Is PAWS Real or Just Another Relapse Excuse?

Post-Acute Withdrawal Syndrome (PAWS): A Safe Treatment Guide

Is PAWS Real or Just Another Relapse Excuse?

Post-acute withdrawal syndrome (PAWS), also called protracted withdrawal, may afflict some people in recovery.

Regular withdrawal can last a few days or weeks, but PAWS causes symptoms to reappear months or years after the fact. PAWS can be incredibly discouraging for people in recovery.


Battling drug and alcohol misuse takes a lot of courage and support. Most people need medical assistance for the first part of their journey, which often includes detox from a substance that was formerly abused.

Symptoms of drug withdrawal occurs as a result of quitting an addictive substance.

Your genes, history of drug use, and the drugs used have an influence on how withdrawal manifests itself and how long it will last. Drugs heroin and benzodiazepines have particularly intense periods of withdrawal.

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A General Overview Of PAWS

Psychology Today says detox is a key first step toward recovery, but it does not curb addiction on its own or prevent a person from feeling withdrawal in the future. There are two primary stages to withdrawal once a person decides to stop using.

  • Acute withdrawal is immediate detoxification and should involve a doctor’s help. The drug is processed from the body, so the person is no longer under its influence
  • Post-acute withdrawal syndrome (PAWS) can last for weeks, months, and even years, depending on the person’s genes, the drugs used, and how long they were used.

PAWS can surprise people in recovery because they often believe that getting sober only involved an initial detox period. Withdrawal symptoms triggered by PAWS occur even after a person’s brain, and body are now free from the substance.

PAWS has been misunderstood for years because some in the medical community doubted its existence. The condition is not yet considered an official health concern because its parameters have not been set in the Diagnostic and Statistical Manual of Mental Disorders.

The medical community has still not made up its mind about whether or not PAWS exists, but many health experts feel that parameters for PAWS should be set. Detractors say PAWS is another justification for intentional relapse.

Reports increasingly define what PAWS consist of. Additional research shows some drugs are more ly to cause PAWS than others.

Common Symptoms

PAWS symptoms are diverse, and gender, size, and drug use can all affect withdrawal. For now, PAWS has been found to last about two years after a person has quit and abstained from a drug, but there is no guarantee that symptoms will stop even after this point.

Symptoms common to post-acute withdrawal syndrome include the following:

  • Decreased desire for sex
  • Confusion
  • Fatigue
  • Moodiness
  • Difficulty sleeping
  • Aggression or irritability
  • Chronic pain

Various drugs can cause PAWS, but people who have used opioids are more ly to report one or more symptoms of PAWS.

The list of drugs linked to PAWS is diverse, but the list of drugs below consists of the main culprits.


Better known as crystal meth, physical withdrawal lasts an estimated two weeks. The first 24 hours are found to be the most difficult. Psychological withdrawal takes much longer and has reportedly taken months.

A person’s physical and mental condition influences their withdrawal experience. People who experience PAWS during meth withdrawal may become anxious, feel fatigue, and start craving the drug. Inhibition stemming from meth use can last for years even with completely abstaining from the drug.


Most people who try cocaine do not feel they can become addicted, but those who have may experience additional difficulties during detox. Cocaine causes withdrawal because of its rebound effect. Using it causes a person to feel alert, but its crash can be very intense.

Withdrawal is a way for the body to get back to normal after cocaine has changed its balance. Former cocaine users report feelings of withdrawal that last for weeks or even months after their last dose.


Teens are more ly to become addicted to marijuana, and they may not know that it causes withdrawal, as reported by the National Institute on Drug Abuse for Teens. People who experience PAWS after quitting marijuana generally report insomnia and lack of energy.


A 2015 study published by the Australian Prescriber reports that withdrawal from benzodiazepines is hard to predict because each form of the medication has different effects. Tapering use helps people decrease their withdrawal symptoms, but it does not stop them.

Benzodiazepines are often used for anxiety or panic disorders. PAWS symptoms, as well as initial anxieties, make recovery difficult for those recovering from this misuse.

Using benzodiazepines for a few weeks causes physical dependence. Using them for an extended period of time can result in a longer withdrawal timeline.


Prescription opioids often provide necessary relief for people with severe or chronic pain. MedlinePlus mentions that withdrawal is especially difficult for people who want to quit or decrease their dose.

These drugs cause tolerance (a need for higher doses to remain effective) and dependence (a need to use these drugs to function). Quitting use of opioids often requires help because stopping opioid use cold turkey is dangerous.

Commonly reported symptoms of PAWS after months of abstaining from opioids are anxiety, lessened ability to control impulses, and depression.

