PAWS

PAWS is a term used for symptoms that continue after acute withdrawal. Such difficulties deserve care, while their causes, pattern and duration can vary and should not be assumed from the label.

PAWS stands for post-acute withdrawal syndrome. It is used to describe continuing difficulties after the acute withdrawal period, often in discussions of alcohol recovery. Sleep problems, anxiety, irritability, low mood, reduced enjoyment or difficulty concentrating can be troubling, but they do not form one reliably defined pattern in every person.

Continuing symptoms are real and are not a measure of weak willpower. The label does not prove their cause, however. Withdrawal-related changes, another health condition, medicine effects and stressful circumstances can overlap. There is no fixed timetable that can tell everyone when they will feel better.

Persistent, worsening or disabling symptoms deserve assessment. Do not assume that sudden confusion, a seizure or severe physical illness is PAWS. A seizure or severe withdrawal needs emergency medical help. Sudden confusion needs immediate medical help. New suicidal thoughts need prompt support and clinical attention, with emergency help if there is immediate danger.

If physical dependence on alcohol or benzodiazepines may be present, obtain medical advice before abruptly stopping or sharply reducing use. A history of withdrawal does not make a later withdrawal safe. Practical support and treatment for the actual problems can continue without waiting for certainty about one syndrome.

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