PAWS: In contrast to acute withdrawal, symptoms of PAWS generally occur 2 months or more after drug cessation and are primarily psychological in nature, affecting a person’s mood, sleep patterns, and response to stress. The symptoms of PAWS generally last for several months in people recovering from addiction, though they can disappear in a matter of weeks or, in rare cases, persist for a year or more.
The term was created to describe the cluster of ongoing withdrawal symptoms, which are largely psychological and mood-related, that can continue after acute withdrawal symptoms have gone away. Although post-acute withdrawal rarely involves aches and pains, nausea, cramping, headaches, or other physical symptoms, it can be just as intense as acute withdrawal and still puts a person at risk of relapse, as they may return to drug use in an attempt to stop the discomfort.
It is Sunday morning and the beginning of Day 19 for me. I am not so impressed with my 19 days of sobriety– I’ve been here before. It is around this time that Betsy starts to get really loud. She starts to say things like, “This is stupid. What are you trying to prove? You don’t have a problem, you just had two great happy weeks alcohol free! What’s a little wine going to hurt? You deserve this. I know they say you can’t moderate, but that’s only for those with a problem. Are you really going to go through the rest of your life without drinking? That’s stupid! There’s no point.” and so on.
This has been my cycle since May, about 6 months now. I quit, dump my alcohol, resolve to do better and start counting the days. For a week or two weeks, I am in a good place. I’m happy to be AF. After 2-3 weeks, Betsy starts talking. They say a craving lasts 20 minutes, so I wait 20 minutes– but she’s still yapping. I go to bed and wake up happy that I didn’t drink the night before. However, something throughout the day will trigger Betsy and she starts jabbering relentlessly. She pipes up the most vulnerable moments, even if I don’t realize that the moments are testy. For each consideration I silently give, her tone gets louder and more aggressive. Eventually after a day or two of Betsy’s initial persuading, I give in and she wins.
Although I’ve heard the term PAWS before, I didn’t realize that this is more than likely why I’ve failed after 2-3 weeks. As my brain chemistry is still returning to normal, parts of my brain are panicking and giving me signals that I need or want alcohol. Knowledge is power. Now I know that when I get an urge, it’s not the same as a craving. It’s not likely to go away after 20 minutes, but likely to stick around for 58-72 hours.
When I first quit drinking in February 2017, I didn’t drink for over 90 days. Week 1 was really hard, week 2 was easier, but I think weeks 3 and 4 were the hardest. I was tired and irritable and questioned my sobriety multiple times a day. I was exhausted and told my therapist that there is no point, since I wasn’t feeling exceptional like I thought I should be. Why not drink vodka if it makes me feel so much more energetic and happy? I think if I hadn’t had this conversation with her, I probably would have given up. She helped me see things for what they really were (although she was not an addiction therapist and didn’t mention PAWS). In retrospect I think it was PAWS rearing its ugly head. I remember things really looking up and life being really good after week 4 four.
Why rehash? As I’m heading into week 3, I’m realizing that this may be a difficult week to stay sober. Even though I’ve had 19 overall good and easy AF days (I’ve not really craved very often), this could be the breaking point.
I. Don’t. Want. Another. Day 1.
I’m not going to do it. This could be a miserable week, but I won’t give in to my inner alcoholic. There are much bigger things than PAWS, than weeks 3 or weeks 4 or 5. So, NO Betsy. I DON’T DO THAT ANYMORE.