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Alcohol and PAWS

Studies are being conducted on alcohol, but a 2010 paper on Addiction Biology reports that abstaining from alcohol for three to six weeks can cause a person to feel cravings that make it harder for a person to stay sober.

So far, it is known that if you try to quit alcohol, you will have a hard time feeling pleasure and joy from activities that once made you happy. These feelings should subside in the weeks to come.

A February 2014 article by writer Jeanene Swanson, published on The Fix, discussed PAWS and alcohol misuse. Swanson stated that many people who used to struggle with addiction relapsed because they felt extremely uncomfortable as their bodies were adjusting to life without drugs or alcohol.

Those in recovery from alcohol addiction could be experiencing PAWS symptoms similar to those felt by people who are in the process of quitting benzodiazepines. This is because alcohol and benzodiazepines are both depressants that have similar effects on the brain.

Home detoxing from alcohol and benzodiazepines carry the possibility of seizures and death. This is why medical detox at an accredited addiction treatment center is essential.

Treating It Safely

Drug detox should always involve a doctor’s supervision. Though some people may end up detoxing at home if their use was not severe, some people may be able to use certain medications to make their withdrawal process more comfortable.

Acute withdrawal (the first stage of quitting a substance) may take place at:

  • Home with the help of family and friends
  • A treatment center that is equipped to help with detox
  • A hospital if your doctor determines that withdrawal will be very uncomfortable or even life-threatening

Doctors may be able to help those who have abused opioids by using medication that can keep them stable and prevent relapse. These medications are:

  • Buprenorphine, to lessen withdrawal symptoms and reduce cravings for opioids
  • Methadone, which is known to assist with the discomfort of detox. Some people may need it for years so they can fully recover. Doctors taper the dose over time until the person can fully live without it. It can also decrease cravings for opioids.
  • Clonidine, which can assist with anxiety, vomiting, nausea, and cramps

Health care providers can also treat you with medication that restores your ability to sleep or assists with vomiting and withdrawal-induced diarrhea. They may also suggest an over-the-counter medication that can help you.

There are additional methods to aid with recovery and help former drug users stay sober.

  • Inpatient treatment at a center
  • Hospitalization
  • Counseling
  • Assistance from self-help groups

MedlinePlus also recommends screening patients for mental health issues and depression during the process of recovery.

A diagnosis could help patients deal with issues that may have caused them to turn to drugs in the first place. Therapy for these issues may help them build confidence to stay strong even if they experience PAWS.

The Fix discourages people in recovery from going through withdrawal on their own.

Strategies To Cope With PAWS

Dealing with PAWS is a long-term commitment. There are a few strategies to help you adjust.

  • Learn how to deal with stress. Misusing substances numbs you to the problems around you, but they are part of life. Stress management strategies can help you improve your outlook and self-esteem. Controlling your reactions will help you in recovery.
  • Identify your triggers and talk about them with your therapist or sponsor.
  • Develop healthy habits. Regular exercise, a nutritious diet, and relaxation techniques can set you up for success.

These strategies will not solve every problem or symptom you experience during regular withdrawal or with PAWS, but they can go a long way in helping you recover and reclaim your life.


Is PAWS Real or Just Another Relapse Excuse?

Is PAWS Real or Just Another Relapse Excuse?



ສະມາຊິກຂອງຊຸມຊົນການຟື້ນຟູໄດ້ເປັນເວລາຫລາຍປີໂດຍໄດ້ຮັບການສະຫນັບສະຫນູນຈາກການຖອນຕົວຂອງໂຣກຖອກທ້ອງ (PAWS) ເປັນສາເຫດທີ່ສໍາຄັນສໍາລັບຜູ້ທີ່ພະຍາຍາມຮັກສາສະອາດແລະອ່ອນເພຍ.

ຫຼັງຈາກທີ່ໄດ້ຮັບການປິ່ນປົວຄົນໂຣກເຫຼົ້າແລະຜູ້ຕິດຢາເສບຕິດໄດ້ຮັບຄວາມເຄັ່ງຕຶງແລະຄວາມຮ້າຍແຮງຂອງ ອາການຖອກທ້ອງ ໃນເບື້ອງຕົ້ນຂອງການບໍ່ສະຫງົບ, ຜູ້ຊ່ຽວຊານບາງຄົນເວົ້າວ່າກຸ່ມອາການອື່ນໆທີ່ມາພ້ອມກັນທີ່ບໍ່ສະບາຍຫຼືຮຸນແຮງພໍທີ່ຈະເຮັດໃຫ້ບາງຄົນລຸດຜ່ອນພຽງແຕ່ເພື່ອຊ່ວຍບັນເທົາອາການປວດຮາກເຫຼົ່ານັ້ນ.

