Learn about protracted withdrawal, why you might experience unpleasant symptoms and what to do if your symptoms just won’t go away.
What do you do if your withdrawal symptoms don’t end when
they’re supposed to?
Well, firstly, know that protracted withdrawal are normal
and they will pass in time …you will get better eventually!
But when you’re unprepared and you get blindsided by
symptoms that just won’t quit – or by symptoms that come back even months after
you think you’re in the clear, it’s easy to get discouraged and relapse back to
drinking or drug use.
So get prepared - read on to learn more about the second
phase of the withdrawal process, something that can last for many months or
even years after your quit date – and be ready to make it through to the other
Acute vs. Protracted Withdrawal
When you suddenly stop using a drug you’ve become addicted
to you experience a brief period of generally unpleasant withdrawal symptoms.
The time frame can vary a bit, but in general, acute
withdrawal will endure:
||Acute Withdrawal Timeframe
||5 to 7 days
||1 to 4 weeks; 3 to 5 weeks with tapering (i.e., reducing dosage gradually)
||2 to 4 weeks
||4 to 10 days (methadone withdrawal may last 14 to 21 days)
|Stimulants (e.g., amphetamines, methamphetamine, cocaine)
||1 to 2 weeks
Acute withdrawal symptoms should largely disappear by the
end of the predicted withdrawal duration.
Protracted Withdrawal (Post Acute Withdrawal Syndrome - PAWS)*
So withdrawal symptoms are supposed to end at the end of the
acute withdrawal period – but sometimes they don’t!
When your withdrawal symptoms continue on
for longer than they’re supposed to and/or when you also start experiencing
more general (non-substance specific) withdrawal symptoms that persist for longer than
the acute withdrawal period - you are in protracted withdrawal.
* Another common name for protracted withdrawal is post acute
withdrawal syndrome (PAWS).
Does Everyone Get Protracted Withdrawal Symptoms?
- Some people experience no withdrawal symptoms after the end
of the acute withdrawal phase
- Some people find that acute withdrawal symptoms last for far
longer than they’re ‘supposed’ to
- Some people feel a lot better at the end of the acute
withdrawal period and then a month or two later withdrawal symptoms come back,
as if out of nowhere
Common Protracted Withdrawal Symptoms
Not everyone will go through protracted withdrawal and
individual symptoms will vary depending on the drug(s) of abuse, your physical
and mental health and other factors.
But that being said, some common protracted withdrawal
- Insomnia and other sleep problems
- Chronic fatigue
- Anhedonia (an inability to feel pleasure, or as much
pleasure as you used to)
- Short term memory problems
- Drug or alcohol cravings
- Concentration problems
- Aches and pains
- A loss of libido
Why Do You Get Protracted Withdrawal Symptoms?
When you use drugs or alcohol for a long time your brain
changes (an adaptation) and researchers can see these changes at the molecular
and cellular levels and through changes to neurocircuitry (how the brain
These changes can affect your emotions, thinking
capabilities and ability to resist impulses, and it can take a long time for
your brain to revert back to a pre-addiction state of functioning.
Basically – through a long period of heavy use you induce
some significant changes to your brain’s structure and functioning, so it’s not
totally surprising that your brain needs a few months or longer to get back to
Getting Through Protracted Withdrawal
Even if there is full recovery from the withdrawal symptoms, the actual devastation to a person's life during a long withdrawal, lasting for months, can be ruinous.
What's more, protracted withdrawal increase your
risk of relapse – so to keep your recovery on the right track, even when
passing through the doldrums of post acute withdrawal symptoms, make sure to:
Understand that things will get better – Though it may seem
like you’ll never feel like your old self again, even protracted withdrawal will pass and in time. Understand that brain healing occurs slowly, but surely,
and with patience and perseverance you will make it through.
Maintain good sleep habits – Since protracted withdrawal can lead to sleeping problems and sleep deficits can lead to relapse it’s
important to make a good night’s sleep a priority. If protracted withdrawal has you tossing and turning, lean more about good sleep hygiene and habits and
make a few simple but effective changes to improve your odds of a restful
Stay involved with community support groups (like AA) – The
support, encouragement and knowledge you find at community mutual self help
groups can help you to stay on the right track and to identify dangerous habits
before the pull you down to relapse. At community meetings, you’ll also get
advice and encouragement from a group of people who understand exactly what
you’re going through.
Stay active – Exercise relieves stress, increases positive
emotions, promotes healthy sleeping and helps distract you from triggers and
cravings…all in all, exercise is a must-do
Reduce stress – Getting through the initial recovery period
is tough enough, so give yourself some room to breathe by minimizing your
outside commitments and responsibilities for a while. This way you can take
care of the most important thing…yourself.
Consider medications – Certain medications, like acamprosate
for alcohol and methadone or Suboxone for opiates, can alleviate some or all of
the protracted withdrawal symptoms you may experience. Talk to your doctor or
therapist about the pros and cons of adding medications to your recovery
Consider therapy – certain therapies, like cognitive
behavioral therapy, teach skills that help you to compensate for the diminished
cognitive functioning and poor impulse control that are typical to many
Warnings and precautions about protracted withdrawal must be part of any pharmacological treatment plan. Don't go through protracted withdrawal without medical support.
Image Copyright: Sherman Geronimo-Tan
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All the best to you and yours,