Post Acute Withdrawal Syndrome | PAWS – First Survey Now Available
Post Acute Withdrawal Syndrome (PAWS) is a term to describe a condition that can cause a person in recovery from drugs or alcohol addiction to relapse. James F. Davis, a Board Certified Interventionist and an expert on Post Acute Withdrawal and the Kindling Effect, shared recently on BreakingTheCycles.com his excellent article, “Why We Relapse: Post Acute Withdrawal,” explaining PAWS. Today, James shares the first ever published survey on PAWS. James F. Davis is also the founder of a rehab center in South Florida that focuses on PAWS treatment and is himself a recovering cocaine addict and alcoholic with more than 32 years of sobriety. He operates an extensive not-for-profit website dedicated entirely to sufferers of PAWS, PostAcuteWithdrawal.org.
First Survey on Post Acute Withdrawal Syndrome (PAWS) – a Condition that Causes Drug, Alcohol Relapse by James F. Davis
James F. Davis shares the first ever published survey on Post Acute Withdrawal Syndrome (PAWS).
More and more people in recovery are starting to recognize that Post Acute Withdrawal Syndrome (PAWS) is the biggest obstacle to long term sobriety. Unfortunately, addiction treatment centers in the U.S. largely ignore this condition and relapse rates are extremely high as a result. So we set out with the intention of polling recovering addicts and alcoholics in order to gauge the prevalence of PAWS, and what we found is something that should be shared with all people in recovery and everyone working in the treatment industry:
9 out of 10 addicts suffer from Post Acute Withdrawal, but only 1 in 10 receives treatment for the condition.
What’s worse is that survey respondents report that nearly 60% of therapists are not familiar with PAWS, and 72% of physicians have little to no knowledge of the condition.
Overall these results show that PAWS education, treatment and support is virtually nonexistent when compared to the astonishing number of new and relapsing treatment admissions each year.
But some detractors of the concept of addiction as a disease and therefore of the merit of PAWS have argued that an addict being aware of post acute withdrawal syndrome serves no definitive purpose and will not prevent relapse. However, I would argue the exact opposite and my best evidence that the PAWS-position is sound can be found in the single most common question myself and others are asked in regard to relapse and post withdrawal symptoms:
“Am I normal?”
Why is PAWS Education and Treatment Planning Important?
When people in recovery begin to experience symptoms related to PAWS, they often feel like there’s something wrong with them and subsequently many spiral down and eventually relapse. But what we find is that when a person is educated about the condition, knows what to expect and exactly what steps to take when PAWS rears its ugly head, they tend to become much more confident and empowered.
Increased confidence generally means decreased anxiety and lower stress levels. Considering that the Post Acute Withdrawal Survey showed that stress is the leading cause of drug or alcohol relapse, it seems logical that education in this regard should be critical for everyone in recovery.
Additionally, because 26% of the more than 1200 survey respondents experienced PAWS symptoms for more than 2 years, this education should extend even to people who are already well into the first few years of sobriety.
Positive Results
However, the Post Acute Withdrawal Survey results aren’t all doom-and-gloom. For instance, the majority of people who suffer from PAWS do not use medications to treat their symptoms – and for many that’s probably a good thing. Most respondents preferred 12 Step programs as the most effective method of combating PAWS symptoms, with exercise being the 2nd most-used PAWS treatment tool by people in recovery.
Nearly 62% of respondents indicated that their PAWS symptoms were only mild to moderate, and 52% reported the occurrence of symptoms as rarely to occasionally. These results are better than we (the survey authors) had expected.
Treatment & Relapse
61% of respondents had been to an inpatient rehab center, with 66% completing those programs successfully. Unfortunately, only 16% of addicts had heard of PAWS before going to treatment, regardless of the number of relapses. Overall 40% of respondents had only relapsed once or twice in their life, while 32% have relapsed more than 7 times.
Interestingly, the majority of survey respondents (66%) were 9 months or less sober. Because this was a self-reporting survey targeting a large section of people in recovery, this is in line with the rest of the survey results, which indicate that most symptoms of PAWS occur in the first few months of recovery.
These results show a clear need for two things:
1.) Implementation of PAWS education, support and treatment programs at addiction facilities nationwide.
2.) Implementation of intensive aftercare programs to continue for at least 9 months after rehab.
What’s Next?
What can you do to help? Spread the word; discuss Post Acute Withdrawal at meetings with your therapist or physician or among other addiction professionals if you work in the field. Consider researching the condition more on your own by reading the works of Terrence Gorski, Dr. Howard Becker and others in the field. Share your own experiences in the comments below, and feel free to ask any questions and expect a personal response. Most importantly, please share this article; we need to get the word out about PAWS. Every time we share this information, we come one step closer to saving another life.
About the PAWS Survey
The Post Acute Withdrawal Syndrome Survey was managed and sponsored by Recovery First, Inc and PostAcuteWithdrawal.org. The survey’s primary authors are James F. Davis, CAS, and Eric Oakes, LCSW.
Lisa Frederiksen
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Some interesting statistics! It’s obviously very important to get the message across about PAWS. Any information that helps addicts stay sober and clean is very welcome.
Thanks, Carolyn. We’re in the process of re-developing the survey to collect some other critical data such as the correlation between PAWS symptoms and co-occurring conditions and whether long-term PAWS symptoms can be correlated with specific drug types. Because respondents chose exercise as their #2 choice to treat PAWS symptoms, we’d also like to know what the most commonly used exercise types are. If you have other suggestions of information that you feel would be important to collect, just let me know and we’ll take it under consideration.
James F. Davis
The problem with rehab facilities is that usually people are discharged too soon. This is because of the insurance they have(usually state aid) or the lack of insurance. Relapse often follows quickly because of this. Also the 12 step programs are only as good as the people involved. When going to NA meetings a lot of the attendees are still actively using. I’ve attended these meetings and felt more like using after them than before. The big thing is changing people, places, and things. I avoid all users and past users to keep myself clean. Another thing that needs addressed is mental illness. There is a correlation between mental illness and addiction. If the mental illness is not addressed then the addiction will not be overcome.
Thank you, Moxie. I can’t agree with you more; insurance usually dictates what treatment is available, and most rehab centers are discharging people when the real substantial work is just getting started. Warehousing someone in order to keep them clean for the “habit breaking” period of 28 days is easy enough, but our job should extend far beyond that. With more research and education about PAWS, we hope that one day the status quo of the treatment industry will change and focus on long term solutions. By focusing on the short term we’re perpetuating the “instant gratification” mindset that is in reality what makes us addicts.
Like individual addicts, the treatment industry is addicted to the Old Ways. We need to change that.
As I mentioned to Carolyn in the comments above, mental illness is a big part of this and the next version of PAWS survey will seek to uncover those connections – such as co-occurring conditions and how they impact PAWS symptoms. Any other suggestions of pertinent data that you think would be valuable to collect will be seriously reviewed.
Thank you,
James F. Davis