Post Acute Withdrawal Syndrome (PAWS)

Postby olskoolru » Thu Nov 14, 2013 8:02 pm

I will copy and paste any information regarding PAWS, that I come across, on this thread.

Post Acute Withdrawal comes AFTER Acute Withdrawal or as I like to call it "WTF??!!!"

The Symptoms of Post-Acute Withdrawal
The most common post-acute withdrawal symptoms are:
•Mood swings
•Anxiety
•Irritability
•Tiredness
•Variable energy
•Low enthusiasm
•Variable concentration
•Disturbed sleep

Post-acute withdrawal feels like a rollercoaster of symptoms. In the beginning, your symptoms will change minute to minute and hour to hour. Later as you recover further they will disappear for a few weeks or months only to return again. As you continue to recover the good stretches will get longer and longer. But the bad periods of post-acute withdrawal can be just as intense and last just as long.

Each post-acute withdrawal episode usually last for a few days. Once you've been in recovery for a while, you will find that each post-acute withdrawal episode usually lasts for a few days. There is no obvious trigger for most episodes. You will wake up one day feeling irritable and have low energy. If you hang on for just a few days, it will lift just as quickly as it started. After a while you'll develop confidence that you can get through post-acute withdrawal, because you'll know that each episode is time limited.

Post-acute withdrawal usually lasts for 2 years. This is one of the most important things you need to remember. If you're up for the challenge you can get though this. But if you think that post-acute withdrawal will only last for a few months, then you'll get caught off guard, and when you're disappointed you're more likely to relapse. (Reference: www.AddictionsAndRecovery.org)

How to Survive Post-Acute Withdrawal

Be patient. You can't hurry recovery. But you can get through it one day at a time. If you resent post-acute withdrawal, or try to bulldoze your way through it, you will become exhausted. And when you're exhausted you will think of using to escape.

Post-acute withdrawal symptoms are a sign that your brain is recovering. Therefore don't resent them. But remember, even after one year, you are still only half way there.

Go with the flow. Withdrawal symptoms are uncomfortable. But the more you resent them the worse they'll seem. You'll have lots of good days over the next two years. Enjoy them. You'll also have lots of bad days. On those days, don't try to do too much. Take care of yourself, focus on your recovery, and you'll get through this.

Practice self-care. Give yourself lots of little breaks over the next two years. Tell yourself "what I am doing is enough." Be good to yourself. That is what most addicts can't do, and that's what you must learn in recovery. Recovery is the opposite of addiction.

Sometimes you'll have little energy or enthusiasm for anything. Understand this and don't over book your life. Give yourself permission to focus on your recovery.

Post-acute withdrawal can be a trigger for relapse. You'll go for weeks without any withdrawal symptoms, and then one day you'll wake up and your withdrawal will hit you like a ton of bricks. You'll have slept badly. You'll be in a bad mood. Your energy will be low. And if you're not prepared for it, if you think that post-acute withdrawal only lasts for a few months, or if you think that you'll be different and it won't be as bad for you, then you'll get caught off guard. But if you know what to expect you can do this.

Being able to relax will help you through post-acute withdrawal. When you're tense you tend to dwell on your symptoms and make them worse. When you're relaxed it's easier to not get caught up in them. You aren't as triggered by your symptoms which means you're less likely to relapse.

Remember, every relapse, no matter how small undoes the gains your brain has made during recovery. Without abstinence everything will fall apart. With abstinence everything is possible. (Reference: www.AddictionsAndRec
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#1

Postby netty28661 » Sat Nov 16, 2013 4:34 pm

Great post olskoo,
The book on the link you've posted is fantastic & I would recommend it to anyone quitting weed.

The following link also has some excellent info on RE PAWS:
http://whatmesober.com/personal-writing ... very/paws/

Jannette
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#2

Postby johnusacitizen » Mon Nov 18, 2013 8:55 am

I'm not quit under the rock of oppression, but still, GROUND-BREAKING, EARTH-QUAKING truth through understanding is....


loved

P.S You did not change my life. You just made it a little better. (nuph said)
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#3

Postby olskoolru » Tue Nov 19, 2013 12:47 am

Here is another good read regarding what you may or may not be going through.

