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How To Minimize Post-Acute Withdrawal Syndrome From Opiates?

Post-acute withdrawal syndrome (PAWS) from opiates can be minimized, but it is important to take the correct steps to get there.

What is Post-Acute Withdrawal Syndrome?

When you’re in the early stages of recovering from opioid dependence, post-acute withdrawal syndrome (PAWS), whether mildly unpleasant or extremely uncomfortable, is unavoidable. If the post-acute syndrome persists for a long time, it can become a risk factor for relapse.

Post-acute withdrawal syndrome describes a collection of symptoms following the “acute” stage of opiate withdrawal. Acute withdrawal occurs after a professionally supervised detox, and it can result in life-threatening complications and signs of physical discomfort like elevated heart rate, headaches, nausea, and muscular aches. Usually, these symptoms go away in two weeks or less. PAWS refers to the psychological and emotional symptoms that occur during the second withdrawal phase. You are more likely to experience PAWS if you used opioids for a long period of time, and usually in greater doses.Resources1

When Does Post-Acute Withdrawal Syndrome Occur?

Stress or circumstances involving people, places, or things that remind the individual of using opiates can often lead to symptoms. Many people in the recovery phase compare the symptoms of PAWS to a roller coaster that goes up and down, or waves that come and go.

Symptoms can switch minute by minute in the early process of quitting substances. The symptoms become less frequent as people enter long-term recovery from alcohol or drug addiction.

What Are the Most Common Symptoms of PAWS?

To reduce the risk of relapse, you need to be able to recognize some of the symptoms of PAWs. Some of the most common symptoms include:


  • Foggy Thinking/Trouble Remembering: This is also known as mental fuzz. Individuals might notice they have a hard time processing information and remembering things.2
  • Cravings: This is one of the common symptoms. You might feel the urge to take opiates, or may feel uneasy if you cannot get opiates.
  • Irritability, Hostility, or Mood Swings: Abstinence from opiates can make you feel overly agitated and hostile.
  • Insomnia or Vivid Dreams
  • Fatigue or Inability to Focus: An individual with PAWS will also experience feelings of extreme tiredness due to the combination of all other symptoms.
  • Issues With Fine Motor Coordination: You might find it difficult to do simple things like tying your shoelaces or buttoning a shirt.
  • Stress Sensitivity: This is when little things bother you more than they used to.
  • Anxiety or Panic: People experiencing acute substance withdrawal syndrome often feel anxious. They may also have panic attacks, increased heartbeat, and shortness of breath.
  • Depression: Individuals experiencing acute substance withdrawal syndrome may be depressed.

Why Do We Experience Post-Acute Withdrawal?

Whether moderate or severe, post-acute withdrawal is a common step in the early stages of recovering from alcohol or other drug dependence. Consider the withdrawal symptoms as the brain’s attempt to restore the chemical imbalances created when the addiction was active.

During the period of drug use, the brain would have adapted and reconfigured to function with those drugs present, so once there’s drug withdrawal, the brain is unable to function properly, which results in the manifestation of post-acute withdrawal symptoms.

How to Minimize Post-Acute Withdrawal Syndrome?

To minimize post-acute withdrawal syndrome from opiates, the first thing that must be done is gradually reducing the concentration of opiates in the body. This helps to reduce the severity of any of the withdrawal symptoms.Resources5

Can PAWS Be Avoided?

Avoiding PAWS isn’t entirely possible. However, you can effectively manage your symptoms and improve emotionally and physically by sticking to your treatment regimen. It will reduce the risk of relapse and boost your motivation.

How Long Do Post-Acute Withdrawal Syndrome Symptoms Usually Last?

Depending on the type of alcohol or drug addiction, the amount and frequency of substance use, and other factors (everyone’s withdrawal pattern is a little different), the majority of symptoms only last a few days at a time. In some cases, however, symptoms could last for weeks or even months.

How to Cope With Post-Acute Withdrawal Syndrome

Here are some of the practical tips on how you can manage the symptoms of PAWS effectively:

  • Self-Care: Self-care is essential to effectively treat the symptoms of post-acute withdrawal syndrome, especially in the first year or two. Take plenty of breaks during the day, and most importantly, take care of your mental and spiritual well-being.
  • Seeking Support: This involves sharing emotions, feelings, and PAWS symptoms you are experiencing with people you trust, like your close friends, peers in 12-steps meetings, family, or counselors. They help you express yourself.
  • Taking Medications: If your doctor prescribes medication, taking it as prescribed is essential even after the symptom has vanished.
  • Avoiding Potential Causes: Avoid scenarios that can cause you to become anxious, stressed, or remind you of past drug use. This will help minimize the symptoms of PAWS.
  • Taking it One Day at a Time: It’s crucial to avoid taking on too much. Putting more emphasis on daily self-care and the victories each day provides can be more beneficial.

Get Help For Post-Acute Withdrawal Syndrome at San Diego Detox

Post-acute withdrawal syndrome can be challenging to navigate. However, help is available. Several outpatient treatment options can help you through the post-acute withdrawal stage of recovery and avoid relapsing. San Diego Detox is a clinic that provides quality detoxification and other treatment plans to help you with your post-withdrawal syndrome.

At San Diego Detox, we’re committed to helping you get the best treatment you deserve. Contact us today, and let’s give you or your loved one the help you deserve.

Common Drugs And Their Associated Post-Acute Withdrawal Symptoms

Some drugs can causeMarijuana severe symptoms of post-acute withdrawal syndrome. These will be detailed below.


Research shows that abruptly stopping the use of marijuana can cause post-acute withdrawal symptoms once acute detox is over. Common post-acute withdrawal opiate symptoms from marijuana are anxiety, headache, irritability, insomnia, and several physical conditions like changes in appetite and stomach pain.

As many people use marijuana daily, and sometimes multiple times a day, suddenly stopping its usage might cause the body to go into enough of a “shock” that causes PAWS.


Common PAWS symptoms for methamphetamine are irritability, insomnia, and poor impulse control.3


Common symptoms of post-acute withdrawal syndrome for opioids include poor impulse control, muscle tension, intense craving, anxiety, depression, and insomnia.


Cocaine is well known for having a variety of long-lasting symptoms. Several users experience sadness, low motivation, weariness, and issues with impulse control.


Benzodiazepines like Klonopin, Ativan, and Xanax cause common PAWS symptoms, including insomnia, sleep disturbance, irritability, panic attacks, and intense anxiety.4

Diagnosis of Post-Acute Withdrawal Symptoms

There is no specific diagnostic test to confirm PAWS, but your doctor may perform the following:

  • Complete Blood Count: This is done to ascertain the value of all the blood components. A test will be done on the blood sample to know the number of red blood cells, white blood cells, and platelets.
  • Metabolic Panel: This is a metabolic panel test for 14 different substances in your body, some of which include albumin, glucose, bilirubin, and calcium.
  • Liver Function Tests: This test determines the functionality of the liver. It measures several substances produced by the liver like enzymes, protein, and other substances.
  • A Urinalysis: A urinalysis tests a person’s urine for signs of infection, disease, or other issues. The test examines the color, odor, appearance, acidity, and quality of urine.
  • A Toxicology Screening: It is possible to perform toxicology testing quickly. Most times, a urine, blood, or saliva sample is used for the test. The result may indicate the presence of a single particular medication or multiple substances at once.