Post-Acute Withdrawal Dealing with post-acute withdrawal is one of the tasks of the abstinence stage [1]. Post-acute withdrawal begins shortly after the acute phase of withdrawal and is a common cause of relapse [17]. Unlike acute withdrawal, which has mostly physical symptoms, post-acute withdrawal syndrome (PAWS) has mostly psychological and emotional symptoms. Its symptoms also tend to be similar for most addictions, unlike acute withdrawal, which tends to have specific symptoms for each addiction [1]. These are some of the symptoms of post-acute withdrawal [1,18,19]: 1) mood swings; 2) anxiety; 3) irritability; 4) variable energy; 5) low enthusiasm; 6) variable concentration; and 7) disturbed sleep. Many of the symptoms of post-acute withdrawal overlap with depression, but post-acute withdrawal symptoms are expected to gradually improve over time [1]. Probably the most important thing to understand about post-acute withdrawal is its prolonged duration, which can last up to 2 years [1,20]. The danger is that the symptoms tend to come and go. It is not unusual to have no symptoms for 1 to 2 weeks, only to get hit again [1]. This is when people are at risk of relapse, when they are unprepared for the protracted nature of post-acute withdrawal. Clinical experience has shown that when clients struggle with post-acute withdrawal, they tend to catastrophize their chances of recovery. They think that they are not making progress. The cognitive challenge is to encourage clients to measure their progress month-to-month rather than day-to-day or week-to-week. Repair Stage In the second stage of recovery, the main task is to repair the damage caused by addiction [2]. Clinical experience has shown that this stage usually lasts 2 to 3 years Link to full article below https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/#R1
