Post Acute Withdrawal Syndrome (PAWS)
What is post acute withdrawal syndrome (PAWS)?
PAWS is a group of symptoms that happen after acute alcohol withdrawal. It often happens
when you are no longer in the hospital. PAWS can make it hard to live a healthy lifestyle.
Who does PAWS affect?
PAWS affects people who have had long-term alcohol use. The effects are also based on factors
Length and amount of use
State of health
When does it start and how long does it last?
Acute alcohol withdrawal can last from a few days to a week. PAWS begins after this. Based on
the amount of alcohol you used, PAWS can last for weeks to months. Longer and heavier use of
alcohol can cause more severe PAWS symptoms that can last even longer.
What are the symptoms of PAWS?
Emotional outbursts or lack of emotion
Difficulty dealing with stress
Having a hard time sleeping, strange dreams, and changes in sleep patterns
Memory problems that make it hard to learn new things
Trouble thinking clearly, making decisions, and solving problems
Problems with balance and delayed reflexes
Increased accident proneness
These symptoms can frustrate you and your support system.
What can I do about PAWS?
Know the symptoms and have a plan to deal with them when they happen. Below is a list of
ideas that may help.
Identify your support system. It can be family, friends, counselors, health care providers,
spiritual or religious group. Anyone that supports your desire to stay clean and sober.
Stay in touch with your support system.
Identify emotional states that trigger your desire to use: anger, boredom, sadness,
loneliness. Get increased support when they arise.
Make a daily routine that allows time to rest and relax.
Try to have a routine sleep pattern.
Eat throughout the day. Reduced junk or processed foods and eat more healthy foods,
such as fruit, vegetables, and whole unprocessed foods.
Exercise can help reduce stress and increase your energy.
Treat yourself with patience and understanding.
Take time to take care of your spiritual self and do things that bring you comfort.
Be good to yourself.
Give yourself time to heal. You won’t feel better right away.
A note to your support system
When your loved one is going through PAWS they may need extra support from you. Ask what
you can do to support your loved one through PAWS.
Addictions and Recovery Organization. (2010). Post-Acute Withdrawal (PAWS). Retrieved from
Heilig, M., Egli, M., Crabbe, J., Becker,H.. (2010) Acute withdrawal, protracted abstinence and negative
effect in alcohol. Addictive Biology. Apr;15(2):169-84.
Martinotti,G., Cloninger R., Janiri L.. (2008) Temperament and Character Inventory Dimensions and
Anhedonia in Detoxified Substance-Dependent Subjects The American Journal of Drug and Alcohol
Abuse, 34: 177–183, 2008
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©1/2015. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7228.