Remember :( :shock: :x :cry: ... This Too Shall Pass! :D 8) :wink: :lol:

Post Acute Withdrawal Syndrome Symptoms

Post Acute Withdrawal symptoms generally fall into 3 primary categories: Physical, Emotional and Mental. PAWS symptoms can be as minor as a headache or as debilitating as insomnia lasting for weeks. Some people will only experience one or two particular symptoms, while others might suffer from a multitude of symptoms. Overall the symptoms of post acute withdrawal can be broken down in the following way:

*Physical Symptoms of Post Acute Withdrawal

Physical symptoms of PAWS include insomnia, headaches (including migraines), nausea, restlessness, lack of coordination, decline in fine motor skills, sweating, aches and muscle pains, sexual dysfunction and severe cravings for drugs or alcohol.

Additionally, the physical symptoms of protracted withdrawal are believed to be responsible for the rise of the term “Dry Drunk.” This term describes an alcoholic who stumbles and sways and loses his or her balance as if they are drunk, despite the fact that they have been clean for some time. These symptoms are caused by PAWS and are generally more severe in long term alcoholics but can be experienced by anyone; especially during the first year of recovery.

*Emotional Symptoms of Post Acute Withdrawal

Emotional symptoms of PAWS can be dangerous and include depression, thoughts of suicide, anxiety, isolation, inability to “feel,” lack of interest in anything, irrational responses to benign stimuli, mania, “clinginess” or co-dependence, mood swings, and an inexplicable craving to use drugs or alcohol.

*Mental Symptoms of Post Acute Withdrawal

Mental symptoms of PAWS can make it difficult to follow a treatment plan, necessitating the help of a support system in order to
mitigate these effects. Symptoms include confusion about simple things, inability to feel organized or form complex thought processes, lack of short term memory, missing elements of long term memory, inability to concentrate, difficulty having sustained conversations, mental exhaustion, inability to perform once-easy tasks, and many more symptoms. The mental symptoms of PAWS are probably the most difficult to self-identify without a well-planned recovery program, although they may be the easiest for others to observe.

I’ve always found it surprising just how different post acute withdrawal symptoms can be from person to person, but sometimes they are identical.

I can’t seem to control my thoughts which lead to stress and eventually anxiety. I’m developing all sorts of phobias and my energy levels fluctuate. Anyone know when this will last? -Jayson


I experience several of the PAWS symptoms after 3 1/2 yrs. Not 24/7 but enough to bother me. -Robert M.


I can’t handle this feeling anymore, the cravings are too much. -Travis


In the past month I started getting tingling sensations in my legs and hands when PAWS strikes. This is accompanied by some of the same withdrawal symptoms that I have always had. Has anybody else had these feelings? Does PAWS sometimes get worse before it gets better? -Garrett


I see myself in this article called “PAWS”. I wonder…do I need to go back to meetings? Do I get off all medication? I am so isolated now, it’s frightening. -Mona


I am actually just over 60 days clean and I have been very emotional and nit-picky with my boyfriend so bad where it’s causing problems in our relationship and arguing a lot. -Casey


2 weeks after quitting I was very clear headed and felt really great, actually; suddenly I woke up one day with maddening anxiety that quickly evolved into paranoia and full on depression over the next couple days. Over a period of a year and a half I experienced simultaneous waves of anxiety, paranoia, and depression that would last weeks at a time before subsiding temporarily. School, work, and a social life were nearly impossible to manage and just added more stress. Eventually the waves became less and less debilitating, and showed up less often. -Anonymous


It took a good year to get my head straight on all levels. -Marie


Extreme exhaustion within the first 3-4 weeks followed by depression and then emotional instability and terrible anxiety. -Diane


8 months since last drink. PAWS symptoms tend to come and go in severity but ability to concentrate and initiative stay severe and pretty constant. -Ralph


How am I expected to find contentment or a sense of self when I feel clinically insane most the time? -Pete


I have been having an incredible difficulty concentrating. My head almost feels like pins and needles at points, I zone out when people talk to me, and I am still suffering from the occasional anxiety attack. -Dan


I am still experiencing wicked stage 1 withdrawal symptoms combined with the onset of PAWS. It royally sucks and I just want a reprieve. I know I can’t though. -Jason S.


