PAWS and Relapse....

[catch22]

Just been looking up on dry drunk and this really stood out for me...so i thought i share it with yous today....they had other subjects, Disability and Addition, Resentments and Addition, Debt and addiction, vacations and Addiction, Loss, addiction, and Recovery, Death and Addicition, Cross Addiction, Denial and Addiction, Medication and Addiction, wish i had time to type it all out wont let me cope and paste for some reason.

PAW, also known as Post Acute withdrawal syndrome, is often a major factor when a person relapses. the symptoms of PAWS can cause aa person to think he/she is going 'crazy', is just losing it And as a result, they frequently relapse if they are unable to deal with the PAWA issues.

There are six are 1 - an inablility to think very clearly, 2 - memory problems, 3 - emotional overreaction or emotional numbness. 4- disturbances of sleep, 5- physical coordination issues, 6 - sensitivity to stress.

when one, or more, of These symptoms is present, a person can become greatly destressed, and may turn to addicitive behaviors, may relapse, to alleviate that distress.

PAWS is present, to varying degrees, in all recovering persons. It is exhibited in four basic styles: 1 regenerative (getting better over time), 2 -Degenerative (getting worse over time), 3- stable (no gteart changes), 4 - intermittent (comes and goes.) The time it takes to overcome PAWS can vary greatly, and the degree to which it will be eventually be eliminated is detemined, to a large eatent, by the amount of damage a person has done to their mind their body.

This is what i have to be careful with i did not realize its call PAWS and Relapse, i had this last time felt like i was going crazy, does anyone else feels like this?

Thanks for reading.x

[Guest]

PAWS and Relapse....

Catch,
Yes, I have a bookmark to a site with this information.

I have all the symptoms. Memory lose of the name of everyday items, what I was just going to do a moment ago is driving me crazy!. Insomnia is a major issue! Emotions up and down, and I have to think to design in my business, very disturbing at times to draw a blank when trying to work through a design problem!
I read this can go on for years, I just can't believe that to be true,I am hoping after a few more months this will disappear.

[Doggygirl]

PAWS and Relapse....

Catch this is a great topic! I had a lot of sleep issues but I'm not sure how much of that was strictly related to coming off AL v. related to hormone / menopause stuff. What I distictly recall as being absolutely related to AL were several weeks of mixing things up verbally. (must have a mental connection too, or originate in the mind!) I would start to say something and just switch words around.

The good news is that it passed! I wasn't journaling or anything so I'm not sure exactly how long that took to get better. It's scary to think back on that and realize how much brain damage I've probably done to myself over the years.

DG

[mollyka]

PAWS and Relapse....

yes, I remember the word thing DG, I reckon my brain is not as sharp as it used to be

[Guest]

PAWS and Relapse....

Alcohol depresses the Central Nervous System, over time your CNS gets used to this action and adjusts to operate normally with this 'blanket'. When you remove the AL the CNS suddenly has it's depressent, blanket whipped off and that's withdrawl - basically your nerves go crazy.

So you get the shakes, insomnia, anxiety, panic, short temper etc etc.

This is what I understand anyway and the generally accepted explaination for these effects.

Makes a lot of sense and is why we must try avoiding certain situations etc for quite some time.

There is a lecture on this given by Father Martin, as well as a lot of other good issues to do with alcoholism.

[gyco]

PAWS and Relapse....

hi catch,good thread,wonder why anyone would think of drinking again after all those symtoms,a panic attack does the same to a human,i beleive most would agree it is not normal to drink the way most of us did,i thot id add one to your post,lapse and relapse there is a difference in these two conditions,take care and one day at a time gyco

[catch22]

PAWS and Relapse....

Thanks for all your replies, i think the main think is i know what it is now and i dont feel like im going crazy now. Just knowning I am aware of this helps me a lot to not pick that first drink up. Also i find more information for anyone who wants to read more about it, that is new to the site just hope it helps anyone. It funny i dont do a lot of research...

PAWS part 1
This I copied from Greatgreebo's journals. Thank you Greebs.

Post Acute Withdrawl (PAW)

Exerpted From "Staying Sober" By: Terence T. Gorski

with additions by: Lee Jamison

When most people think about alcoholism or drug addiction they think only of the alcohol/drug-based symptoms and forget about the sobriety-based symptoms. Yet it is the sobriety-based symptoms, especially post acute withdrawal, that make sobriety so difficult. The presence of brain dysfunction has been documented in 75-95% of the recovering alcoholics/addicts tested. Recent research indicates that the symptoms of post-acute withdrawal associated with alcohol/drug-related damage to the brain may contribute to many cases of relapse.


