Substance withdrawal can be a challenge for those who struggle with substance use disorder. The symptoms can last anywhere from a few days to a few weeks. And for some, they can linger on for months or even years. Post-acute withdrawal syndrome (PAWS) can cause persistent symptoms that impact daily life and early recovery. At Greenbranch Recovery in Egg Harbor Township, we understand the complexities of post acute withdrawal and provide compassionate, evidence-based care to help you move forward. If you are navigating long term recovery in Atlantic County, Cape May County  or nearby areas, we are here to support you. Call us today at 609-622-5101 or contact us online to learn more. 

What Is Post Acute Withdrawal Syndrome?

Post acute withdrawal syndrome is a set of symptoms that linger after the acute withdrawal stage has passed. Unlike the first stage of withdrawal, which is primarily physical and lasts days to weeks, PAWS involves psychological and emotional effects that may persist for several months. These symptoms are part of a broader withdrawal syndrome that can complicate early recovery and lead to relapse if not properly managed.

Common Symptoms of Post Acute Withdrawal Syndrome

Post acute withdrawal symptoms affect everyone differently, but there are some common symptoms many individuals experience as they adjust to life after substance use. These symptoms often reflect the brain’s efforts to rebalance after the acute withdrawal stage and can persist during early recovery.

Mood Swings and Irritability

Emotional ups and downs are typical during PAWS. You may feel hopeful one day and overwhelmed the next. These mood swings often come with irritability, frustration, or even anger, particularly when dealing with minor stressors.

Anxiety and Panic Attacks

Persistent anxiety is one of the most common symptoms of post acute withdrawal. Some individuals experience panic attacks with sudden episodes of intense fear or discomfort, especially in situations that remind them of past substance use or stress.

Depression and Low Energy

After substance cessation, many people struggle with low mood or emotional numbness. These symptoms often include a lack of motivation, difficulty feeling pleasure, and general fatigue, even after adequate rest.

Insomnia and Sleep Problems

Sleep disruptions can take many forms, including difficulty falling asleep, waking up frequently, or experiencing nightmares. Poor sleep can worsen other PAWS symptoms like anxiety, depression, and fatigue.

Cognitive Issues

Post acute withdrawal can affect your ability to focus or remember things. You may have trouble concentrating at work or during conversations, which can be frustrating and isolating.

Physical Symptoms

Although PAWS is mostly psychological, some physical symptoms persist. These may include chronic pain, digestive issues, or unexplained aches. Cravings and urges to use substances may also feel physical in nature.

These symptoms are part of a broader withdrawal syndrome that can make early recovery more challenging. Recognizing them as a natural part of the healing process can help reduce fear and shame. If you or someone you love needs help call Greenbranch Wellness and Recovery at  609-622-5101 or contact us online to learn more. 

woman dealing with pain during PAWS - post acute withdrawal syndrome

Why PAWS Happens: The Science Behind It

Understanding the biological roots of post acute withdrawal syndrome (PAWS) can help reduce fear and reinforce that symptoms are not a personal failure—they are a natural part of healing.

During active addiction, substances like alcohol, opioids, benzodiazepines, and prescription drugs significantly alter brain chemistry. These substances disrupt how the brain regulates mood, stress, sleep, and motivation. Over time, the brain becomes dependent on these chemicals to function, weakening the natural systems that support emotional balance and physical stability.

When substance use stops, the brain and body enter a state of imbalance. This is where chemical imbalances become central. Neurotransmitters such as dopamine, serotonin, and GABA—responsible for pleasure, calm, and focus—are depleted or unregulated. This disruption causes common symptoms like depression, anxiety, irritability, and cravings.

The central nervous system is also heavily impacted. For example, alcohol and benzodiazepines act as depressants. They slow down brain activity during use, so once those substances are removed, the brain can rebound into a hyperactive state, resulting in panic attacks, insomnia, and heightened sensitivity to stress.

Over time, and with continued abstinence, the brain begins to heal, but the process is not immediate. These protracted symptoms may last for several months, depending on the substance used, overall health, and presence of co-occurring mental health disorders. It’s important to remember that these symptoms do not mean you’re going backward. They are a sign that your body is recalibrating.

