Meth and Post-acute Withdrawal Syndrome (PAWS)

Some meth users experience PAWS in sobriety. This condition appears one to two after detox, lasts no longer than one year, and causes former meth users to experience several withdrawal symptoms.

Last updated: September 20, 2019
Man having psychological issues

Because of the powerful nature of meth, it’s extremely addictive. In fact, most people become addicted to meth after only trying it a handful of times. However, just because someone develops an addiction to meth doesn’t mean that it forces them to live that way forever. There are many recovered meth addicts who are now sober and free from their addictions. With that being said, the road isn’t always easy. You have to really and truly want sobriety. When you first stop using meth, you will probably experience withdrawal symptoms. These symptoms will begin 1-2 days after you last used the drug and will continue for upwards of one month. After 30-40 days, most former meth users felt much better. However, some develop a disorder called post-acute withdrawal syndrome (PAWS).

What is PAWS?

Post-acute withdrawal syndrome, also known as PAWS, is exactly what the name suggests. Also known as protracted or prolonged withdrawal, PAWS refers to when former addicts or alcoholics experience withdrawal symptoms long after they stopped using their drug of choice. Those who experience PAWS typically see their withdrawal symptoms resurface between 4-8 weeks after detox. PAWS can last anywhere from several months to an entire year and symptoms can appear, reappear, and disappear several times over the course of the year. When someone has PAWS, it can feel like they are experiencing a roller coaster of withdrawal symptoms. For a while, they won’t have any symptoms, and then for weeks on end they may experience every single withdrawal symptom.

What factors increase risk for PAWS?

Not every former meth user will experience PAWS. However, it is not uncommon, either. There are several factors that can increase your risk of getting PAWS.

  • Type of drug used: Those who abuse substances like alcohol, opioids, benzodiazepines, cocaine, and meth are most likely to experience PAWS.

  • How long meth was used: The longer you used meth, the higher your chances are of getting PAWS. For example, someone who abused meth for a few months is far less likely to experience PAWS than someone who used the substance for several years.

  • How much meth was used: If you snorted, smoked, or injected a large amount of meth each time you used the drug, you may experience PAWS. This is because your body became dependent quickly on a substantial amount of meth. When that substance is removed from your body, it could take longer for your bodily functions to normalize.

  • How frequently meth was used: If you used meth often, you may be at a higher risk for PAWS. The more often you use a drug, the more your body becomes reliant on the substance. Thus, the longer it takes for all withdrawal symptoms to cease and the more likely it is that you will experience PAWS.

  • Genetics: Your genetic makeup can affect both your likeliness to become addicted to meth in the first place, as well as your chances of experiencing PAWS.

  • Mental health: Oftentimes, meth users also struggle with unrelated mental health issues including depression, anxiety, and bipolar disorder. If you have any mental health problems, you are at a higher risk of getting PAWS. This is because you are at a higher propensity for stress, which can lead to both relapse and prolonged withdrawal symptoms.

PAWS symptoms

So what exactly is PAWS? PAWS symptoms are essentially the same as typical meth withdrawal symptoms. However, these symptoms just come back further into sobriety and are more intense. Some PAWS symptoms are generic, while others are specific to the type of substance used. Here are some common PAWS symptoms for former meth users:

  • Mood swings
  • Hostility
  • Anhedonia: Anhedonia is the inability to feel pleasure. This is because certain neurotransmitters are released when someone uses meth that eventually causes them to only feel good when using the drug. This means that someone who has PAWS may not feel pleasure during typically pleasurable activities, such as their favorite hobbies or sex.
  • Cognitive problems: These problems include trouble focusing, inability to think clearly, and difficulty remembering people, places, or things.
  • Fatigue
  • Anxiety
  • Depression
  • Intense cravings
  • Stress: A common PAWS symptom is the propensity to become stressed at the smallest incidents. This is because meth use lowers the user’s threshold for stress, meaning that they are more likely to become very stressed very quickly and for minor reasons.
  • Sleep problems: These sleep problems can include restless sleep and insomnia.
  • Ineffective executive functions: A PAWS symptom that is particularly a problem with former meth users is ineffective executive functions. Executive functions including impulse and emotional control, planning, and organization are impaired when experiencing PAWS.

Is PAWS normal?

While not every former meth user experiences PAWS, it is a normal part of the sobriety process. PAWS is a separate process from acute withdrawal, which most former meth users experience in their first few weeks of sobriety. While acute withdrawal involves mostly physical symptoms, PAWS involves mostly psychological symptoms. PAWS is not uncommon, but may be experienced differently by each person. Not everyone who goes through PAWS will experience every symptom in the list above.

How to combat PAWS

While there is no way to avoid PAWS, there are several ways to combat it. If you are experiencing PAWS, just know that you aren’t helpless. Try some of these tips to help make the battle through PAWS easier:

  • Get professional help: PAWS symptoms can be too much for you to handle on your own. And that’s okay! That’s why rehabilitation centers and counselors exist.

  • Get involved with a 12-step program: 12-step programs are effective and reliable ways to stay clean from meth. These programs teach you how to combat PAWS symptoms and also provide you with a support system of people who know exactly what you’re going through.

  • Replace meth use with healthy behaviors: When you stop using meth, you suddenly have so much more time on your hands. However, this time can make you start to crave or experience PAWS symptoms more aggressively. Instead of sitting with these feelings, replace meth use with healthy behaviors like exercising, attending 12-step meetings, eating healthy, and spending time with friends and family.

  • Identify emotional triggers: Emotional triggers can exacerbate PAWS symptoms. If you can identify your emotional triggers, you can steer clear of them and thus alleviate your PAWS symptoms.

  • Practice patience: Patience is key to overcoming PAWS symptoms. Remember that PAWS doesn’t last forever, the same ways that acute meth withdrawal symptoms didn’t last forever.

Unfortunately, PAWS is a leading cause of relapse for former meth users. Don’t let this happen to you! While PAWS symptoms may feel unbearable, remember that you can make it through anything. You probably didn’t think you could quit using meth, but you did! Likewise, you may feel you can’t get through PAWS, but you can. Remember that it doesn’t last forever. Meth addicts who are able to stop using the drug indefinitely are some of the strongest people around.

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