PAWS
Post-Acute Withdrawal Syndrome involves persistent withdrawal symptoms like mood swings, sleep disruption, and cognitive fog lasting months after detox. These symptoms come in waves, making people question their recovery progress and increasing relapse risk. Understanding PAWS helps individuals recognize these as temporary brain healing, not personal failure.
TL;DR
PAWS is a normal but challenging phase of brain healing after detox, with mood swings and fog lasting months—understanding it prevents relapse and self-blame.
Expert Insights
“Not everyone who quits alcohol experiences post-acute withdrawal syndrome (PAWS). Those who addressed their alcohol problem using the Degtyaryov method rarely experience PAWS.”
— Discussion of PAWS variability
“Don't think this condition developed because you stopped drinking—it developed because you drank in the past and disrupted your body's balance of endogenous alcohol and neurotransmitters.”
— Explaining the root cause of PAWS
From the Sober.Live Knowledge Base
Key Points
- âś“Symptoms arrive in waves for 4-6 months, sometimes up to 2 years
- âś“Common triggers: stress, multitasking, conflict, poor sleep or diet
- âś“Five-minute resets (cold water, brisk walk, call a friend) shrink a wave
- âś“Track waves on a calendar to spot patterns and celebrate progress
- ✓Tell supporters: “This is PAWS, not a relapse—please stay close”
Post-Acute Withdrawal Syndrome (PAWS) is the brain’s way of re-wiring itself after you stop drinking. Once the shakes and sweats of acute withdrawal fade, a second wave of subtler symptoms—mood swings, cloudy thinking, insomnia, and cravings—can roll in for months. These episodes feel like setbacks, but they are signs of healing, not failure.
What PAWS feels like
Symptoms come and go in unpredictable bursts, each wave lasting minutes to days. You might wake up with razor-sharp anxiety, struggle to recall a grocery list, or snap at a loved one and wonder, “Wasn’t I past this?” Sleep breaks into fragments, joy feels dialled down, and alcohol pops into your mind as the quickest fix. Most people peak around weeks 6–12 of sobriety, with smaller ripples continuing for a year or more.
Why it happens
Chronic alcohol use floods the brain with dopamine and GABA, then leaves receptors scrambled. During PAWS, the nervous system recalibrates: stress hormones spike faster, pleasure pathways under-react, and the prefrontal cortex (responsible for planning and impulse control) works in slow motion. The result is an internal smoke alarm that blares at the smallest spark.
Practical tools for the waves
1. Name it to tame it. Say out loud: “This is PAWS, it will pass.” Labeling the experience activates the thinking brain and lowers panic.
2. Five-minute reset. When a wave hits, choose one: splash cold water on face, walk briskly around the block, or phone a supportive person. Short, intense activities reboot neurotransmitters faster than rumination.
3. Anchor routines. Go to bed and wake up at the same times, eat protein every three hours, and schedule gentle exercise. Predictable inputs calm the limbic system.
4. Track, don’t judge. Use a calendar or app to note wave intensity (1–10). Patterns emerge—often three to seven days after a stressful event—giving you advance warning and proof of improvement.
5. Ask for coverage. Tell friends, sponsors, or therapists when you’re in a wave so they can check in daily. Connection is the opposite of addiction.
When to seek extra help
If depression or anxiety stays above a 7/10 for two weeks, or cravings override your strategies, consult a professional. Medications such as acamprosate or SSRIs, combined with therapy, can soften severe symptoms and protect your recovery.
Remember: every wave you ride without drinking strengthens the new neural paths you’re building. PAWS is temporary; the resilience you earn is permanent.