Post Acute Withdrawal Syndrome

James has been clean and sober for six months. He attends 12-step meetings every day, he walks his children to school, he has returned to his career on a part-time basis, and he has assumed most of his pre-addiction responsibilities. Everyone is happy with him. His wife is astonished at how quickly he was able to get off drugs. His mom and dad wish that they could give him the Medal of Valor for accomplishing what their other adult children have not been able to do: James has gotten off drugs. His kids are happy to have their "old" dad back again, and all is well -- except for one thing: James feels miserable.

PAWS is Discouraging but Normal.

Inside, James is dying. He forgets what he's talking about in mid-sentence, he has almost crippling anxiety and depression, he shakes all the time, and even the simplest tasks feel overwhelming to him. He has also become accident prone and clumsy, has difficulty managing stress, is filled with self pity, and sometimes feels numb. Everyone else is convinced that James is okay, but behind his facade of happiness, James feels out of control.

But James is not cracking up. He has post acute withdrawal syndrome.

What is Post Acute Withdrawal Syndrome?

Post Acute Withdrawal Syndrome (or PAWS) is the brain's adjustment to living without chemicals. During periods of addiction to drugs or alcohol, there is artificial stimulation and disruption of normal brain function. The brain gets used to the drug. Altered brain cells and their functioning take 6 to 18 months to return to normal. PAWS can be moderate to severe.

A Bad Day of PAWS is Better Than a Good Day as an Addict.

Post Acute Withdrawal Symptoms

• Forgetfulness
• Self-pity
• Defensiveness
• Difficulty thinking clearly
• Accident prone
• Denial
• Problem with managing stress
• Difficulty handling feelings and emotions
• Problems sleeping
• Compulsive behavior
• Over-reacting or feeling numb

Every recovering addict or alcoholic experiences PAWS symptoms -- some more than others. It's important for people in recovery to know that what they are feeling is normal for someone learning to live without drugs or alcohol. It doesn't feel normal, but it is to be expected.

This Too Shall Pass. . .

These things help the person with PAWS:

• Don't isolate.
• Keep expectations (of self and others) reasonable.
• Eat three regular meals a day.
• Limit work to 40 hours per week.
• Maintain family relationships.
• Journal feelings.
• Take vitamins.
• Regularly attend 12-step groups (NA, AA, CA, etc.).
• Learn relaxation techniques.
• Call other clean and sober friends.

Eventually You Will Feel Better.

Related Links

Post–acute withdrawal syndrome -- (This site gives a concise definition of PAWS): http://en.wikipedia.org/wiki/Post%E2%80%93acute_withdrawal_syndrome


Post-Acute Withdrawal Syndrome (PAWS) — Why we don’t get better immediately? -- (This article is about the changes in neurological function that occur after withdrawing from drugs and alcohol, aka, PAWS): http://digital-dharma.net/addiction/post-acute-withdrawal-syndrome-why-we-dont-get-better-immediately/


Post Acute Withdrawal Syndrome (PAWS) -- (This article is about the three major areas that PAWS impacts an individual: Cognitive processes, the emotions, and memory): http://www.interventionctr.com/paws.htm


Post Acute Withdrawal Syndrome -- (This is about the brain's adjustment, while returning to a life without chemicals): http://www.hopelinks.net/addiction-treatment/post-acute-withdrawal.html


Post Acute Withdrawal Syndrome (PAWS): An Easy to Understand Explanation -- (This site gives the definition, affects, and articles on PAWS): http://www.squidoo.com/postacutewithdrawalsyndrome

Addiction: You Don't Have to Talk About It

Unless you die of an overdose, you don't have to talk about your addiction or your recovery from addiction. Well, if you're dead, you won't be the one doing the talking anyway, but everyone else will!

What motivated this rant was an actress on a talk show I watched last night. With every topic of discussion, she tossed her drug recovery into the ring. It was annoying to hear this on a comedy talk show because addiction is not funny.

