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Post Acute Withdrawal Syndrome (PAWS) Experiences

Old 01-25-2008, 04:36 PM
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Post Acute Withdrawal Syndrome (PAWS) Experiences

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.

Last edited by ManchurianC; 01-25-2008 at 04:52 PM.
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Old 01-25-2008, 04:48 PM
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Thanks for this.

Rigid Thinking is a biggie with PAWS.

Keeping an open mind is key to a healthy recovery.

Seren
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Old 01-25-2008, 05:36 PM
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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 still am experiencing some symptoms and I will have 7 years in March. I was primarily an alcoholic. Drugs just interfered with my drinking so I avoided them.
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Old 01-25-2008, 06:40 PM
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Here is the info
I find the closest to my expereinces/observations.

Post Acute Withdrawl - Relapse Prevention Specialists - TLC The Living Center

I've not had any problem with PAWS
since around 6 months of AA recovery.

Opiates are not nor have they been part of my life.
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Old 01-26-2008, 12:55 AM
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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.
I'm gonna break one of my 'inner rules' and go ahead and talk about this, since it seems to be something bothering you.
I usually choose not to talk about PAWS because I feel it might discourage a newcomer or something. I don't know where I GOT that idea, it just seemed like a wise thing at the time. YOu know - being all selfless and all that crap.

After a year and a few months -
if you startle me -
I'm the POSTER CHILD for PAWS.

The people I work with -
Know more about it ... than *I* do.
They see it all the time.
Because they work with me.
They know I'm in recovery.
After a year here -
any little 'PAWS' thing is now officially a 'barb' thing.
How'd all the pens get in this drawer?
Ohhhh. BARB worked last night....
that kind of thing.

I'll tell ya one thing - learn to laugh at it.
May as well.
Because there's apparently nothing that can be done about it.
It's brain damage.
Pure and simple.
A scratch on the great DVD in our heads.

Scary?
Hell yeah.
Becauwse I don't know what I don't know any more.
Until I remember I've forgotten it.
DO people stop drinking when they hear about it?
Nope.
Would I have?
Nah.

I had it so bad when I detoxed, I had to be trained to do this job three count em three times. And I've done this work off and on for almost twelve years.
If I get excited talking to someone about a topic I'm passionate about- I will suddenly forget words. If I get excited here online - I become TYPEZILLA ... unable to type without misspelling every other word.
If we meet in person - dont even bother telling me your name.
I won't remember it.
For months.
But I'll never forget your pets names if I meet them.
Dont' tell me where something is by telling me the street.
Tell me what's on the corner.
Tell me what bar it's near.
Then I can find it.
Some of these 'behaviors' I've had all my life ...
(I'm sorry, Miz Dwyer - I dropped the baby)
But I often wonder,
was it the acid, or was it the booze?
did we live too close to the power lines -
(hey look! a penny!)
did I really sit too close to the tv?
you mean that was true?
or was it all the atom bombs they blew up in the fifties...
WIll it ever go away?
Well, I think NandM just cleared that one up for me.

Yep -
may as well learn to laugh.
otherwise - I'm just gonna get really pissed off.
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Old 01-26-2008, 01:04 AM
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I have no porblem with abstract thinking.
I have problems ... not only thinking linearly...
physically navigating in a linear fashion.

Just the opposite.

For example - one thing -


I'll pour a cup of coffee.
Go to open a packet of sweetner ...
dump the sweetner in the trash -
and drop the empty packets in my coffee.

I've done that so many times now -
I've practically quit using sweetner.
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Old 01-26-2008, 09:37 AM
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Thanks barb dwyer (fascinating post), and thanks lovingseren, nandm and CarolD for the other information.

DO people stop drinking when they hear about it?
Nope.
Would I have?
Nah.
It is difficult moral question barb -- should people be told about PAWS, if it is known the knowledge will significantly demotivate them to quit drinking?

I'll dig around on the Net and see if it is possible to suggest a broadly accurate prognosis for PAWS (based of the details of the addiction). Information collected so far indicates PAWS is somewhat random in severity and duration among recovering alcoholics with the same profile.

Oh well
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Old 01-26-2008, 10:05 AM
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Thanks ManchurianC

Yes, I would like to hear more. So if you find out information, would be interested to read it. I had problems with thinking clearly for about 3 months after I quit drinking. At one point I thought I totally lost my mind. But every day I would get a little better. And today I feel ok and don't have any problems. But I wondered if that is what was going on with me.
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Old 01-26-2008, 10:54 AM
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I went through "the terrible two's" between 18 months to three years sober, I was very rigid in my thinking, everything was either black or white.
I am happy to report I am much more flexible in my thinking these days.

Seren
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Old 01-26-2008, 11:01 AM
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Thanks for this thread and all the informative posts. I have two weeks sober and can really identify with a lot of the symptoms. It is a relief to know other people have gotten through this stuff. So maybe I'm not going mad after all!
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Old 01-26-2008, 09:40 PM
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I enjoyed this thread too.

And remember - I said - if you STARTLE me.

I've had people ask me if I'm drunk - because apparently my speech changes - just like all that I read about it when I first got sober... only it's over a year later.

Now, I'm NOT like that all the time - and I was quite abstract to begin with.