ແຕ່ວ່າ, ປະກົດການທີ່ເອີ້ນວ່າໂຣກຖອນຕົວອອກມາຕໍ່ມາຫຼືພຽງແຕ່ຖອນການໃຊ້ເວລາດົນນານບໍ່ແມ່ນໂດຍບໍ່ມີການໂຕ້ຖຽງບາງຢ່າງ. ມັນບໍ່ແມ່ນການວິນິດໄສທາງການແພດຢ່າງເປັນທາງການແລະມັນບໍ່ໄດ້ພົບເຫັນຢູ່ໃນຄູ່ມືການວິນິດໄສແລະສະຖິຕິຂອງຄວາມຜິດພາດທາງຈິດ.

ມີການສຶກສາຄົ້ນຄວ້າວິທະຍາສາດທີ່ມີການເຜີຍແຜ່ຫນ້ອຍທີ່ສຸດເຊິ່ງເຖິງແມ່ນຈະຢືນຢັນເຖິງຄວາມເປັນຢູ່ຂອງ PAWS ແລະມີການຄົ້ນຄ້ວາບໍ່ດົນມານີ້ກ່ຽວກັບການຖອນຖອຍຫລັງ.


ການຂາດແຄນຫຼັກຖານທາງວິທະຍາສາດແລະການຍົກເວັ້ນຈາກປື້ມຄູ່ມືການວິນິດໄສຂອງໂຣກນີ້ໄດ້ເຮັດໃຫ້ເກີດຄວາມສັບສົນບາງຢ່າງໃນຊຸມຊົນທາງການແພດສ່ວນໃຫຍ່ວ່າບໍ່ວ່າຈະເປັນ PAWS ເປັນປະກົດການທີ່ແທ້ຈິງຫຼືພຽງແຕ່ເປັນ ຂໍ້ແກ້ຕົວທີ່ສໍາລັບການເລີກ .


ສໍາລັບຜູ້ທີ່ມີປະສົບການອາການທີ່ບໍ່ຄາດຄິດຂອງ PAWS, ຢ່າງໃດກໍຕາມ, ອາການໂຣກຖອນຖອຍຫຼັງຈາກນັ້ນກໍ່ແມ່ນຈິງແທ້ໆ.


ການສຶກສາຫນຶ່ງໄດ້ຖືກດໍາເນີນໂດຍສະເພາະເພື່ອພິຈາລະນາວ່າ PAWS ຄວນຈະຖືກລວມຢູ່ໃນ DSM-IV. ຫຼັງຈາກການທົບທວນຄືນຂອງວັນນະຄະດີທີ່ມີຢູ່ໃນເວລານີ້, Satel ແລະເພື່ອນຮ່ວມງານຢູ່ໂຮງຮຽນວິທະຍາໄລ Yale ວິທະຍາໄລໄດ້ສະຫຼຸບວ່າການວິນິດໄສບໍ່ຄວນຈະຖືກລວມເຂົ້າ.

ແຕ່ນັກວິທະຍາສາດ Yale ໄດ້ສະຫລຸບວ່າ, ບໍ່ແມ່ນຍ້ອນວ່າໂຣກນີ້ບໍ່ມີຢູ່, ແຕ່ເນື່ອງຈາກວ່າ «ຂໍ້ຈໍາກັດທາງວິທີການຂອງການສຶກສາແລະການຂາດການຄໍານຶງເຖິງຄໍາເວົ້າຂອງຕົວມັນເອງ».


  • ເຮັດຕົວຢ່າງທີ່ໃຊ້ເວລາຫຼາຍຈຸດ
  • ໃຊ້ເຄື່ອງມືມາດຕະຖານ
  • ໃຊ້ກຸ່ມຄວບຄຸມ
  • ການບໍລິຫານສານໃຫມ່ເພື່ອຄວບຄຸມອາການ


ເຖິງແມ່ນວ່າການຄົ້ນຄ້ວາຫຼາຍໆປີຜ່ານມາເຫັນໄດ້ຊັດເຈນກ່ຽວກັບຄໍານິຍາມແລະຕົວກໍານົດຂອງການຖອນຕົວຢ່າງຍາວນານ, ບາງນັກສືບໄດ້ບັນທຶກບາງບັນດາອາການທີ່ກ່ຽວຂ້ອງກັບໂຣກນີ້.