When celebs "broadcast" in a discussion about their taking drugs and their recovery from drugs, it sets up a precident for everyone who has ever had a problem with drugs or alcohol. This is not to shortchange the work of many celebrities and regular folks in overcoming their addiction problems. There is nothing harder to pull off than to recover from addiction. Anyone who succeeds is a giant in my eyes.

If a recovering addict wants to talk about his addiction, that is his prerogative, and I wish him the best. I'm not saying that he is wrong to talk about his recovery -- even online. But, sometimes in their enthusiasm to help others, recovering addicts share dark secrets about their drug pasts that are just as well left unsaid.

An addict in recovery should be known as a really nice guy, or a great actor, or a generous philanthropist -- not as an addict. People are so much more than their addictions -- they are moms and dads and co-workers and valued friends. Why tarnish their image? Not everyone shares my positive views on addicts who have overcome the disease of addiction. In fact, many people (like potential employers) are downright mean spirited about it.

Just something to think about. Addiction is ugly and deadly -- and there is nothing (and I mean nothing) funny about it. 

Meth Kills



Methamphetamine (or Meth) is a powerful, addicting drug that stimulates the central nervous system and delivers an intense euphoria that lasts anywhere from an hour or two to 24 hours at a time.  Withdrawal from methamphetamine, though, is no easy endeavor.

What are Meth’s Withdrawal Symptoms? 

Withdrawal from methamphetamine causes long and short-term symptoms which may include:

 •Anhedonia (the inability to experience pleasure)

 •Drug cravings

 •Irregular heartbeat

 •Extreme irritability

 •Depression

 •Sweating

 •Hyperventilation

 •Convulsions

 •Confusion

 •Nausea

 •Insomnia or excessive sleeping

 •Loss of energy

 •Tremors of the hands

Loss of Control:

When an addict gets to the point where he goes into treatment, it is usually because he has reached the end -- or his “bottom.”  He has nowhere else to go, and may even enter drug rehabilitation because he has been mandated there by the court system.

Why Enter Treatment?

The best way for a meth addict to withdraw from his drug is to enter drug treatment.  A medical-model facility is best because the withdrawing addict is monitored at all stages of his withdrawal.  Often a medical-model detox facility will provide a withdrawing addict with “step-down” drugs to make the withdrawal less painful.

After Detox, What Happens?

After withdrawal, the recovering meth addict should go directly to treatment, where he will learn strategies to help him cope with life as a thinking, feeling person without the use of methamphetamine to make it more tolerable.  This is the most difficult part of recovery from meth because many life skills must be re-learned, and this can be painstakingly difficult.

In rehab, the recovering addict continues to recover physically, as he learns more about the destructiveness and danger of his drug and assimilates into his life the new coping strategies he is being taught.

A Relapse Plan:

Before leaving treatment, the recovering meth addict will learn how to prevent relapse and develop a relapse plan where he contracts with his counselor to utilize his relapse plan, if he ever has a strong urge to resume using methamphetamines.

12-Step Program:

After treatment, every addict should enter a 12-step program, like Narcotics Anonymous, where he will find empathy and understanding from other recovering addicts.  Because it is one addict helping another, the 12-step support system is very effective in preventing drug relapse.  

Addiction is a Disease:

Both the American Psychological Association and the American Medical Association classify addiction as a disease because it is chronic, progressive, and fatal, if not arrested.  But because of the behaviors associated with the Disease of Addiction, such as stealing and lying, along with the burden it places on families, it is difficult for an addict’s family to look at addiction as a disease.  This is understandable because they end up experiencing, sometimes, more pain than the addict.  Hence, the family of an addict needs to heal also.  Most treatment programs offer help for families of addicts.

How Do I Begin?

If you are an addict in the throes of methamphetamine withdrawal, take heart, because, as they say in Narcotics Anonymous, "This, too, shall pass."  You only have to stay off meth one day at a time.

If you are looking for help with a methamphetamine addiction, I have listed places and resources that will put you on the path of recovery.

Don’t let methamphetamine ruin your life.  Free yourself today.

