Symptoms of Post-Acute Withdrawal Syndrome (PAWS) and What to Do | Banyan Mass

Symptoms of Post-Acute Withdrawal Syndrome (PAWS) and What to Do


When most people think of detox, they think of the initial withdrawals that occur during the first few days or weeks of detoxification.

But withdrawals actually occur in two phases, the first acute phase during the initial days of detox and the post-acute phase, which can last for months. The latter half of withdrawals is known as post-acute withdrawal syndrome, aka PAWS. PAWS is the consequence of the major changes within the brain that occurred during active addiction, such as changes in the brain’s anatomy and chemistry.1 These changes can result in severe cravings and other withdrawal symptoms weeks or even months after the last time of substance use. PAWS is also known as protracted withdrawal.

After completing treatment for heroin addiction treatment in Massachusetts, many patients experience PAWS symptoms while they’re working through IOP or alumni programs. But opiates aren’t the only drug associated with post-acute withdrawal symptoms. PAWS can happen with any drug and alcohol as well, with varying symptoms depending on the type of substance used, number of substances used, and duration of the substance abuse.

Common Post-Acute Withdrawal Symptoms

Because symptoms of post-acute withdrawal vary depending on type of substance used, duration of substance abuse, and other factors, the symptoms of PAWs may vary from patient to patient. There are some common post-acute withdrawal symptoms seen for patients recovering from addictions to differing substances. These PAWs symptoms include:

  • Anxiety
  • Sleep Problems
  • Fatigue and Tiredness
  • Mood Swings
  • Increased Sensitivity to Pain
  • Depression
  • Reduced Motivation
  • Tremors
  • Cravings
  • Gastrointestinal Distress

Certain drugs, such as benzos, are associated with specific PAWS symptoms including issues with motor function and tinnitus. Researchers theorize that these types of symptoms may be linked to brain damage stemming from long-term benzo abuse.2 With many symptoms of post-acute withdrawal syndrome, the appearance is linked to chemical changes in the brain or body.

How to Treat Post-Acute Withdrawal Syndrome

Many of the symptoms of PAWS can be treated through therapy and lifestyle changes. For more severe symptoms, support from a doctor or medical specialist may help to mitigate symptoms. The important thing to remember is that PAWS happens to many people in recovery, but it does not last forever.

How Long Does Post-Acute Withdrawal Syndrome Last?

The duration of PAWS varies from one patient to the next, but in some cases, post-acute withdrawal syndrome can last for up to two years. The severity of experienced symptoms will vary throughout the duration of PAWS. Support makes all the difference in overcoming post-acute withdrawal syndrome and cravings. Our program for relapse prevention program in Boston can help those who are facing PAWs, relapse, or other challenges.

At Banyan Treatment Center Massachusetts, we’re here to help patients through their recovery. We offer inpatient, PHP, and IOP in Massachusetts, giving patients the tools they need to build lasting sobriety. If you are experiencing symptoms of PAWS, call 888-280-4763 for support from our team.


  1. Psychology Today – Detoxing after Detox
  2. Benzo – Protracted Withdrawal Syndromes from Benzodiazepines

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Alyssa is Banyan’s Director of Digital Marketing & Technology. After overcoming her own struggles with addiction, she began working in the treatment field in 2012. She graduated from Palm Beach State College in 2016 with additional education in Salesforce University programs. A part of the Banyan team since 2016, Alyssa brings over 5 years of experience in the addiction treatment field.