframes. A system combines services, supports, and a clear set of values that flex around the patient.

Medications That Support PAWS Recovery in Des Plaines

Symetria is a licensed Opioid Treatment Program (OTP), which means medications are dispensed on-site as part of a comprehensive treatment program. Medications available at our Des Plaines clinic include Methadone and Suboxone® (also known as buprenorphine-naloxone).

Methadone and buprenorphine-naloxone play a direct role in easing PAWS. They stabilize the opioid receptors in the brain, which reduces the intensity of cravings and mood disruption your loved one experiences. According to NIDA, these medications help treat withdrawal symptoms that come on when people stop taking opioids and reduce drug cravings without producing the strongly pleasurable effects of opioid drugs. Many patients find that consistent dosing also smooths out sleep and stress responses over the first few months of treatment.

Important safety information: Combining Suboxone® (buprenorphine-naloxone) with benzodiazepines (such as Xanax or Valium), alcohol, gabapentinoids, or other sedating medications significantly increases the risk of respiratory depression and overdose. Tell your medical provider about all medications your loved one takes, including over-the-counter drugs. Your provider will work with you to manage these safely. All patients starting Suboxone® should have naloxone available at home in case of emergency.

Unlimited Counseling Through PAWS Recovery

PAWS recovery in Des Plaines is as much emotional as it is physical. The mood instability and reduced ability to feel pleasure that come with PAWS can lead your loved one to question whether recovery is worth continuing. Counseling provides the tools to reframe those moments and build resilience.

Symetria offers unlimited counseling to every patient. Your loved one can engage with their counselor as often as they need, daily if that’s what their recovery requires. There are no session caps and no barriers to support when PAWS symptoms intensify. This kind of consistent access is what separates a system of care from a program with fixed rules.

How Family Support Shapes PAWS Recovery in Des Plaines

If you’re reading this, you’re already doing something important. You’re learning about what your loved one is going through. Research backs up just how much that helps. When family members stay involved in treatment, people in recovery tend to do better. 

Research consistently shows that when family members and other concerned significant others are actively involved in encouraging treatment, their loved ones are more likely to enter and stay engaged in care. A meta-analysis found that treatment involving significant others had a greater effect in reducing substance use than individually-based therapies alone. 

Here are ways you can support your loved one through PAWS:

• Keep naloxone at home: Naloxone (Narcan) can reverse an opioid overdose, and it should be available wherever your loved one spends time.
• Learn the signs of overdose: Knowing the warning signs and how to respond gives you a way to act if you ever need to.
• Encourage rather than pressure: Support for your loved one’s recovery works better than monitoring it.
• Join family counseling: Symetria’s family counseling helps you build the language and the approach that strengthen your relationship through recovery.
• Separate the behavior from the person: PAWS symptoms can show up as irritability or quiet withdrawal. These are neurological, and they aren’t directed at you. 

Look for patterns over time rather than reacting to isolated incidents. A single rough day rarely tells the full story of where your loved one is in recovery.

Why Continuing Treatment Through PAWS Matters Most

PAWS recovery in Des Plaines reaches its most vulnerable point when symptoms feel overwhelming and stopping treatment seems like relief. Staying in treatment through that window changes outcomes. Discontinuing MOUD during PAWS dramatically increases the risk of return to use and overdose, because tolerance drops during abstinence, meaning a previous dose can become dangerous. 

The SAMHSA Overdose Prevention and Response Toolkit (2025) names using drugs after a recent period of abstinence as a significant overdose risk factor, because that break may lower previous tolerance levels. 

Symetria’s Intensive Outpatient Program and PAWS Recovery in Des Plaines

For patients navigating PAWS recovery in Des Plaines, Symetria’s Intensive Outpatient Program (IOP) provides structured, high-frequency support without requiring residential admission. Your loved one can receive counseling, medication management, psychiatric care, and family counseling while staying engaged in daily life, including work. Your loved one can fit treatment around their daily responsibilities while still receiving structured clinical care. 

Symetria holds CARF Gold Seal accreditation, a standard held by approximately 22% of U.S. addiction treatment providers. Our 96% patient satisfaction rating and 4.9/5.0 Google reviews (as of November 2024) reflect what clinical commitment looks like in real patient experiences. Treatment outcomes vary based on individual circumstances and goals.

We accept commercial insurance and Medicare. Most major insurance plans are accepted, and many patients experience little to no out-of-pocket cost (coverage varies by individual plan). We strive to offer same-day or next-day assessments and do not maintain a waitlist. Initial appointments are approximately three hours, and follow-up appointments are 45 to 60 minutes.

Take the Next Step Toward PAWS Recovery in Des Plaines

What you’re watching isn’t failure. It’s recovery, and the longer your loved one stays in treatment, the more time the brain has to adjust and get stronger. Most people in opioid recovery will move through post-acute withdrawal, and what makes the difference isn’t willpower. It’s whether the right support is in place to carry them through.

Call Symetria’s Des Plaines team at (866) 287-5921. Whether you’re calling for yourself or alongside a loved one, we’ll walk you through The Symetria Method®, explain what counseling and medication look like during PAWS, and help you take the next step together.