What the Hell Is PAWS? (Post-Acute Withdrawal Syndrome)

Have you ever noticed that your recovery feels harder every 30 days or so? Like clockwork, depression kicks in. You get short-tempered. Your cravings come back strong. You start dreaming about drinking or using again. And suddenly, you're wondering:

“Am I losing my mind?” “Is this a relapse waiting to happen?” “Why am I still struggling when I’m doing everything right?”

You’re not broken. You’re not doomed.You’re probably experiencing something called PAWS—Post-Acute Withdrawal Syndrome.

What Is PAWS?

PAWS is what happens after the initial detox stage. You’ve already gotten the drugs or alcohol out of your system. Maybe you're a few weeks or months in. People around you think you’re “better.” But internally, your brain and nervous system are still under construction.

PAWS is the second wave of withdrawal.It can last anywhere from 6 months to 2 years, depending on how long and how hard you used.

And it’s a bitch.

What Causes It?

When you’ve spent years numbing out your emotions, flooding your body with chemicals, or chasing chaos—you've rewired your brain’s reward system.

• Your dopamine receptors (responsible for feeling joy and motivation) are fried.

• Your stress response system is on high alert.

• Your emotional regulation is out of whack.

• Your sleep cycles are disrupted.

So even though you're clean or sober, your body hasn’t gotten the memo yet. It keeps throwing symptoms at you like:

• Mood swings

• Irritability

• Fatigue

• Depression or anxiety

• Sleep disturbances

• Memory fog

• Cravings that feel exactly like day-one detox

The Pattern You Don’t See Until It’s Too Late

In my early recovery, I relapsed every 30–60 days—like clockwork. I thought I was broken. Or weak. Or just not cut out for recovery.

But then I learned what was really happening:My brain was cycling through repair. And every time it hit a new stage, the symptoms felt like I was detoxing all over again.

I wasn’t failing. I was healing. But healing hurts sometimes.

Once I knew it was PAWS, I stopped panicking. I started riding the wave instead of drowning in it.

The Stats They Don’t Tell You in Rehab

• PAWS affects up to 90% of people recovering from opioid, alcohol, or benzo addiction.(National Institute on Drug Abuse)

• Relapse rates peak between 30–90 days—when PAWS symptoms hit hardest.(Journal of Addiction Medicine)

• People in early recovery often experience PAWS cycles every 21–35 days, which is why so many say “I feel crazy every month.”(SAMHSA, 2023)

• The more years you used, the longer PAWS tends to last—but symptoms usually decrease in intensity over time.

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What Helped Me Survive PAWS

Once I recognized the pattern, I stopped relapsing.Here’s what I did differently:

1. Tracked my cycles – I started writing down when the mood dips, cravings, and dreams happened. They were like hormonal cycles—predictable once I saw them.

2. Told myself the truth – I would say:“This is PAWS. It’s gonna suck. But it will pass in 24 hours. Just don’t drink today.”

3. Built a plan for Day 30 – Every month, I planned a distraction: a hike, a meeting, a massage, a phone call with someone real.

4. Stayed loud about it – I told my sponsor, my therapist, my kids. That way someone else could see the storm coming, even if I couldn’t.

   
   

What You Need to Know

If you’re in early recovery and wondering why you feel worse now than you did at 10 days sober, you’re not failing. You’re going through the most dangerous part of recovery, and no one warned you.

Let me be that warning. And that hope.

You will get better.Your brain is healing faster than you think.One day, the fog lifts. And the cravings stop coming.And you finally feel grown, whole, and real again.

But you have to stay long enough to find out.

If you’re having a rough day in recovery and it feels like withdrawal all over again—pause.Check the calendar.If it’s around Day 30, it’s not weakness. It’s PAWS.Breathe. Eat. Sleep. Tell someone.Then wait 24 hours before you decide anything. You’ve got this.