I hadn’t read this in over a year.

Post Acute Withdrawl. (PAW)

Exerpted from “Staying Sober” by : Terence T. Gorski

“When most people think about alcoholism or drug addiction, they think only of the alcohol/drug-based symptoms and forget about the sobriety-based symptoms.  Yet it is the sobriety based symptoms, especially post acute withdrawal, that make sobriety so difficult.  The presence of brain dysfunction has been documented in 75-95% of the recovering alcoholics/addicts tested.  Recent research indicates that the symptoms of post-acute withdrawal associated with alcohol/drug related damage to the brain may contribute to many cases of relapse.

Post acute withdrawal is a group of symptoms of addictive disease that occur as a result of abstinence from addictive chemicals. In the alcoholic/addict these symptoms appear seven to fourteen days into abstinence, after stabilization from the acute withdrawal.

Post acute withdrawal is a bio-psycho-social syndrome   It results from the combination of damage to the nervous system caused by alcohol or drugs and the psychosocial stress of coping with life without drugs or alcohol.

Recovery causes a great deal of stress.  Many chemically dependent people never learn to manage stress without alcohol and drug use.  The stress aggravates the brain dysfunction and makes the symptoms worse.  The severity of PAW depends upon two things:  the severity of the brain dysfunction caused by the addiction and the amount of psychosocial stress experienced in recovery.

The symptoms of PAW typically grow to peak intensity over three to six months after abstinence begins.  The damage is usually reversible, meaning the major symptoms go away in time if proper treatment is received.  With proper treatment and effective sober living, it is possible to learn to live normally in spite of the impairments.  But the adjustment does not occur rapidly.  Recovery from the nervous system damage usually required from six to 24 months with the assistance of a healthy recovery program.  Recent research is showing that for some recovering people the symptoms of PAW often occur at regular “moon cycle” interval and without apparent outside stressors.  Often those 30, 60, 90, 120, 180, and 1 and 2 year sobriety dates seem to be “triggering” times for PAW symptoms to increase.  People recovering from long term opiate and stimulant use often have PAW symptoms for no apparent reason for up to 10 years after they have stopped using their drug of choice.  Often PAW symptoms appear to come and go without apparent reason and without any specific pattern.  Individuals who intend to have consistent long-term recovery must learn to recognize these symptoms and learn how to manage them.

Symptoms of Post Acute Withdrawal

The most identifiable characteristic is the inability to solve usually simple problems.  There are six major types of PAW symptoms that contribute to this.  They are the inability to think clearly, memory problems, emotional overreactions and numbness, sleep disturbances, physical coordination problems, and general problems managing stress.  The inability to solve usually simple problems because of any or all of these symptoms leads to diminished self esteem.  A person often feels incompetent, embarrassed, and “not okay” about themselves.  Diminished self esteem and the fear of failure interfere with productive and challenging living…”

I had studied all of this before, but as I read this, I realize that I need to keep focused.  I have experienced some of these symptoms, and luckily I have not relapsed.  It was very hard. I will better be able to handle recovery, if I understand what is happening.