01/23/2026
Post-acute withdrawal Syndrome (PAWS) is defined as a set of persistent impairments that occur after the initial withdrawal phase from substances like alcohol and opioids.
These impairments are a collection of protracted withdrawal symptoms that linger even after the acute withdrawal period has ended, reflecting the lingering effects of drug use on the brain and body.
According to Johnson, Journal of Addiction Medicine (2023), PAWS can include cognitive and emotional instability, which can hinder the recovery process and increase the risk of relapse.
The duration of PAWS varies widely, but it generally lasts anywhere from a few months to several years, depending on the individual and the substance involved. The initial period of PAWS begins shortly after the acute withdrawal phase and persists as a stage of opioid withdrawal or after someone stops drinking alcohol.
According to Smith in the Archives of Clinical Psychiatry (2022), PAWS typically lasts between 6 months to 2 years, although some symptoms may linger longer in cases of severe dependence or prolonged substance use.
This extended duration of PAWS shows that individuals with PAWS are at a higher risk of returning to substance use. The syndrome is considered a critical aspect of supporting neuroadaptation during the extended recovery process.
According to the National Institute on Drug Abuse (NIDA, 2022), there is a prolonged challenge that PAWS presents compared to the more acute phase of withdrawal.
It underlines the need for ongoing treatment and support long after the initial withdrawal symptoms have subsided emphasising the need for comprehensive care and support systems to maintain cognitive and emotional stability during this vulnerable period.
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