man going through Post-Acute Withdrawal Syndrome

What Is PAWS: Post-Acute Withdrawal Syndrome?

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You’re coming up on six months sober and you couldn’t be more grateful that the worst of withdrawal is now far behind you. Finally, the haunting memory of your last interaction with drugs and/or alcohol is fading away. Occasional using dreams, passing thoughts of using, phantom sensations of intoxication come and go. More confident in your sobriety, these experiences don’t shake you like they did just a few months ago. Until, that is, you wake up and it feels like day one. Your clarity of mind has disappeared. Moody and emotional, you feel like everything is pushing you toward a total breakdown. Cravings have been in your head all day, making you feel jittery, uncomfortable, and on edge. That night, you can’t sleep. You’re tossing and turning, obsessing and craving, crying and anxious, depressed and pessimistic. Within a few short days, possibly a week, all of these symptoms pass and you’re back to normal.

PAWS, post acute withdrawal syndrome, is the timely reoccurrence of minor withdrawal symptoms which can last for up to the first 18 months of sobriety. Understanding that PAWS happens is critical to navigating the disruptive experience when it happens. Without an understanding of what PAWS is, the sudden onset of old discomfort is so unnerving, it causes irrational thoughts. Symptoms of craving can be interpreted as failing in recovery, not “getting it”, not being ‘willing’ enough not to have cravings, and other thoughts. At 30, 60, 90 days, 6 months, 9 months, and 18 months, PAWS tends to show up as a humbling reminder. While the resurgence of minor withdrawal symptoms might feel like a punishment, it isn’t.

PAWS happens in the same way nerves die after an injury. After a great period of recovery, you suddenly feel the pinching, burning sensation of nerves, a return of pain to the point of injury, then it passes. The body is still healing, still processing the injury. Such is the case with PAWS. Addiction is a constant poisoning of the body and the brain. Even after months of recovery, past the detox phase, the body is working hard to heal itself, repair damaged nerves in the brain, and recover.


Tree House Recovery is a men’s addiction treatment program in Portland, teaching men how to find freedom from addiction through sustainable change. Adventure and nature based, we help men create a lifestyle of complete recovery, head to toe. For information, call: (503) 850-2474

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