Opioid Post Acute Withdrawal Syndrome

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Making Opioid Withdrawal Treatment a Success After Your Detox is Complete

When you have completed the main phase of opioid withdrawal – when the opioid withdrawal symptoms have ended and you’re aware of the changes that have happened – your life has a chance to really begin anew.


There’s another chapter to the story of post-detox life renewal. It’s a condition that frequently surprises patients who have recently completed opioid withdrawal treatment at facilities other than Novus. Just when they were thinking that they’re now in the clear, they discover they may not be. Not quite yet.

At Novus, we educate our patients thoroughly on their future following their stable physical withdrawal from opioids. Because our patients want to remain totally drug-free, we arm them with the facts of a sustainable sober life.

And so we educate them on a condition called Post Acute Withdrawal Syndrome. Using the first letter of each word, it’s usually just called PAWS for short.

PAWS: The tiger in the room

Post-Acute Withdrawal Syndrome (PAWS) can follow what appears to be a successful withdrawal from numerous types of drugs and alcohol.

PAWS is the reason some other opioid detox programs can look successful and feel successful, and yet in a matter of days or weeks or even months later, suddenly turn around in a relapse.

At Novus, we work with our patients to help ensure this doesn’t happen to them.

What PAWS looks like

PAWS is a variety of negative physical, mental and emotional manifestations that can follow withdrawal from substance dependence and addiction:

  • PAWS is a different collection of symptoms for each person, and can include:
    • Craving opioids
    • Depression
    • Sadness and Pessimism
    • Resentment and Guilt
    • Anxiety and Panic attacks
    • Sleeplessness and Nervousness
    • Loss of appetite
    • Loss of feeling or caring about things
    • Loss of enjoyment in things
    • Impaired cognition – cloudy thinking, memory loss and poor decision-making
    • Irritability and Crankiness
    • Loss of “get-up-and-go”
    • Obsessive-compulsive behavior
    • and more
  • Symptoms occur more frequently to those with longer-term dependencies
  • Symptom severity depends on
    • the substance(s) used
    • the dosages that were used
    • the duration (length of time) of dependence
  • Symptoms can go on for weeks or months
  • Symptoms can roller-coaster up and down or come and go without notice
There is hope for a new life.Call to speak to one of our experienced & caring detox advisors today!

What you can do about PAWS

The symptoms of PAWS are the primary reason that successful, long-term recovery is directly related to the length of time in rehab. It can take 3, 4, 5 or even 6 months for the PAWS symptoms to fade enough to be comfortably manageable.

Keep in mind that stress plays a big role in the frequency and severity of PAWS. Anything you can do to minimize stressful situations during the post-detox / rehab period is going to be in your favor.

Of course you can’t downplay an individual’s strength of purpose to make it all work. And you can’t over-emphasize the importance of strong, trustworthy and sober family members, friends, companions and mentors on the team helping with the journey.

It would be rare indeed for someone to manage an opioid withdrawal and make it all the way on their own.

Dealing with the physical symptoms

The first thing that should be addressed is one’s physical health. At Novus, we bring our patients back to health, often healthier than before their opioid mis-use, and this helps to ensure the sustainability of their sobriety and their resilience to PAWS.

Because opioid addiction or dependence can, over time, leave you in short supply of the very things that can help reduce symptoms of PAWS, Novus uses proprietary IVs and protocols that rebalance the nutritional needs of our patients.

Also, we know from many patients that exercise is essential to help reduce the physical symptoms of PAWS. And as any doctor or physical trainer will tell you, exercise is also an essential component of mental and emotional therapy too. That’s one reason we have our own work-out gym for you at Novus.

Why exercise works and why you need to do it

As you probably know, exercise releases endorphins into your system, the special “feel good” chemicals that are produced by the central nervous system and the pituitary gland when we exercise. Endorphins are why athletes get that “sense of well-being” – almost a high – after a workout.

The only cautionary note is this: Do NOT go overboard for exercise in a mad attempt to get high off your endorphins. Two things: First, that won’t work, especially if you’re already depleted because of your opioid dependence – see the doctor and get that treated. Second, you are very likely not in good enough physical condition to benefit from heavy exercise. In fact, it could harm you. Again, ask the doctor.

Endorphins – the whole story

You’ve probably heard of endorphins, but you may not know where that name comes from.

The word “endorphins” was put together a long time ago, from the scientific term “endogenous morphine” – yes, that’s right, we make a morphine-like substance right here in our own bodies. The substance is actually “endogenous opioid neuropeptides and peptide hormones.”

“Endogenous” just means “made in our body.” We all know what “opioid” means. And “peptides” and “neuropeptides” are the special molecules that are programmed to create specific effects.

In our case, those effects are a reduction of physical pain and elevated mental and emotional tone.

Endorphins are our own medicine. And they’re right here for us 24/7. Just slip into some sneakers and start walking, jogging or whatever you are comfortably and safely capable of doing.

Dealing with the mental and emotional symptoms

Here is what seems to be the number one advice from numerous successful opioid withdrawers: Indulge your interests – anything you ever loved or even just liked, anything you ever wanted to do as a hobby or as a pro. It doesn’t matter if it’s reading every book in the library or chasing butterflies or just spending hours online chasing your dreams. This is what’s going to get you through and out of the mental fog and rehabilitate your desire to feel things again.

A lot of patients also meditate in one way or another, or get with sober people for quiet chats about anything at all that takes your mind off your cravings and your symptoms.

Because they will pass. They always pass.

Some final thoughts

Especially if you do not use Novus for your medically-managed withdrawal, it’s important to keep a few things in mind:

  • PAWS symptoms can seem to be gone but then they can come back
  • There’s no particular way of estimating how long PAWS symptoms will last, or even what they will be
  • The longer you spend in a rehab environment, the easier it will be to get past it
  • PAWS always fades, it just takes time
  • Every day, more and more people are getting through it and getting their lives back.
  • If you can make the resources available, do your opioid withdrawal treatment at Novus to help ensure a Sustainable Sobriety.

The keys to making your opioid withdrawal treatment a success are vigilance and determination by everyone involved – both the patient and the patient’s support team. It’s a little like the old advice given to ball players back in the day, advice that applies to anyone trying to achieve a goal:

Keep your eye on the ball!

In other words, keep your attention focused on the big prize. Don’t get distracted by the noise and bother as the last vestiges of drugs leave your system. Because a new world awaits.

There is hope for a new life. Call to speak to one of our experienced & caring detox advisors today!

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