ການສຶກສາຂອງເຢຍລະມັນໄດ້ຄົ້ນພົບວ່າການໃຊ້ເຫຼົ້າໃນໄລຍະຍາວມັກຈະຍັບຍັ້ງຜົນກະທົບຂອງສານເຄມີບາງຢ່າງໃນສະຫມອງ (atrial natriuretic peptide) ແລະຜົນກະທົບເຫຼົ່ານັ້ນຍັງສືບຕໍ່ຫຼຸດລົງຫຼາຍໆອາທິດຫຼັງຈາກການບໍ່ນັບຖື. ນີ້ເຮັດໃຫ້ຄວາມຢາກທີ່ເພີ່ມຂຶ້ນສໍາລັບເຫຼົ້າແລະຄວາມຮູ້ສຶກເພີ່ມຂຶ້ນຂອງຄວາມກັງວົນໃນໄລຍະການຖອນເງິນຍາວ.

ການສຶກສາໄລຍະຍາວທີ່ມະຫາວິທະຍາໄລ Johns Hopkins ຂອງ 312 ຄົນເຫຼົ້າເຫຼືອງທີ່ບໍ່ມີຕົວຕົນໄດ້ພົບວ່າອາການບາງຢ່າງທີ່ມີອາການອ່ອນເພຍ, ການຊຶມເສົ້າ, ການຊຶມເສົ້າ, ຄວາມອ່ອນໄຫວທາງເພດ, ຫຼຸດລົງຢ່າງລວດໄວດ້ວຍການບໍ່ນັບຖືຍາວ, ແຕ່ໃນບາງກໍລະນີອາດຈະໃຊ້ເວລາ 10 ປີ «ລະດັບປົກກະຕິ.»

ຜູ້ຂຽນຂອງການຄົ້ນຄວ້າຂອງ Johns Hopkins ໄດ້ສະຫຼຸບວ່າການຄົ້ນພົບຂອງພວກເຂົາແມ່ນ «ສອດຄ່ອງກັບແນວຄິດຂອງໂຣກຖອນຕົວທີ່ຍາວນານ».


ໃນເວລາທີ່ ອາການຂອງການຖອນເຫຼື້ອມ ໃນການຖືພາໃນເບື້ອງຕົ້ນເລີ່ມຫຼຸດລົງແລະສະຫງົບ, ອາການຂອງການຖອນຕົວຢ່າງໄວວາເລີ່ມຕົ້ນສະແດງ, ປົກກະຕິແລ້ວ ລະຫວ່າງ 7 ຫາ 14 ມື້ເຂົ້າໄປໃນຄວາມສະບາຍ .

ການໃຊ້ເຫຼົ້າແລະຢາເສບຕິດໄລຍະຍາວອາດເຮັດໃຫ້ເກີດ ການປ່ຽນແປງທາງເຄມີໃນສະຫມອງ . ໃນເວລາທີ່ຜູ້ໃດຜູ້ຫນຶ່ງຢຸດເຊົາການນໍາໃຊ້ຢ່າງກະທັນຫັນ, ສະຫມອງຕ້ອງປັບຕົວຄືນໃຫມ່ໂດຍບໍ່ມີສານເຫຼົ່ານັ້ນ. ໄລຍະເວລາດົນປານໃດນີ້ສາມາດຂຶ້ນຢູ່ກັບຄວາມເສຍຫາຍຂອງສານເສບຕິດຕໍ່ສານລະບົບປະສາດຂອງຮ່າງກາຍຫຼາຍປານໃດ.

ຂະບວນການຂອງສະຫມອງທີ່ປັບຕົວ ບໍ່ແມ່ນຢາຫຼືເຫຼົ້າ ສາມາດເພີ່ມຂື້ນໂດຍຄວາມກົດດັນຂອງຄວາມພະຍາຍາມທີ່ຈະຮັກສາລະເວັ້ນຫຼັງຈາກດື່ມຫຼືຢາເສບຕິດ.

ເນື່ອງຈາກວ່າປະຊາຊົນຈໍານວນຫຼາຍໃນການຟື້ນຟູການໃຊ້ເຫຼົ້າແລະຢາເສບຕິດເພື່ອແກ້ໄຂຄວາມເຄັ່ງຕຶງໃນອະດີດ, ທຸກຄວາມກົດດັນທີ່ເຂົາເຈົ້າມີໃນເວລາທີ່ພະຍາຍາມຮັກສາສະຖຽນລະພາບສາມາດເຮັດໃຫ້ອາການຖອນຂອງພວກເຂົາແຜ່ໄວຂຶ້ນ.

