Acute withdrawal is the first stage of detox and primarily consists of physical withdrawal symptoms that can last from a few days up to two weeks. Acute withdrawal symptoms are the initial or immediate withdrawal symptoms that appear as a result of the rapid reduction or the sudden cessation of the use of addictive substances, including alcohol. Due to the wide range of acute withdrawal symptoms that may occur, and the various addictive substances that may be used, it is always advised to seek medical assistance rather than quitting on your own, or cold turkey.

The second stage of detox, known as post-acute withdrawal syndrome (PAWS) occurs as the brain re-adjusts itself after prolonged addiction. Unlike acute withdrawal, which is mainly made up of physical withdrawal symptoms, the symptoms of post-acute withdrawal are primarily psychological and emotional symptoms. Depending on the duration and intensity of alcohol or other drug use, post-acute withdrawal is capable of lasting for many months. Post-acute withdrawal symptoms typically last between one to two years; however, the severity and frequency of symptoms tend to dissipate as time passes without the use of addictive substances.

Some of the most common symptoms of post-acute withdrawal are:

  •  Insomnia 
  •  Irritability
  •  Aggression
  •  Panic attacks
  •  Anxiety
  •  Depression
  • Inability to focus 
  •  Apathy
  •  Mood swings
  •  Fatigue
  •  Inability to think clearly
  •  Memory loss

Certain drugs are known to result in more severe post-acute withdrawal symptoms, such as:


Cocaine is known for various PAWS that last for prolonged periods of time. Many users report symptoms of fatigue, depression, low motivation, and poor impulse control.


Common PAWS for methamphetamine include poor impulse control, disturbed sleeping patterns or insomnia, and irritability.


Common PAWS from opioids include depression, anxiety, insomnia, intense cravings, muscle tension, and poor impulse control.


Benzodiazepines, such as Ativan, Klonopin, and Xanax are known for having common PAWS, including panic attacks, intense anxiety, irritability, and extreme sleep disturbances, including insomnia.

Post-Acute Withdrawal Symptoms and Relapse

Post-acute withdrawal symptoms that persist or randomly occur during early recovery can become a risk factor for relapse. These symptoms can be uncomfortable; without healthy coping skills, they can lead to relapse, no matter how committed you may be to remaining sober. Learning about the symptoms of post-acute withdrawal syndrome, along with enforcing healthy coping strategies, is the most useful way to prevent relapse.

Coping with PAWS

In the beginning, post-acute withdrawal symptoms may begin to feel as if you are on an emotional rollercoaster, with mood swings ranging from happy to irritable, to sad. It can be overwhelming at first, but as you make progress in your recovery, symptoms of post-acute withdrawal syndrome begin to dissipate. Be sure to practice patience and give it time, as the symptoms will decrease through time in severity and occurrence as long as there is continued abstinence. Learning healthy coping strategies for managing PAWS is one of the best ways to overcome the discomforting symptoms that may appear.The supervised detoxification and residential treatment programs at Asana Recovery are offered in a supportive, relaxing, and inspiring environment. We’re deeply committed to ensuring your long-term recovery and guiding you on your path to a healthier and happier future. There is no better time than now, and we’re always available to speak with you. Call us at (949) 438-4504 to learn more about our comprehensive drug and alcohol addiction treatment program today.


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