I am 20 months clean and sober from Crack Cocaine Addiction. Back in school to become a Substance Abuse Counselor. PAWS symptoms are still pronounced. Sleep Disorders. Fatigue, Anxiety. -David


I feel extremely frustrated with the PAWS symptoms that I am experiencing. Lately I have felt a lot less productive, and a significant decline in my intellectual capabilities. -Tara Lynn


Any attempt to share activities I enjoy with my friends or family is met with both physical cramping of the body, and mental side effects (inability to communicate, feel feelings, confusion anger). -Anonymous


The Main Symptom I suffer from is the memory troubles and depression they stay constant it’s driving me crazy. -Anonymous

As you can see, some of these people feel helpless about their symptoms; even though they understand that they are related to the condition known as post acute withdrawal syndrome.

(from: http://www.postacutewithdrawal.org/post ... -symptoms/)
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#4

Postby olskoolru » Tue Nov 19, 2013 1:07 am

Post-Acute Withdrawal (longer-term withdrawal symptoms) Ways to Cope

Depression & Anxiety
Note: Addiction causes/greatly worsens depression and anxiety symptoms.

Avoid any addictive substances
Eliminate the cause by:
Meditation
Exercise
Relaxation: unwind
Yoga
12-step Meetings
Talking (counselor or sponsor)
Get out
Get up
Do something (distraction)
Make a checklist of ideas to help
Be with others
Make a gratitude list
Make a worry list* (do not keep this list; write down all worries then rip up and trash because we want these thoughts to leave our mind)
Try inspiration:
music, hiking, reading, sunset
Prayer
Illumination (get out in the light)
Be creative: build, paint, sew, poetry
Don’t Give Up
Change your diet (avoid sugar/caffeine)
Be kind to yourself
Get help
Turn it over


PAIN
Note: Drugs don’t zap out pain, just eliminate its perception.

Acupuncture
Acupressure
Biofeedback (sensors and body response – help you learn to control your pain)
Chiropractor
Cold therapy
Heat therapy
Elevation
Exercise (swimming is great)
Hydrotherapy (hot bath)
Heating pad
Hypnosis
Massage
Meditation
Physical therapy
Relaxation
Rest
TENS (nerve stimulation)
Ultra-sound
Aspririn
Tylenol
Ibuprophen
Tordol (talk to your Dr.)

Trouble Sleeping

Have a sleep routine
Warm Bath/Shower
Read
Soothing music
Meditation
Relaxation
Prayer
Warm milk
Counting backwards from 100
Have an active day
Get up @ same time every morning
Exercise (not right before bed)
Don’t nap during day
Look at your sleeping quarters: dark room? Too hot/too cold? Quiet (white noise)? Eye covers/ear plugs? Bed comfy?
Avoid foods that give you indigestion
Avoid caffeine after 2pm
Avoid heavy meals
Avoid stimulating things (loud music, angry discussions, exercise)
Remember that problems sleeping in early recovery are NORMAL and IT IS BETTER THAN USING
Sleep evaluation (last resort)


***Post acute withdrawal (or longer-term symptoms of withdrawal) can start while you are still in detox and last 3-6 months or longer depending on your length of use/substances abused. Give your recovery time and try to learn to cope with these symptoms. It will get better with time!

(from: http://dopaminedialogue.wordpress.com/withdrawal-2/)
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#5

Postby Luded » Fri Nov 29, 2013 12:51 pm

Olskooru, this is a great thread! Lots of valuable information here, which I believe applies to a range of addictions. Worth noting that medications like the benzodiazepines, which are often used to assist alcohol withdrawal, are notorious for inducing PAW symptoms on cessation. Therefore, short term use only is best. Cheers.
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#6

Postby Patience22 » Sat Nov 30, 2013 1:40 am

It sounds to me like all of these things you describe also happen in the beginning of withdrawal too.
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#7

Postby olskoolru » Sat Nov 30, 2013 2:52 am

Luded wrote:Olskooru, this is a great thread! Lots of valuable information here, which I believe applies to a range of addictions. Worth noting that medications like the benzodiazepines, which are often used to assist alcohol withdrawal, are notorious for inducing PAW symptoms on cessation. Therefore, short term use only is best. Cheers.


Thank you Luded. I agree with your Benzo comment.
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#8

Postby olskoolru » Sat Nov 30, 2013 2:59 am

Patience22 wrote:It sounds to me like all of these things you describe also happen in the beginning of withdrawal too.


Patience22, you are correct. The difference is that during the initial acute stage these symptoms are much greater in intensity and accompanied by physical pain. Although, there can also be physical symptoms during PAWS episodes.

