ManchurianC

Most of the articles on the Net about Post Acute Withdrawal Syndrome (PAWS), seems to be a copy-and-paste of earlier articles, or, it appears, are seriously lacking in research -- especially regarding the severity and specifics of PAWS in recovering alcoholics.

We can contribute and maybe come to some generally useful conclusions.

Post Acute Withdrawal Syndrome is given to be a set of impairments that occur immediately after withdrawal (from alcohol). The condition is said to occur in 75% of recovering alcoholics, and last from six to eighteen months after the last use, and is marked by a fluctuating but incrementally improving course.

PAWS is said to affect the recovering alcoholic's ability to recover and benefit from recovery, influence alcoholism treatment options (by clinicians), bear upon the ability hold down a job and function effectively, and bear upon the ability to interact normally with family and friends, and regain emotional health.

It known to have three major areas of impact upon the individual -

Cognitive (possible affects):

- Concentration and attention span impaired.
- Confusion
- Racing or recycling thoughts (highly distracting).
- Thoughts scattered and incoherent.
- Rigid thinking and lack of (normal) required flexibility.
- Difficulties with abstract and conceptual thoughts.
- Cause and effect reasoning impaired.
- Themes and threads connecting events not recognised.
- Prioritization (management of one's time and energy) impaired.

Emotional (possible affects):

- Emotionally dead or emotionally hyper.
- Small events of little consequence treated as catastrophic.
- Valent thoughts (not bonded with reality/experience) difficult to shake.
- social withdrawal.
- Recovering alcoholic believes they are going, or have gone, mad.
- Lack of emotion affects personal resolve to stay sober.

Memory (possible affects):

- Recently learned information (within last 30 minutes) quickly forgotten.
- New skills or routines not learned or assimilated naturally (if at all).
- Information retained but then lost after days/weeks.
- Developmental and childhood memories broken (patchy early memory).

It is well documented that in almost all cases, the severity of PAWS decreases as time progresses and that PAWS is stress sensitive.

Clinicians and researchers have found that lowering of stress and healthy habits are helpful in reducing the negative impact of PAWS.

Eating three balanced meals a day, reducing or excluding caffeine, exercising three/four times weekly, and getting 8/10 hours of sleep a night are highly recommended. And meditation, or relaxation exercises are said to be invaluable, once properly learned.

I suppose one needs to say how much one drank and for how long, for the information to be any use.

I drank every day for 10 years -- 85 units of alcohol per week (about 38 pints of 4% beer per week). I have been sober for 29 days.

I'm not counting the first 10 days of quitting, as that rightfully falls into the detox period (sweating, shaking etc.) So here goes -

1. At around day 12 I noticed that when I was typing my finger felt like sausages that were just flopping about and I made tons of mistakes.

2. I forgot where letters and symbols were on my keyboard (weird!)

3. I started spelling some words phonetically ('thay' instead of 'they'). It was like my hands had a (stupid) mind of their own.

Thankfully, the problems with typing and spelling have improved a lot and now I'm back to just thinking what I want to type and my hands doing it without conscious effort, or them doing weird stuff on their own.

4. At 18 days I had a bad spell of wholly inappropriate emotional responses. -Lost my temper with a person I should have deferred to (she was wrong but it was political suicide on my part to make a big deal of it). -Laughed with glee at other peoples' misfortune and suffering. -Had the overwhelming urge to knock a load of old people down like skittles in the supermarket with my trolley (because they were doddering about and blocking the way).

5. Form about day 10 till a few days ago, I was sleeping or in bed 12 hours and more or less just did the minimum to survive.

6. At 14 days I felt as if I was going mad and that drinking would make me 'myself' again. (luckily I knew a little bit about PAWS and guessed it might be a symptom of recovery).

7. Again from day 14 I had enormous difficulties concentrating, and would loose track of a TV after a few minutes and come back after loosing the plot. I had to start watching DVDs instead (that I could rewind because my mind had meandered into the past, cogitating some rubbish memories about someone who did me a wrong years ago).

8. Also, I was stuck regurgitating some nasty prejudices that I thought I had reasoned away decades ago, and felt a strong need to vent my spleen.

For 3 weeks I have been trying to take the recommended step to navigate PAWS (sleep, food, stress, exercise etc.) and have just started getting more energy and am feeling more my old self. A lot of the symptoms I described above have eased or completely gone.

I understand that PAWS is a fluctuating phenomenon (and I might get the symptoms again [especially if stressed] - but probably to a lesser degree than originally experienced) that, in the majority of cases, follows an incrementally improving course. However, my experience of PAWS is far less of a burden than the scary picture painted by the articles I discovered on the Internet.

My guess is that PAWS in low-to-moderate-alcohol-consumption alcoholics is nothing like PAWS in heavy opiate users, who, in many cases have to use opiate substitutes, such as Methadone for the rest of their lives, to keep PAWS manageable, and that for most recovering alcoholics, it is a syndrome that probably lasts weeks or months (with spasmodic re-emergence under stress for perhaps a few years).

I hope people will contribute and we see a pattern emerging (for alcoholics) - the Internet is dreadful for lazy science and research where entire communities copy and paste what might be a flawed original research project. Descriptions of our experiences might further understanding and treatment of PAWS in alcoholics.