Post-acute withdrawal means symptoms that occur after acute withdrawal. Post means after. And syndrome means a group of symptoms.

Syndrome: A group of symptoms

Post: After

Post Acute Withdrawal: Symptoms that occur after acute withdrawal.

Post-acute withdrawal is a group of symptoms of addictive disease that occur as a result of abstinence from addictive chemicals. In the alcoholic/addict these symptoms appear seven to fourteen days into abstinence, after stabilization from the acute withdrawal.

Post-acute withdrawal is a bio-psycho-social syndrome. It results from the combination of damage to the nervous system caused by alcohol or drugs and the psychosocial stress of coping with life without drugs or alcohol.

Recovery causes a great deal of stress. Many chemically dependent people never learn to manage stress without alcohol and drug use. The stress aggravates the brain dysfunction and makes the symptoms worse. The severity of PAW depends upon two things: the severity of the brain dysfunction caused by the addiction and the amount of psychosocial stress experienced in recovery.

The symptoms of PAW typically grow to peak intensity over three to six months after abstinence begins. The damage is usually reversible, meaning the major symptoms go away in time if proper treatment is received. So there is no need to fear. With proper treatment and effective sober living, it is possible to learn to live normally in spite of the impairments. But the adjustment does not occur rapidly. Recovery from the nervous system damage usually required from six to 24 months with the assistance of a healthy recovery program. Recent research is showing that for some recovering people the symptoms of PAW often occur at regular "moon cycle" intervals and without apparent outside stressors. Often those 30, 60, 90, 120, 180, and 1 & 2-year sobriety dates seem to be "triggering" times for PAW symptoms to increase. People recovering from long term opiate and stimulant use often have PAW symptoms for no apparent reason for up to 10 years after they have stopped using their drug of choice. Often PAW symptoms appear to come and go without apparent reason and without any specific pattern. Individuals who intend to have consistent long-term recovery must learn to recognize these symptoms and learn how to manage them.

SYMPTOMS OF POST ACUTE WITHDRAWAL

How do you know if you have PAW? The most identifiable characteristic is the inability to solve usually simple problems. There are six major types of PAW symptoms that contribute to this They are the inability to think clearly, memory problems, emotional overreactions and numbness, sleep disturbances, physical coordination problems, and general problems in managing stress. The inability to solve usually simple problems because of any or all of these symptoms leads to diminished self-esteem. A person often feels incompetent, embarrassed, and ?not okay? about themselves. Diminished self-esteem and the fear of failure interfere with productive and challenging living. Let?s take a look at some of the PAW symptoms that contribute to the inability to solve usually simple problems.

TYPES OF PAW SYMPTOMS

1. Inability to think clearly

2. Memory problems

3. Emotional overreactions or numbness

4. Sleep disturbances

5. Physical coordination problems

6. Stress sensitivity

Inability to Think Clearly

There are several thought disorders experienced by a recovering person when PAW is activated. Intelligence is not affected. It is as if the brain is malfunctioning sometimes. Sometimes it works all right. Sometimes is does not.

One of the most common symptoms is the inability to concentrate for more than a few minutes. Impairment of abstract reasoning is another common symptom of post acute withdrawal. An abstraction is a nonconcrete idea or concept, something that you cannot hold in your hand, take a picture of, or put in a box. Concentration is more of a problem when abstract concepts are involved.

Another common symptom is rigid and repetitive thinking. The same thoughts may go around and around in your head and you are unable to break through this circular thinking in order to put thoughts together in an orderly way.

Memory Problems

Short-term memory problems are very common in the recovering person. You may hear something and understand it, but within 20 minutes you forget it. Someone will give an instruction and you know exactly what to do. But you may walk away, and that memory becomes clouded or may disappear completely.

Sometimes during stressful periods it may also be difficult to remember significant events from the past. These memories are not gone; the person may be able to remember them easily at other times. The person realizes that he or she knows but just cannot recall it while experiencing the stress.

