Dealing with PAWS

pawlPAWS, or Post- Acute Withdrawal Syndrome (also known as Protracted Withdrawal Syndrome) is far less known about, or understood, than the withdrawal symptoms that accompany most people's earliest recovery from the use of alcohol and other drugs. Even those experiencing what seem to them to be inexplicable problems of mood fluctuation, malaise or other unpleasant feelings will blame themselves for their misery, or be tempted to believe that life was better when using. A recent article in The Fix, a web-based magazine dealing with recovery issues, has an article titled "How to Isolate and Treat Protracted Withdrawal Syndrome. <>" The article gives this definition: PAWS is a series of post-acute symptoms of recovery from dependence on benzodiazepines, barbiturates, and ethanol; opiates; and sometimes, antidepressants. Some commonly abused benzodiazepines are Valium, Xanax, and Ativan, and some opiate drugs of addiction are heroin, Vicodin, and OxyContin. Symptoms of PAWS include mood swings resembling an affective disorder, anhedonia (the inability to feel pleasure from anything beyond use of the drug), insomnia, extreme drug craving and obsession, anxiety and panic attacks, depression, suicidal ideation and suicide, and general cognitive impairment. The article is very much worth reading, especially for those dealing with troubling symptoms well after the "normal" time for experiencing withdrawal. See the article <>


  1. Steve Burkhart on March 5, 2014 at 4:42 pm

    More attention needs to be focused on nutritional therapy as a way to combat acute withdrawal symptoms and alleviate cravings.
    I’m embarking on such a program, my early results have been very promising.
    Diet and at first megadoses of specific nutritional supplements seem to be the key.
    Will let all know after I’ve had time to quantify and confirm my results.

  2. George Murdo on February 21, 2014 at 3:02 pm

    An interesting article .. but, as I believe every situation has two sides it might be worth considering the other side of the coin. The first warning signals were raised by Ivan Illich in 1975 in his article “Medical Nemesis” and is carried forward today by Peter Conrad in his book, The Medicalisation of Society.” Once more, the claims he makes are not based in science, but in opinion. There is another approach which believes that the conclusions reached are heavily influenced by various types of talking” therapies, and, of course, Big Pharma, who both have a financial interest in these issues being understood in a medical sense. The expansion of power in regard to the medical profession itself has to be a consideration too. The first warning signals were raised by Ivan Illich in 1975 in his article “Medical Nemesis” and is carried forward today by Peter Conrad in his book, “The Medicalisation of Society.” The old chestnut, create a problem and then produce a solution, springs readily to mind. No one, I believe, would doubt that neurological pathways are created and maintained by whatever substances one introduces to their body, and, as a result, tolerance and expectations are also developed. However, this is a human condition that has been with us since time immemorial, though some of the actual substances are new in a chemical sense. The language in the article is highly emotive too, when he speaks of damage rather than an adaption to physiological circumstance. Problems are the mother of insight, as one struggles through them to produce a more realistic view of the world and give birth to the solutions which carry us onwards to the next set of circumstances. I, personally, do not see every problem I encounter as having a medical aspect ; they are just a part of growing up and moving on. In hindsight, many issues which appeared insurmountable at the time were only blips on the screen views through the fullness of time. They also have many origins, be they long term withdrawal issues or otherwise. If I wish I can assign an origin to them, usually only to change my mind, and then, as time passes, to change my mind yet again as understanding deepens and broadens. Mostly, trying to pin them down once and for all, is like trying to hold quicksilver in my hand. It’s a bit silly too, in my opinion, as the more origins I can find for a problem the more enlightened aspects of my life the solution provides. Believing there is only one origin severely inhibits and restricts the benefits I can accrue. I continue to find the terminology amusing when it employs “replacement therapy” rather than the word “substitution”, but only when they are using a substance prescribed by psychiatrists, who, as we know, have the ability to vote illnesses in and out of existence. Yes, cultural creations are always vulnerable to linguistic analysis as many of their weaknesses are exposed. My own experience has shown that if I use any psycho active substance to mediate my thoughts or behaviour I sell myself short in as much as I am only setting another chemical trigger which has been artificially introduced to produce a certain mindset. This actually hinders me in my attempt to set new norms in my brain chemistry which will react in the manner it should to situations IF, and only IF, I remain free from psycho-active substances. If I were shareholder in these companies, or a trainee addiction counsellor, though I might have other motives to consider. It’s worth keeping in mind. Indeed, anything that provides short term relief at cost of long term growth, in my opinion, is worthy of caution. I also ponder as to whether or not PAWS could be adequately described in layman’s language as “it takes a person a wee while to learn from, get their life back on track, after any sort of trauma?”