But it does come back.
And some of us have more damage than others.
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Old 01-26-2008, 10:03 PM
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Ahh, so thats what i had, PAWS. Cute name for some ugly symptoms. Same symtoms as a head injury, i have had 6 major concusions. So between Paws and concusions i am doin just fine
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Old 01-27-2008, 02:41 AM
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It *is* a head injury, IMO
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Old 01-27-2008, 11:22 AM
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Originally Posted by barb dwyer View Post
It *is* a head injury, IMO
IMHO, my experience is although I did suffer a significant head injury several months prior to my stopping drinking there was and is a difference between the residual effects of that and PAWS symptoms although sometimes subtle.

Knowing what I know about both I can see the effects of both acting on me today.
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Old 10-09-2009, 10:23 PM
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I recognise that this is an older post, but no doubt people searching for answers will read these old threads. I just wanted to add my two cents.

- Most days I don't go out in public because I feel retarded.
- I hate going shopping, because I walk around in a daze, not knowing where things are in the supermarket.
- When family friends come over, I interact with them, but I feel like I'm 'acting', and not really myself.
- My short-term memory is really bad. I'll get to dinner time and wonder what I did all morning.
- I sometimes get stressed not knowing what I did in the morning. But it doesn't matter, it's just irrational worry.
- I repetitively think about the same old argument that I had with a friend. I don't care about it, but my mind likes to think about it.
- I sleep okay some nights, other nights, I sleep terribly.
- I crave sweet food, especially chocolate, but have found that 'glutamine supplements' helps with my sugar cravings. (they also help with my mood, and sleep)
- Most days I feel like I'm living in a dream.
- When I have good days, it's like I forget what it was like to feel 'not like myself'.
- When interacting with people I'm often on autopilot.
- I used to not be able to concentrate when I watched movies, I'm getting better at it.
- My concentration is better, but only lasts for about 15 minutes... but it improves on at off all the time.
- I am fatigued all the time.
- Green tea relaxes me.
- my emotions are either vacant, or extreme.

I can't write anymore on here... because I am losing my focus, but I'm ALWAYS available to discuss PAW's symptoms with anyone who wants to talk about it.

i know how it feels, to feel like you're going crazy. to feel like you're losing your mind.

like ManchurianC - i got very frustrated at old people walking slowing in the supermarket.
I get frustrated with bad service, with heaps of things.

blah, blah, blah...

message me, if you need to talk. it helps.
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Old 10-09-2009, 11:05 PM
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all of these posts make me grateful for having dodged the bullet on paws, except serens. 18 months, eeeek! Oh well, one day at a time right? I will worry about that if/when I need to.

Maybe I didnt get the crazies so bad because I was all ready a super healthy eater, I work out/exercise almost every day, and sleep really well most nights. It is also really good to know that it goes away or improves lots with time.
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Old 10-10-2009, 12:02 AM
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Andy.....Welcome back to SR

Have you had a recent medical check up?
That is always a wise idea I think.

I sure hope things improve for you soon...
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Old 10-10-2009, 07:08 AM
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I think this thread is timeless....thanks for digging it up.

I have almost 16 months sober and have found a lot of the PAWS symptoms have left me. I'm glad to see that in time, I may lose more of the symptoms. Just another reason to enjoy Sobriety.
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Old 10-10-2009, 03:45 PM
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I'm going on 13 months, and I still have some concentration and memory problems (sometimes can't remember things I did 30 mins earlier).

Other than that, I feel pretty good.
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Old 10-10-2009, 11:55 PM
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Grr, I hate PAWS. I'm a freshly sober person, but the last two months, this has been the answer to almost every question I have had--and I can't remember what's on the list. Have to keep looking at it again, and I keep forgetting to do that.

In fact, I'd like to add a whole category under the Memory section, don't know if it's me only or more universal.

I have forgotten everything I ever knew. I got lost on a block I lived on for a few years until April--this morning. A major city street, in a straight line, I couldn't remember which way to the store. Had to look. Schoolwork, discussions in class--my teachers are remarking that I'm not as good at remembering details in open debates like I used to. Don't remember anybody's name/ department/ position, but I never was good with names, so that's okay I suppose. I took a test detoxing and did better than one a week later--I could not remember basic things. I have had to write down appointments and such for the first time in my life.

I can barely walk in a straight line, and if I have to walk up stairs, I will bounce off both walls as I ascend--reaching out with my hands to 'catch' me. And that's with careful attention placed on the "left foot...good...now move the right one...*right* one, not that one, that's the left... okay good... left again..." part of walking around.

"Emotionally dead or emotionally hyper," usually the latter. That's what drives me to post things only to have somebody send me back to the PAWS stuff.

The cognitive, that one I seem to have avoided.

Mostly it's the memory. And the emotions. But the emotional part is right for me as written. The memory part is missing a lot of what's going on with me.

If it matters, I drank a bunch, for about 20 years, till I needed a quart or two of hard liquor to get through the day without shaking. Through it all I ate very healthy, exercised moderately (heavily when I was younger), and had a really good memory.

Okay, I admit, I'm upset about losing my memory. I liked it--it was very convenient.

Would knowing this have made me keep on drinking? No... I know it now. And I'm still trying for more sobriety--it's a trying thing, but it's a better feeling than uncertainty and despair and an empty bottle that needs to be replaced... again. What would have scared me off is knowing about detox...

So here I am, PAWS and all.

-TB
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