For an alcoholic named Jan this created a problem in AA. ?I have trouble presenting my story at AA,? she said. ?I have trouble remembering events that happened before my drinking days, let alone things that happened while I was drinking. So to put my life in story form is hard for me. I don?t remember all of my story. I do remember that some things occurred, but I get confused about when they happened. Many times I can remember things when I am alone with no pressure that I can?t remember under the stress I feel when I talk at meetings.?

Because of memory problems in recovery, it may be difficult to learn new skills and information. You learn skills by acquiring knowledge and building upon what you have already learned. Memory problems make it difficult to build upon what you have already learned.

Emotional Overreaction or Numbness

Persons with emotional problems in sobriety tend to overreact. When things happen that require two units of emotional reaction, they react with ten. It is like holding the ?times? key down on a calculator. You may find yourself becoming angry over what may later seem a trivial matter. You may feel more anxious or excited than you have reason to be. When this overreaction puts more stress on the nervous systems than it can handle, there is an emotional shutdown. If this happens to you, you become emotionally numb, unable to feel anything. And even when you know you should feel something, you do not. You may swing from one mood to another without knowing why.

Sleep Problems

Most recovering people experience sleep problems. Some of them are temporary; some are lifelong. The most common in early recovery is unusual or disturbing dreams. These dreams may interfere with your ability to get the sleep you need. But they become less frequent and less severe as the length of abstinence increases.

Mike was a periodic drinker. Periods of sobriety usually lasted for several months. During the time he was not drinking, he had dreams that severely disrupted his sleep. His wife said, ?I never realized the nightmares Mike was having had anything to do with drinking or not drinking. He would frequently jump out of bed, screaming in terror. When I was able to awaken him and calm him, he couldn?t remember what he dreamed, but he remembered being afraid. After a year of sobriety, he seldom had the dreams. Only then did I realize that they were related to his drinking.

Even if you do not experience unusual dreams, you may have difficulty falling asleep or staying asleep. You may experience changes in your sleep patterns; sleeping for long periods at a time or sleeping at different times of the day. Some of these patterns may never return to ?normal,? but most people are able to adjust to them without severe difficulty.

Physical Coordination Problems

A very serious PAW problem ? though perhaps not as common as the others ? is difficulty with physical coordination. Common symptoms are dizziness, trouble with balance, problems with coordination between hand and eye, and slow reflexes. These result in clumsiness and accident proneness. This is how the term ?dry drunk? came into being. When alcoholics appeared drunk because of stumbling and clumsiness, but had not been drinking, they were said to be ?dry drunk.? They had the appearance of being intoxicated without drinking.

Stress Sensitivity

Difficulty in managing stress is the most confusing and aggravating part of post acute withdrawal. Recovering people are often unable to distinguish between low-stress situations and high-stress situations. They may not recognize low levels of stress, and then overreact when they become aware of the stress they are experiencing. They may feel stressful in situations that ordinarily would not bother them, and in addition, when they react they overreact. They may do things that are completely inappropriate for the situation. So much so that later on they may wonder why they reacted so strongly.

To complicate things further, all of the other symptoms of post acute withdrawal become worse during times of high stress. There is a direct relationship between elevated stress and the severity of PAW. Each intensifies the other. The intensity of PAW creates stress, and stress aggravates PAW and makes it more severe. At times of low stress, the symptoms get better and may even go away. When you are well rested and relaxed, eating properly, and getting along well with people, you will probably appear to be fine. Your thoughts will be clear, your emotions appropriate, and your memory all right. At times of high stress, however, your brain may suddenly shut down. You may begin experiencing thinking problems, inappropriate emotions, and memory problems.

If your thoughts become confused and chaotic or you are unable to concentrate, if you have trouble remembering or solving problems, you may feel you are going crazy. You are not. These symptoms are a normal part of your recovery and are reversible with abstinence and a recovery program. If you do not understand this you may develop shame and guilt which leads to diminished self-esteem and isolation which creates stress and increased PAW. It is a painful cycle that is unnecessary if you understand what is happening. As your body and your mind begin to heal and as you learn ways to reduce the risk of post acute withdrawal symptoms, productive and meaningful living is possible in spite of the very real possibility of recurring symptoms.

Recovery from the damage caused by the addiction requires abstinence. The damage itself interferes with the ability to abstain. This is the paradox of recovery. Use of alcohol or other drugs can temporarily reverse the symptoms of the damage. If alcoholics drink, or drug addicts use, they will think clearly for a little while, be able to have normal feelings and emotions for a little while, feel healthy for a little while. Unfortunately, the disease will eventually trigger a loss of control that will again destroy these functions.