It affects everyone very differently, especially with THC withdrawal.
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#9

Postby Patience22 » Sat Nov 30, 2013 3:31 am

This is a good list to refer to. Do you have any similar type of things you can post for people in the very beginning of recovery? I understand it is pretty much the same things just more intense, so it probably isn't worth reposting anything.
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#10

Postby wakinglife » Sat Nov 30, 2013 4:13 pm

Thanks for starting such an informative and valuable thread, olskoolru!

The info you've shared here might really help people through the various stages of recovery.
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#11

Postby olskoolru » Sun Dec 01, 2013 7:37 pm

What has gotten me through the toughest period of my life? My wife, my therapist and knowing that this is all temporary. The hardship and pain you are suffering now shall all pass. If you have been addicted to marijuana for more than half your life, you will have to go through a period of brain restructure. It's a rebirth. You will be faced with situations that you would've otherwise handled with a joint, blunt or bong hit. Even before you took that toke you started to feel better. Your mind has been conditioned to relying on the THC chemical instead of healthy stress/anxiety reduction techniques. The THC was your dopamine to help you feel "happy" no matter the situation. You felt numb and nothing really affected you negatively when you were high.

...

Then you stopped cold turkey!! Your body and mind are in absolute shock. You don't know how to handle the slightest stressful situation. You are plagued with headaches, insomnia, insane heart rates, depression, extreme anxiety, etc., etc., etc. You isolate yourself. You hate everything. You are terrified and paranoid of what is happening to you. You have back pains. You wake up ten times a night gasping for air. You suffer horiffic and vivid nightmares. You go to the ER fearing that you are dying or will have a heart attack. How could this possibly be due to weed withdrawal?? Impossible. Weed is harmless! We've heard this for as long as we can remember and all your weed buddies laugh it off as craziness.

I've heard it all and I went through this at a pretty extreme level. I know because my addiction psychotherapist worked at the San Quentin Correctional Facility in California for 30 years and told me so.

It is imperative that you believe in yourself. It is imperative that you know that this will all pass, no matter how much your mind plagues you with anxiety, OCD and paranoia. You must get up and do things you like to do. You must find identify what you like to do. Like a very skilled blogger told me "recovery is NOT a thinking thing, it's a doing thing." This means that just trying to mentally get yourself out of a depression, for example, won't work. You must get up and do something like take a walk, exercise, go to the movies, go buy yourself something nice, etc. You deserve it!

I am nearing my 10 month anniversary and I am finally seeing a light at the end of a very long and stinky tunnel. It IS possible to get through this. I am proof! As extreme as my withdrawal and PAWS have been, I was relentless and didn't succumb to my addiction.

It has been the scariest period of my life by far. I would never have permanently quit if I hadn't seen how ugly this addiction was. For this I am thankful.

Thank you Waking Life for the compliment. Your "Benefits of Quitting" has helped me tremendously!

OSR
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#12

Postby Luded » Mon Dec 02, 2013 6:09 am

Thanks for sharing your situation and how you've recovered, OSR. My husband smokes cannabis every single day, has done for about thirty-five years. I don't know that he'll ever stop, though I'd like him to. Best wishes to you.
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#13

Postby john_navajas » Mon Dec 02, 2013 5:42 pm

This thread has helped reevaluate my recovery. I started out strong, feeling great, and by the end of the first month I was starting to feel most of these symptoms. The information in this thread has helped me to understand that feeling these things is a normal part of the process.
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#14

Postby olskoolru » Mon Dec 02, 2013 6:42 pm

Luded wrote:Thanks for sharing your situation and how you've recovered, OSR. My husband smokes cannabis every single day, has done for about thirty-five years. I don't know that he'll ever stop, though I'd like him to. Best wishes to you.


Thank you Luded. My wife constantly told me that she wanted me with her for as long as possible. Smoking anything for so long will cause Cancer, no matter what these skeptics claim. We'll all seen what just one smoking session can do to a brand new bong or bowl. Imagine 35 years of doing that to your lungs, every single day. I don't know where he is with this, but I was on the "I can quit whenever I want" stage for 20 years. Fact was I couldn't. Glad you're learning about this. Your support for him is crucial, but please be weary of becoming a co-dependant spouse. You have your own life and he has to be responsible for his.

OSR
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