ຜູ້ຊ່ຽວຊານດ້ານການຟື້ນຟູເຊື່ອວ່າຄວາມຮ້າຍແຮງຂອງອາການສະແດງອາການສ້ວຍແຫຼມແມ່ນຂຶ້ນກັບສອງປັດໃຈ: ຈໍານວນການເສຍຫາຍຂອງເຫຼົ້າແລະການນໍາໃຊ້ຢາທີ່ເຮັດໃຫ້ລະບົບປະສາດໃນໄລຍະປີແລະຈໍານວນຂອງຄວາມຄຽດທີ່ຄົນໄດ້ພົບໃນໄລຍະການຟື້ນຕົວ.


ປະຊາຊົນຜູ້ທີ່ມີອາການສະແດງອາການໂຣກຖອນຕົວສັ່ນສະທ້ອນອະທິບາຍອາການທີ່ຈະມາຢູ່ໃນ «ຄື້ນຟອງ» ຫຼືມີການກະທົບກະເທືອນທາງດ້ານອາລົມ. ການປິ່ນປົວຄົນໂຣກເຫຼົ້າແລະຜູ້ຕິດຢາເສບຕິດ, ເປັນເວລາຫຼາຍອາທິດໃນການລະເວັ້ນ, ລາຍງານວ່າມີອາການເຫຼົ່ານີ້:

ຄວາມຮູ້ສຶກທີ່ບໍ່ສະຖຽນລະພາບແລະບໍ່ແນ່ນອນ — ຫນຶ່ງໃນອາການທົ່ວໄປທີ່ລາຍງານໂດຍຜູ້ທີ່ທຸກທໍລະມານຈາກ PAWS ແມ່ນການ ປ່ຽນແປງສະຕິປັນຍາ ຫຼືການປ່ຽນແປງທີ່ບໍ່ແນ່ນອນໃນໂປຣໄຟລຂອງພວກເຂົາ. ພວກເຂົາເຈົ້າລາຍງານຄວາມຮູ້ສຶກຢ່າງກະທັນຫັນຂອງການຊຶມເສົ້າ overwhelming ໂດຍບໍ່ມີເຫດຜົນໃດໆຫຼື provocation, ໃນຂະນະທີ່ປະສົບການຊຸກຍູ້ຂອງ bouts anxiety ຫຼື agitation.

Anhedonia — Anhedonia ແມ່ນສູນເສຍຄວາມສົນໃຈໃນສິ່ງທີ່ທ່ານມັກເຮັດ, ອະທິບາຍບາງຄັ້ງວ່າມີຄວາມສາມາດຂອງທ່ານທີ່ຈະມີຄວາມສຸກຄວາມສຸກໄດ້ປິດ. ໃນກໍລະນີທີ່ລຸນແຮງ, ການຮັກສາຄວາມປອດໄພສາມາດຂະຫຍາຍໄປສູ່ການສູນເສຍຄວາມສົນໃຈຕາມຄວາມຕ້ອງການຂັ້ນພື້ນຖານເຊັ່ນການກິນອາຫານ.

ອາລົມຊຶມເສົ້າຫຼືຄວາມຮູ້ສຶກຂອງການຕິດເຊື້ອ — ອາການນີ້ສາມາດແຕກຕ່າງກັນຢ່າງກວ້າງຂວາງໃນການຟື້ນຕົວບຸກຄົນ. ຫຼາຍຄົນມັກຈະ overreact. ບາງຄັ້ງພວກເຂົາສາມາດກາຍເປັນຄວາມຕື່ນເຕັ້ນຫຼາຍເກີນໄປແລະມີຄວາມໂກດຫຼາຍເກີນໄປກ່ຽວກັບບັນຫາເລັກນ້ອຍ, ຫຼັງຈາກນັ້ນເຂົ້າໄປໃນຂັ້ນຕອນຂອງການບໍ່ຮູ້ສຶກວ່າມີຄວາມຮູ້ສຶກໃດໆ. ບາງຄົນໄດ້ອະທິບາຍວ່າມັນເປັນຫວ່າງເປົ່າຫຼືຂັງຢູ່ພາຍໃນ.

ບໍ່ສາມາດມຸ່ງເນັ້ນຫລືຄິດຢ່າງຊັດເຈນ — ປະຊາຊົນທີ່ໄດ້ຮັບການຖອນຕົວຢ່າງຕໍ່ເນື່ອງຫຼາຍຄັ້ງຈະບໍ່ມີຄວາມສາມາດແກ້ໄຂບັນຫາງ່າຍໆແມ້ບໍ່ສາມາດຄິດຢ່າງຊັດເຈນ. ພວກເຂົາເຈົ້າລາຍງານຄວາມຫຍຸ້ງຍາກໃນການສຸມໃຈໃສ່ແລະບາງຄັ້ງມັນແມ່ນຍ້ອນວ່າພວກເຂົາຄິດວ່າມັນຍາກທີ່ຈະຄິດກ່ຽວກັບສິ່ງໃດກໍ່ຕາມແຕ່ຄວາມຈິງທີ່ວ່າພວກເຂົາບໍ່ດື່ມຫຼືໃຊ້ຢາ. ແນວຄິດທີ່ຮຸນແຮງຫຼືຊໍ້າຊິ່ງແມ່ນຍັງພົບເລື້ອຍໆ.

