Post-Acute Withdrawal--Symptoms & Treatment

By Cassandra Senior

Drug detoxification lasts anywhere from eight hours to 7 days. What follows is called Post-Acute Withdrawal Syndrome (PAWS), which can last up to two years depending on how long the addict used.

These symptoms vary in intensity from person to person and are usually separated into six clusters:

1) Cognitive Impairments

• Problem solving difficulties: has trouble formulating a strategy
• Verbal expression: often appears uncertain, has difficulty being direct
• Periods of confusion: mixes up dates, loses perception of time

2) Emotional Liability

• Rapid mood changes: moving through the stages of grief
• Emotions incongruent with current situation
• Excessive crying
• Inappropriate laughter

3) Long-term/Short-term Memory Problems

• Difficulty retrieving previously available information
• Needs help learning
• Unable to retain new information
• Misinterpretation of information recently conveyed

4) Psychomotor/Visuospatial Difficulties

• Difficulty walking (ataxia)
• Hand-eye coordination is off
• Muscle control is limited (twitches and tics)
• Hyper-reflexia

5) Sleep Disorders

• Insomnia
• Fatigue at uncommon times
• Vivid, disturbing nightmares
• Inability to reach REM state
• Increased agitation and tension due to inadequate sleep

6) Unable to Recognize Internal Cues (especially regarding stress)

• Tics
• Weight fluctuations
• Heightened sensitivity to noise
• Lowered libido
• Inability to read, learn from and attend to internal states

Treatment of PAWS

These measures facilitate recovery in various body systems including the central nervous system.

These measures facilitate recovery in various body systems including the central nervous system.

1) Learn to manage everyday stress (cognitive behavior approach)

• a) Journaling, letter writing
• b) Meditation, deep muscle relaxation
• c) Practicing problem solving
• d) Assertiveness training
• e) Working on communication skills

2) Learn what is normal in early recovery

• a) Identifying PAWS as it occurs
• b) Talking to others in recovery

3) Address the affected areas of function

• a) Practicing memory improving exercises (write it down and review periodically throughout day)
• b) Physical exercise to improve motor coordination
• c) Practicing hand-eye coordination (i.e., finger to tip of nose)
• d) Setting down strategies for problem solving
• e) Setting goals and creating a step by step plan
• f) Using therapy

4) Nutrition

• a) Vitamin supplements
• b) Meal planning
• c) Monitor sodium intake
• d) Reduce sugar and caffeine intake