PAWS is the body’s way of finding a new normal without addictive substances. With the right support, including therapeutic care and structured treatment programs, it is possible to stabilize emotionally and rebuild a life rooted in clarity and health.

PAWS and Different Substances

Post acute withdrawal syndrome (PAWS) can present differently depending on the type of substance used. The severity, duration, and nature of post acute withdrawal symptoms are deeply influenced by the substance’s impact on brain chemistry and how long the person was in active addiction. Understanding these differences is essential for tailoring effective treatment programs.

Alcohol

Chronic alcohol use disrupts the brain’s inhibitory neurotransmitters, like GABA. When alcohol use stops, the body often rebounds with hyperactivity in the central nervous system, leading to anxiety, mood swings, irritability, and insomnia. In some cases, individuals may also experience panic attacks or intense cravings, particularly in stressful environments. These alcohol withdrawal effects can last long after the acute withdrawal stage, especially without ongoing clinical support.

Opioids

Opioids increase dopamine and create intense euphoria during use. When someone stops using, dopamine production crashes, leaving them vulnerable to depression, fatigue, and a lack of motivation. Post acute symptoms with opioids may persist for several months, including low energy, cravings, sleep problems, and difficulty concentrating. This makes it essential to pair ongoing therapy with strategies like Medication-Assisted Treatment (MAT), especially in early recovery.

Benzodiazepines

Benzodiazepines slow down brain activity. Long-term use can deeply affect the brain’s stress and sleep regulation. Once discontinued, PAWS symptoms can be severe and long-lasting, including cognitive fog, sleep disruption, anxiety, and sensory hypersensitivity. These protracted symptoms often ebb and flow unpredictably, making continued abstinence challenging without structured support.

Stimulants and Prescription Drugs

Stimulants like cocaine or methamphetamines, and even certain prescription drugs, can lead to prolonged emotional withdrawal. Common symptoms include irritability, memory problems, depression, and intense drug cravings. These effects may not be immediately life threatening, but they are a serious risk factor for relapse and often require both medical and psychological care.

Each case is substance specific, and how PAWS manifests depends not only on the drug used, but also on the duration and intensity of substance abuse, co-occurring mental health issues, and environmental stressors. That’s why individualized treatment is key to successful long term recovery.

Managing PAWS: Coping Strategies and Support at Greenbranch Recovery

Managing post acute withdrawal syndrome requires more than willpower. It calls for a combination of practical coping strategies and professional treatment programs that support long term recovery. At Greenbranch Recovery, we guide individuals in developing sustainable routines and accessing the care they need to heal.

Self care plays a central role in navigating post acute symptoms. Establishing positive daily routines can help regulate your mood and energy. Regular physical activity, balanced nutrition, and hydration support the brain’s recovery. Practicing mindfulness, deep breathing, or grounding exercises can reduce anxiety and increase emotional resilience.

Sleep problems are also common during PAWS. Maintaining good sleep hygiene, such as turning off screens before bed, keeping a consistent schedule, and creating a restful environment, can make a significant difference.

However, lifestyle changes alone may not be enough. That’s why clinical support is essential. Greenbranch Recovery offers a range of evidence-based treatment programs tailored for individuals experiencing symptoms after detox. These include:

Whether you’re coping with anxiety, fatigue, irritability, or cravings, our team can help you develop personalized strategies that align with your recovery goals. Serving Egg Harbor Township, Atlantic County, and surrounding areas like Galloway and Sea Isle City, Greenbranch Recovery offers trauma-informed care that meets you where you are.

You don’t have to manage PAWS alone. With compassionate treatment and a clear plan, healing is possible. Call us today at 609-622-5101 or contact us online if you are looking for help.

Healing Beyond Detox: Your Recovery Journey Continues Here

Recovery does not end with detox. If you or a loved one are experiencing post acute withdrawal symptoms in Cape May County, Egg Harbor Township, or surrounding areas, Greenbranch Recovery is here to help. We offer compassionate support, effective treatment, and tools to help you feel pleasure in life again. Call us today at 609-622-5101 to begin the next phase of your recovery journey.