What Is Post Acute Withdrawal Syndrome 

Likely, you’re already familiar with the concept of acute withdrawal, which generally occurs in the first few days to two weeks after an individual ceases their heavy use of an addictive substance. However, you may not be as familiar with the more protracted symptoms that can arise during an individual’s withdrawal from drugs or alcohol. 

Called post acute withdrawal syndrome, this phenomenon is caused by changes to the brain and body that occur when it has become accustomed to the presence of certain chemicals. It is not generally physically dangerous in the same way that shorter term detox from certain substances is, but it can cause severe enough symptoms to interfere with usual day to day functioning. It can continue cyclically, with symptoms waxing and waning and often lasting for a few days at a time, for periods ranging from a few weeks to as long as two years. 

Symptoms of Post Acute Withdrawal Syndrome

The symptoms and severity of post acute withdrawal syndrome can vary greatly depending on what substance was used for how long and factors of individual biology, which is complicated by the fact that some of the symptoms that could be caused be post acute withdrawal could also be caused by the reemergence of pre-existing mental illnesses that were being suppressed with self medication through substance abuse. These symptoms tend to be most intense during withdrawal from benzodiazepines, opioids, and alcohol, but have also been reported for other drugs like cannabis, cocaine, and methamphetamine. 

Also, while they are not generally drugs of abuse, post acute withdrawal syndrome-like symptoms have also occurred during withdrawal from some antidepressants and antipsychotics. Symptoms of post acute withdrawal syndrome can include:

  • Irritability 
  • Anxiety and panic attacks
  • Oversensitivity to stress
  • Depression
  • Lack of motivation
  • Brain fog and trouble focusing
  • Mood swings
  • Fatigue
  • Intense cravings for the substance of abuse
  • Memory problems
  • Coordination issues
  • Sleep disturbances (insomnia or unusually vivid dreams)
  • Poor impulse control 
  • Inexplicable chronic pain
  • Low libido

Though this may be an overwhelming list, remember that it’s unlikely that any one person would experience all of these symptoms⁠—this is just a round up of all of the possibilities.

Managing Post Acute Withdrawal Syndrome

Because Post Acute Withdrawal Syndrome symptoms can be so unpleasant, they are a major risk factor for relapse. But, with adequate management and enough patience, the condition does not have to hamper your recovery. With enough time, your brain and body will readjust as your levels of neurotransmitters return to normal. Relapse will only lengthen the post acute withdrawal symptom process by “telling” the brain that more drug is coming, so it’s best to just bear with it and ride things out. 

However, that doesn’t mean you are powerless when it comes to managing it. For withdrawal from certain drugs, medications like antidepressants can be helpful in stabilizing mood, and other medications can play a role in suppressing cravings, such as naltrexone for alcohol and opioids. 

Staying on top of your physical and mental health can also lessen the impact of post acute withdrawal symptoms. A healthy diet, regular exercise, and enough sleep can go a long way towards combating the malaise of post acute withdrawal syndrome and boosting your mood, and regular therapy can help you develop coping skills that can enable you to better cope with the condition’s impact.  

Regularly attending support groups and building a support system that you can rely on can also help you cope with post acute withdrawal syndrome, as you can learn from the experiences of others who have already weathered the storm and amass friends you can turn to if cravings become too intense for you to manage on your own.

Knowing that you are vulnerable to relapse, you can also take extra care to avoid triggers when you are experiencing peak post acute withdrawal symptoms, staying away from any people, places, and things that you might associate with substance abuse.

ou should also make an effort to avoid any unduly stressful situations, which can both trigger an increase in post acute withdrawal syndrome symptoms and challenge your ability to cope without drugs. If you can, avoid taking on any overly stressful jobs or obligations while in early recovery, and make an effort to go easy on yourself.

This is the time to relax and truly recover, not to rush back into the rat race of everyday life. Decompress with meditation,  use the arts as an outlet, have a chill movie night with some sober pals; any fun and drug-free activity can help you feel better in the moment even if they cannot alleviate your post acute withdrawal symptoms entirely.

If you are currently struggling with addiction or with withdrawal, whether acute or not, feel free to reach out to our helpline at (833) 489-5577 for advice on obtaining the appropriate treatment. As long as you attend to them properly, your mind and heart can and will heal. 

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