Resources:

Help Finding Treatment:    http://www.oas.samhsa.gov/tx.htm

Narcotics Anonymous:  http://www.na.org/

Alcoholics Anonymous:  http://www.aa.org/?Media=PlayFlash

Al-Anon and Alateen:  (Organizations for Family Members of Addicts and Alcoholics):  http://www.al-anon.alateen.org/meetings/international.html

I'll Quit Tomorrow by Vernon E. Johnson.  Available at bookstores and on Amazon at: http://www.amazon.com/Ill-Quit-Tomorrow-Practical-Alcoholism/dp/0062504339

** The author, Jenna Pope, is a Certified Alcohol & Drug Counselor and has spent the last seven years writing about addiction and helping addicts to break free from meth and recover.

Changing Our View of Addiction

According to the U.S. Department of Justice, in 2009, 50.7 percent of the inmates in United States federal prisons were there for drug offenses. This percentage represents an increase of 28.2 percent from 2000 to 2009. Just in case  you’re not convinced that these figures are problematic, let me give you some more.

Drug Incarcerations on the Rise:

With drug incarcerations rising so consistently, the decrease in releases from prison and re-incarceration for technical parole violations, there is a gargantuan  problem of overcrowding in state and federal prisons. In 40 out of 50 states, the prisons are at 90 percent or more over capacity. Twenty-three of those states are operating at over 100 percent capacity. How cou any addict become rehabilitated in an environment like that? It could, therefore, be surmised that nonviolent drug offenders enter prison with a drug problem and are paroled from prison with a drug problem. Only now, violence may have become part of the equation because of repeated exposure to violence while in prison.  

The Disease Concept:

The American Medical Association and the American Psychological Association use the disease-model approach to addiction. This is because addiction is chronic, progressive and fatal, if not put into remission. This is like cancer, but if you entered prison with cancer, you would receive chemotherapy, radiation and other aggressive cancer treatment. Even one the Manson Family murderers, Susan Atkins, received cancer treatment while in prison.

Drug Program Failure:

In California, the SAP (Substance Abuse Program) was an abysmal failure. While not going into the reasons for this failure, it must be said that though it didn’t work, there are other models of treatment that should be implemented until a successful one is found. Otherwise, we are going to waste more taxpayer money incarcerating drug offenders, releasing them and then re-incarcerating them for similar drug or drug-related offenses. To even a totally uninformed citizen, this revolving-door approach to drug addiction must seem entirely counter-productive.

Look at this quote from the Justice Policy Institute:

"Substance-involved people have come to compose a large portion of the prison population. Substance use may play a role in the commission of certain crimes: approximately 16 percent of people in state prison and 18 percent of people in federal prison reported committing their crimes to obtain money for drugs. 21. Treatment delivered in the community is one of the most cost-effective ways to prevent such crimes and costs approximately $20,000 less than incarceration per person per year.22 A study by the Washington State Institute for Public Policy found that every dollar spent on drug treatment in the community yields over $18 in cost savings related to crime.23 In comparison, prisons only yield $.37 in public safety benefit per dollar spent. Releasing people to supervision and making treatment accessible is an effective way of reducing problematic drug use, reducing crime associated with drug use and reducing the number of people in prison." 

It is time to stop sending addicts to prison. Lowering recidivism will cut down on prison costs, elevate the status of addicts to people suffering from a disease, and it will cut down on crime.

Re-educate Society:

Why can’t society be re-educated in the disease-concept of addiction when it must be obvious to most people that the “Lock-‘em-up-and-throw-away-the-key” approach isn’t working and is a colossal waste of money that could be directed into solutions that do work.

Addiction is not a criminal problem or a failure of will. Rather, it is about biology and resultant behavior – a disease that society is treating like a crime.

Sources:

1.  Justice Policy Institute, "How to safely reduce prison populations and support people returning to their communities,"(Washington, DC: June 2010), p. 8. /www.justicepolicy.org/images/upload/10-6_FAC_ForImmediateRelease...

2.  American Psychological Association, “What does it mean that addiction is a brain disease ,” Alan I. Leshner, Ph.D.; June 2001 http://www.apa.org/monitor/jun01/sp.aspx

3.  Get the Facts: Prisons & Drug Offenders; 2011 http://www.drugwarfacts.org/cms/node/63