ການປະສານງານທີ່ບໍ່ດີແລະບໍ່ສະບາຍ — ອາການນີ້ບໍ່ແມ່ນເປັນອາການຂອງ PAWS ແຕ່ມັນເປັນອັນຕະລາຍຫນຶ່ງ. ປະຊາຊົນບາງຄົນໃນປະສົບການການຖອນເງິນຢ່າງວ່ອງໄວ, ວ່ອງໄວ, ຊັກຊ້າຊ້າ, ບັນຫາການປະສານງານແລະບັນຫາທີ່ມີຄວາມສົມດຸນ. ປະຊາຊົນທີ່ມີປະສົບການໃນການຖົດຖອຍແລະຊັກຊ້າໃນໄລຍະຍາວອາດຈະເປັນອັນຕະລາຍໃນເວລາທີ່ພວກເຂົາເປັນຕົວຈິງ.

ການຫ່ວງໃຍນອນ — ອາດຈະເປັນອາການຂອງ PAWS ທີ່ຮັບຜິດຊອບຫຼາຍທີ່ສຸດສໍາລັບການກັບມາແມ່ນກ່ຽວຂ້ອງກັບການລົບກວນນອນ. ບໍ່ພຽງແຕ່ເຂົາເຈົ້າເຫັນວ່າມັນຍາກທີ່ຈະນອນຫລັບ, ພວກເຂົາຈະພົບເຫັນການນອນຂອງພວກເຂົາຖືກຂັດຂວາງ. ຫຼາຍຄົນໄດ້ລາຍງານວ່າ ນອນ ຂອງພວກເຂົາ ຖືກລົບກວນ ເມື່ອພວກເຂົາຕື່ນຂຶ້ນຫຼັງຈາກທີ່ມີການໃຊ້ «ຝັນນໍາໃຊ້» ທີ່ພວກເຂົາໃຊ້ເຫຼົ້າຫຼືຢາເສບຕິດ.

ຄວາມເຄັ່ງຕຶງທີ່ຫນັກແຫນ້ນ — ນີ້, ແນ່ນອນ, ເປັນເຫດຜົນອີກຢ່າງຫນຶ່ງທີ່ຫຼາຍຄົນພະຍາຍາມອອກຈາກການຕັດສິນໃຈທີ່ຈະເລີກລົ້ມ. ເຖິງແມ່ນວ່າພາຍຫຼັງຫຼາຍອາທິດ — ແລະບາງຄັ້ງເວລາຫຼາຍປີ, ຜູ້ທີ່ຢູ່ໃນການຟື້ນຕົວກໍ່ສາມາດປະສົບກັບ ຄວາມຢາກຮ້າຍແຮງ ສໍາລັບການເລືອກຢາຂອງເຂົາເຈົ້າ.

ຄວາມກົດດັນທີ່ເພີ່ມຂຶ້ນຕໍ່ຄວາມກົດດັນ — ຫນຶ່ງອາການຖອນເງິນທີ່ບໍ່ຄາດຄິດສໍາລັບການຕິດຢາເສບຕິດຈໍານວນຫຼາຍແມ່ນຄວາມຮູ້ສຶກທີ່ເພີ່ມຂຶ້ນຕໍ່ຄວາມກົດດັນແລະເຫດການຄວາມກົດດັນ.

ບາງຄົນໄດ້ລາຍງານວ່າພວກເຂົາບໍ່ພຽງແຕ່ໄດ້ຮັບຄວາມກົດດັນຢ່າງງ່າຍດາຍ, ແຕ່ກໍ່ສາມາດໄດ້ຮັບຄວາມກົດດັນໂດຍສະຖານະການຄວາມກົດດັນບາງຢ່າງ.



