Post Acute Withdrawal Syndrome: 6 Signs of PAWS You Need To Know

Are you wondering why you’ve stopped using drugs or alcohol, only to find you still don’t feel great?


Has it been 3, 6, or 9 months since you stopped using, and you still don’t feel like you are back to yourself?

In this post, I hope to clarify for you what you might be experiencing – Post Acute Withdrawal Syndrome (PAWS).  Knowing the symptoms you are experiencing and their origin can be the next step for you in making changes to enhance your recovery and quality of life. 

Many people experience PAWS symptoms in early recovery.

PAWS can look different for everyone, depending on the types of substances that were used during active addiction, and the length of time the substances were used.

Although there are differences, many people in early recovery experience some combination of the following six symptoms. If you look over this list of symptoms and have an “aha” moment, you are not alone!

Many people don’t know why they feel the way they feel in early recovery. My hope is that the following information will help you to develop increased understanding of what your body and brain are going through in early recovery.  

1.     Stress Sensitivity

Have you found yourself overreacting to minor stressful situations? A small problem that should produce a minimal amount of stress instead producing an overwhelming amount of stress for you?  This is an example of your brain and body adjusting to the “normalness” of life without substances. An example could be feeling heightened stress at work or school, with tasks that normally do not feel quite as stressful like an additional assignment.

2.     Sleep disturbance

People experiencing PAWS may have trouble falling asleep, trouble staying asleep, or even waking up throughout the night and having difficulty getting back to sleep. Again, this is the brain’s way of adjusting to “normal” restful sleep without any substances to help.

3.     Difficulty thinking clearly

This could be having a hard time making decisions, even minor ones like what to eat for dinner. This could also look like difficulty concentrating at school or at work, or even just feeling as if you are in a fog.

4.     Difficulty managing emotions

Usually people fall into 2 categories with this – emotional overreactions or emotional numbness. Some clients have shared they have even experienced both, at different time periods.

5.     Physical coordination

People experiencing PAWS might have difficulty with balance, fine motor skills, or even hand-eye coordination. Some people have described feeling incredibly clumsy, even though they have never been that way before.

6.     Memory

PAWS tends to affect short term memory. A great example is learning something new and not being able to retain the information, such as learning a new concept in therapy. Another example might be not remembering the few things you need to pick up at the store, even though your spouse just told you an hour before.

If you are in early recovery and experiencing these symptoms, there is a good chance you are experiencing PAWS.

For many clients, knowing this information AND knowing what to do with it can be part of the key to their recovery. Knowing that you have stress sensitivity and learning how to manage it and the emotional reactions that go along with it could be the difference between staying clean versus a relapse.

Early recovery is also a time period when brain chemicals are trying to find their way back to balanced, so it is an especially susceptible time for relapse.

Knowing these symptoms and the tools to cope with them will only help to solidify your recovery!