For this reason it is necessary to do everything possible to reduce the symptoms of PAW. It is necessary to understand PAW and to recognize that you are not incompetent and you are not going crazy. Because post acute withdrawal symptoms are stress sensitive, you need to learn about PAW and methods of control when stress levels are low in order to be able to prevent the symptoms or to manage them when they occur.

Here are some stories about some people who experienced post acute withdrawal and how it affected their lives without their being aware of what was happening to them.

Ray is a young, single, recovering alcoholic. He stopped drinking when he was 22 and was very excited about the possibilities that lay ahead of him in his sobriety. After his initial treatment he began restructuring his life around recovery. He was eager to make up for the time he had wasted during his years of drinking. He got a full-time job, enrolled in college, and committed himself to doing some volunteer work.

After a while he began to notice that he was having trouble with his schoolwork. He found himself confused about things that had at one time been easy for him to follow and figure out. He was having trouble taking care of his financial responsibilities, and when people that cared about him tried to help him figure things out, he felt panicky and overwhelmed. Thoughts rushed through his head, and he was unable to put them in order. He says, ?When someone in the financial aid office at the college started talking to me about grant money, loan money, interest, and forms that needed to be filled out, I was so confused and overwhelmed that I couldn?t hear what she was saying. Everything was going around in my head at once and I had to get away. I got up and left without filling out the financial aid form.?

In desperation, and out of fear that he would drink, Ray ?ran.? Instead of evaluating what things in his life he needed to change and what he needed to hold onto, he gave up everything. He quit his job, dropped out of school, and stopped doing volunteer work. He gave up his apartment and moved in with a relative until he could ?get himself together.? These actions created additional problems with which he found it increasingly difficult to cope. Until he went to a counselor and learned some ways to manage his symptoms, Ray thought he was having a nervous breakdown, when in fact what he was experiencing was PAW.

catch22 xXx

[Gearhead]

PAWS and Relapse....

catch22;845330 wrote: Thanks for all your replies, i think the main think is i know what TYPES OF PAW SYMPTOMS

1. Inability to think clearly

2. Memory problems

3. Emotional overreactions or numbness

catch22 xXx

Hum... I feel like I have alot of the PAWS symptoms but it also sounds exactly like my self diagnosed ADHD from what I researched. Everyone tells me its impossible I could accomplish so much in my career if I had ADHD but I am having trouble differentiating what is me and what is recovery... anyway good reading thanks for posting.

[Montana Mommy]

PAWS and Relapse....

What a great thread!!! I totally have the emotional overreactions, and that's why i kept slipping. Now that i know I can come at it from a different angle. Great information.

[Flip Top]

PAWS and Relapse....

I can relate to this, oh yes....

[momofpaws]

PAWS and Relapse....

I'm a mom of an ex-heroin addict who is experiencing many symptoms which I now realize may be PAWS - post acute withdrawal syndrome. One thing I haven't seen as part of the symptoms is light sensitivity. He feels the need to wear sunglasses indoors even. Has anyone experienced that or know of someone else who has?

[Doggygirl]

PAWS and Relapse....

Hi Momofpaws and welcome to MWO. I'm so glad to hear that your son is off of heroin. I'm sure life has not been easy for either of you.

I do not have first hand experience with recovery from heroin addiction, and the acute and chronic effects of that. I have a friend, however, who has been off of heroin for several years now, and is very willing to share about his own experience. I will ask him your question and report back. I know my friend will confirm symptoms similar to PAWS. You might also google anhedonia which is an inability to experience pleasure. I know my friend talks about this being a very difficult experience for him. Not sure if your son is experiencing that.

I haven't heard about light sensitivity but will let you know later what my friend has to say.

Good luck to you, and to your son.

DG

[Doggygirl]

PAWS and Relapse....

Hi Mom. I talked to my friend who has been involved with heroin for over 25 years. Many years as an addict, now as a person in recovery who helps a lot of others. He said in all those years he never encountered anyone who was "light sensitive" due to past heroin use. His first question was "has the son relapsed?" I guess hiding behind the shades is quite common.

That's not to say your son has relapsed. Those are just the thoughts from someone who has experience with this.

I hope your son finds his way out, if indeed he is still struggling with this.

DG