ມັນເປັນສິ່ງສໍາຄັນທີ່ຄວນສັງເກດວ່າອາການຕ່າງໆຂອງ PAWS ທີ່ໄດ້ອະທິບາຍຂ້າງເທິງ, ເຊັ່ນໂປຣໄຟລທີ່ບໍ່ສະຖຽນລະພາບ, ການຮັກສາຄວາມດັນເລືອດ, ຄວາມບົກພ່ອງແລະຄວາມບົກພ່ອງຂອງນອນກໍ່ອາດຈະສະທ້ອນເຖິງຄວາມຜິດປົກກະຕິຂອງອາລົມເຊັ່ນ: ຊຶມເສົ້າ. ຄວາມຜິດປົກກະຕິມັກຈະເກີດຂື້ນກັບການນໍາໃຊ້ສານເສບຕິດ. ຖ້າອາການເຫຼົ່ານີ້ຍັງຄົງຢູ່, ແມ່ນຮ້າຍແຮງ, ແລະໂດຍສະເພາະຖ້າພວກມັນຖືກປະກອບດ້ວຍຄວາມຄິດ suicidal, ຄວນຈະຊອກຫາການປະເມີນຜົນທາງຈິດໃຈ.


ເຖິງແມ່ນວ່າຂໍ້ມູນຂ່າວສານກ່ຽວກັບການຖອນຕົວຢ່າງໄວວາແມ່ນບາງຢ່າງທີ່ຫຍາບຄາຍໃນວັນນະຄະດີວິທະຍາສາດ, ມັນເປັນເອກະສານທີ່ດີໃນຊຸມຊົນທີ່ຟື້ນຟູ. ຜູ້ທີ່ປິ່ນປົວອາການຖອນເງິນແລະພະຍາຍາມປ້ອງກັນບໍ່ໃຫ້ເກີດການລ່ວງລະເມີດແມ່ນມີຄວາມເຂົ້າໃຈກັນກັບການຖອນເງິນທີ່ຍາວນານ.

ຖ້າທ່ານໄດ້ຜ່ານໂຄງການປິ່ນປົວແບບມືອາຊີບຫຼືເປັນສະມາຊິກຂອງກຸ່ມສະຫນັບສະຫນູນເຊັ່ນ Alcoholics Anonymous ໃນໄລຍະ 20 ປີທີ່ຜ່ານມາ, ທ່ານອາດຈະໄດ້ຍິນຫຼາຍກ່ຽວກັບໂຣກຖອນຖອຍຫຼັງ.

ຜູ້ຂຽນທີ່ຂາຍດີທີ່ສຸດແລະຜູ້ຊ່ຽວຊານດ້ານການທາລຸນຢາເສບຕິດທີ່ໄດ້ຮັບການຍອມຮັບໃນທົ່ວໂລກ Terrence T. «Terry» Gorski ຕົວຈິງແລ້ວໄດ້ຂຽນຫນັງສືກ່ຽວກັບການຖອນຖີ້ມຢ່າງຖີ່ຖ້ວນ. ປື້ມຂອງພຣະອົງ, «Staying Sober: ຄູ່ມືສໍາລັບການປ້ອງກັນ Relapse» (ຊື້ມັນຢູ່ໃນ Amazon) ບໍ່ພຽງແຕ່ອະທິບາຍສະພາບຂອງລະບົບລາຍລະອຽດແຕ່ວ່າວິທີການກູ້ຄືນປະຊາຊົນສາມາດຮັບມືກັບ PAWS.


ອີງຕາມການ Gorski, ທີ່ສໍາຄັນທີ່ຈະບໍ່ປ່ອຍໃຫ້ອາການໂຣກຖອນຕົວກໍ່ຈະເຮັດໃຫ້ເກີດການຊຶມເຊື້ອອີກເທື່ອຫນຶ່ງຄືການສຶກສາຕົວເອງກ່ຽວກັບອາການດັ່ງກ່າວເພື່ອວ່າທ່ານຮູ້ວ່າຈະເປັນແນວໃດຄາດວ່າຈະກຽມຕົວເພື່ອຈັດການກັບອາການຕ່າງໆທີ່ເກີດຂື້ນແລະພັດທະນາແຜນການຈັດການຄວາມກົດດັນ ຢາແລະເຫຼົ້າ.

Gorski ຂຽນວ່າ «ເງື່ອນໄຂທີ່ເຮັດໃຫ້ທ່ານມີຄວາມສ່ຽງສູງທີ່ຈະປະສົບຜົນກະທົບຕໍ່ອາການຖອກທ້ອງຢ່າງສະຫມ່ໍາສະເຫມີແມ່ນການຂາດແຄນການເບິ່ງແຍງຕົວເອງແລະການຂາດຄວາມສົນໃຈກັບໂຄງການການຟື້ນຟູຂອງທ່ານ». «ຖ້າທ່ານຈະຟື້ນຕົວໂດຍບໍ່ມີການເລົ້າອາລົມທ່ານຈໍາເປັນຕ້ອງຮູ້ກ່ຽວກັບສະຖານະການທີ່ມີຄວາມກົດດັນໃນຊີວິດຂອງທ່ານທີ່ສາມາດເພີ່ມຄວາມສ່ຽງຂອງທ່ານໃນການປະສົບກັບ PAWS.»

