1. Post Acute Withdrawal

2. Student will demonstrate an Understanding of Post Acute
OBJECTIVE:
Student will demonstrate an
Understanding of Post Acute
Withdrawal Syndrome and its
effect on their struggles with relapse.

3. Post Acute Withdrawal - PAW
Definition:
A normal, predictable period of stress when the
alcoholic/addict undergoes experiences that
propel one to “use” despite sincere and honest
efforts to maintain sobriety. (18 – 24 months)
Physiological (Body) hunger for alcohol, pills, drugs leads
To psychological (Mind) discomfort or emotional inebriation
which produces a specific behavior. Recovering person
will experience several of all of these “flare-ups” with
varying intensity for a period of 3 – 5 days at a time,
and periodically over a two-year period during recovery.

4. PAW-Symptoms of Internal Dysfunction
Inability to think clearly
Can’t solve simple problems
Same thoughts keep repeating themselves
Mind goes blank
Can’t concentrate on anything for very long
Can’t make mind up about what to do next
Make bad decisions even when I know better
Can’t Manage Feelings and Emotions
Feel too much; overly sensitive
Feel nothing; emotionally numb
Don’t really know what I am feeling
Feel like I am going crazy as I feel the “wrong” thing
Mood Swings
Feel down in the dumps
Feel worried, but stuff these feelings
Have fears that I can’t explain
Overreact in ways not like me

5. Difficulty in Managing Stress
Memory Problems
I can’t remember things I’ve learned for more than 20 minutes
I can’t remember important things from my past
Sometimes I remember; other times I can’t
Feel cut off from my memories
Make bad decisions because I can’t remember things
Difficulty in Managing Stress
Don’t realize when I am stressed
Can’t relax when I do feel stressed
Hard to relax even when doing things that should help (exercise)
Feel like I am going to collapse, physically or emotionally
Difficulty in Sleeping Restfully
Can’t fall asleep
Have unusual or disturbing dreams
Wake up often and can’t get back to sleep
Wake up feeling tired
Feel sleepy at the wrong times of the day
Sleep around the clock for one or more days

6. Difficulty with Physical Coordination
Lose balance at times
Feel dizzy
Eye-hand coordination “off”
Have slow reflexes
Clumsy
Accident-prone
Shame, Guilt, and Hopelessness
Feel like I am emotionally disturbed
Feel like something is wrong with me; I am no good
Feel guilty because I think I am not doing what I should do
Won’t talk about things that bother me with others
Cover-up my warning signs
Dishonest at times to hide my shame
Can’t handle things
Feel that it is hopeless for me to stay clean and sober

7. Remember: Progression is un-dramatic, difficult to notice, the
individual is not consciously aware of its onset.
It creeps up on you UNLESS you know what to look for:
Bored; restless; anxious; depressed
Difficulty in eating and sleeping
Altered behavior patterns; irritability
Fight or flight
Cut people off; skip meetings; dream of drinking or using
The fall; drink; pop; chip; alibi system takes over
Congratulations! Begin again