Post Acute Withdrawal
(PAW)
The Sobriety Based Symptoms of Recovery
PAW- What is it?
PAW is the symptoms/things that people
experience after they stop using alcohol or
other drugs.
They are usually experienced after 7-14 days.--after the early withdrawal. May vary with
different drugs.
They are usually worst 3-6 months into
recovery
They usually last from 6 months to 2 years
Let’s take a closer look
What things did you experience during
your using days?
What happens when you stop
using—especially during the first
one or two weeks?
This is typically the Acute
Withdrawal time.
The Brain is impacted long
after this first few days after
you stop using.
If people don’t
understand these
symptoms, that can
increase the chance
of relapse.
But the more you
know about them, the
better you can learn
to deal with them.
Two Things to Remember
1. The damage to the
brain is usually
reversible—things
will get better—there
is no need to fear.
2. With a good
recovery program
and not using alcohol
or other substance,
your brain can get
back in balance.
We’re going to do two things in
the next few minutes:
Get a chance to know
what these PAW
symptoms are-And more
importantly, we’re
going to look at the
tools you can use to
deal with these
symptoms.
Now Let’s look at the PAW
Symptoms:
Inability to think clearly
Memory Problems
Emotional Overreaction or Numbness
Sleep Disturbances
Physical Coordination Problems
Oversensitivity to Stress
Thinking Problems
Have a hard time
concentrating/paying
attention.
Having rigid,
repetitive thinking.
Difficulty dealing
with non-concrete
(abstract) concepts
or ideas.
Memory Problems
 Short term memory:
 Hear something and
understand it, and 20
minutes later you can’t
remember it.
 Long term memory:
 Sometimes,under stress,
can’t remember
important events from
the past. They aren’t
gone, just forgotten for
the moment.
Emotional Problems
Over-reaction to
situations-everything
becomes a “big
deal.”
When the stress gets
too great, tend to
“shut down”—
become emotionally
numb.
Sleep Problems
 Unusual or disturbing
dreams.
 Hard to fall asleep.
 Difficulty staying asleep.
 Restless sleep; don’t feel
rested when you awake.
 Changes in
sleeping/awake cycles.
Physical Coordination
Problems
Trouble with balance
Dizziness
Poor eye/hand
coordination.
Clumsiness
Accident Prone
Slow reflexes
Difficulty dealing with Stress
 Can’t recognize stress at
low levels.
 Over-react when stress is
recognized.
 May do things
inappropriate for the
situation.
 Other PAW symptoms
become worse under
stress.
No wonder I have a hard time
getting along
You may feel—
Embarrassed
Filled with Shame
Feel inadequate or
“less than others”
OK, Show me
how to deal
with this…..
Managing the Symptoms
You can manage the
symptoms so they:
Become less frequent
Are less severe
Last shorter periods
of time.
Here are some of the recovery
tools you’ll need to use.
1.Get regular feedback
from those you trust:
Therapy group
Professional
counselor/doctor
Self-help group
Sponsor
Need reality
checks.
2. Verbalize: Need to
talk about what your
experiencing.
But talk to people
who are not going to
accuse, criticize, or
minimize.
It helps your
awareness of
symptoms.
And More Recovery Tools
3. Ventilate : with “safe
people” talk about
what you’re thinking
and feeling even if it
seems irrational.
Be open to helpful
feedback.
4. Reality Testing:
Ask someone you
trust if you are
making sense—not
just what you are
saying, but also your
behavior.
And More Recovery Tools
5. Problem Solving and
Goal Setting:
Identify and Clarify
the Problem
Identify options and
best possible outcome
Get feedback if
needed
Take action and
review outcome
And More Recovery Tools
6. Backtracking: If
something isn’t going
well, stop and look at
when things got off
track. What could be
done differently?
Were there any PAW
symptoms? How can
you get back on
track!!!
And More Recovery Tools
7. Education and ReTraining:

Learn all that
you can.

Knowledge is
Power

As a recovering
person you need to
know what is normal.
8. Self-Protective
Behavior:

When all is said
and done, you need
to do what it takes to
strengthen the
recovery that you
value and gives your
life hope.
And More Recovery Tools
9. NUTRITION
 Reduces stress!!
 3 balanced meals and 3
snacks each day
 Reduce sweets, caffeine,
and nicotine
 YOUR RECOVERY
DIET!!
And More Recovery Tools
10. Treat yourself to
EXERCISE each day
 It relaxes, calms, and
reduces tension.
 Produces brain
chemicals that make you
feel good.
 Helps improve sleep
 Helps weight control
 HELPS YOU FEEL
GOOD!!!
And More Recovery Tools
11. Relaxation--Natural
Stress Reducers:
Daydreaming
Laughing
Playing
Music
Reading
And more:
Taking a walk
Singing
Taking a hot bath
Soaking your feet
Massage
Relaxation tools
Deep Breathing
Tense/Relax muscles
Spirituality
12. Spirituality as a
key to healthy
recovery:
One of the best ways
to deal with early
dual recovery is to
have an active
relationship with a
power greater than
yourself.
And More Recovery Tools:
Spirituality
Meditation:Practice
listening to and
coming into the
presence of your
Higher Power—
praying only for
knowledge of my
HP’s will for me and
the strength to carry
it out.” (Step 11)
 Prayer—conversation
with your Higher Power
 Turning it over
 Letting Go
 Journaling—keeping a
personal record of
thoughts, feelings, ideas
 Spiritual Fellowship
friendship based on
shared spirituality
And More Recovery Tools:
SIMPLICITY
GROWING SPIRITUALLY ONE STEP
AT A TIME
Personal Inventory:
In the morning to plan the day
In the evening to review the day
Your Keys to Dual Recovery
The HOW of the Program
HONEST about what is happening,
OPEN to feedback and support
WILLING to use the tools of
recovery