Stress Management

ທ່ານ Gorski ເວົ້າວ່າ: «ຍ້ອນວ່າທ່ານບໍ່ສາມາດເອົາຕົວທ່ານເອງຈາກທຸກສະຖານະການຄວາມຄຽດທີ່ທ່ານຕ້ອງກຽມພ້ອມເພື່ອຈັດການກັບພວກມັນໃນເວລາທີ່ພວກເຂົາເກີດຂຶ້ນມັນກໍ່ບໍ່ແມ່ນສະຖານະການທີ່ເຮັດໃຫ້ທ່ານຫມົດໄປ.

Bob Carty, ຜູ້ອໍານວຍການບໍລິການດ້ານການປິ່ນປົວຢູ່ເມືອງ Hazelden ໃນ Chicago, ເຫັນດີວ່າຮູ້ວ່າອາການຂອງການຖອນເງິນແມ່ນມີຄວາມສໍາຄັນແນວໃດໃນການຮຽນຮູ້ວິທີການຈັດການ.

«ການຄຸ້ມຄອງສົບຜົນສໍາເລັດຂອງອາການເຫຼົ້າຫຼືອາການຂອງທ່ານຈະຊ່ວຍໃຫ້ທ່ານຮູ້ສຶກດີຂຶ້ນທາງດ້ານຮ່າງກາຍແລະຈິດໃຈ, ປັບປຸງຄວາມນັບຖືຕົນເອງແລະຫຼຸດຜ່ອນຄວາມສ່ຽງຕໍ່ການກັບຄືນມາອີກ», Carty ເວົ້າໃນເວັບໄຊທ໌ Hazelden Betty Ford.


ເນື່ອງຈາກວ່າຄວາມກົດດັນສາມາດເຮັດໃຫ້ອາການຂອງ PAWS ຮ້າຍແຮງຫຼາຍ, ການຮຽນຮູ້ກ່ຽວກັບຄວາມກົດດັນສາມາດຊ່ວຍໃຫ້ທ່ານຄວບຄຸມອາການຂອງທ່ານ.

ອີງຕາມ «Staying Sober» ເຫຼົ່ານີ້ແມ່ນເຄື່ອງມືທີ່ທ່ານສາມາດໃຊ້ເພື່ອຄວບຄຸມອາການຖອນ:

  • ກໍານົດແຫຼ່ງຄວາມກົດດັນຂອງທ່ານ
  • ການພັດທະນາຄວາມສາມາດໃນການຕັດສິນໃຈແລະແກ້ໄຂບັນຫາ
  • ຮັກສາອາຫານທີ່ເຫມາະສົມ
  • ອອກກໍາລັງກາຍຢ່າງເປັນປົກກະຕິ
  • ພັດທະນານິໄສປົກກະຕິ
  • ຮັກສາທັດສະນະໃນທາງບວກ
  • ຮຽນຮູ້ທັກສະການຜ່ອນຄາຍ

ທັງ Gorski ແລະ Carty ໄດ້ຕົກລົງເຫັນດີວ່າການເວົ້າກ່ຽວກັບອາການຂອງທ່ານແລະຜົນກະທົບຕໍ່ຄວາມກົດດັນກັບຄົນທີ່ທ່ານໄວ້ວາງໃຈ, ເຊັ່ນວ່າຜູ້ໃຫ້ຄໍາປຶກສາຫຼືຜູ້ສະຫນັບສະຫນູນ AA, ສາມາດຊ່ວຍທ່ານຮັບມືກັບການຖອນເງິນທີ່ຍາວນານ. ບອກຄົນອື່ນກ່ຽວກັບສິ່ງທີ່ທ່ານກໍາລັງປະສົບສາມາດຊ່ວຍໃຫ້ທ່ານເຫັນສະຖານະການທີ່ມີຈິງແທ້.


ບາງຄົນທີ່ປະຕິເສດການດື່ມເຫຼົ້າແລະຢາເສບຕິດບໍ່ເຄີຍມີອາການສະແດງອາການສ້ວຍແຫຼມຢ່າງໃດເລີຍ, ໃນຂະນະທີ່ຄົນອື່ນຍັງສາມາດປະເຊີນກັບອາການບາງຢ່າງເປັນເວລາຫຼາຍປີ. ຈໍານວນເວລາທີ່ອາການສາມາດຢູ່ໄດ້ຍັງສາມາດຂຶ້ນຢູ່ກັບປະເພດຢາທີ່ທ່ານກໍາລັງຖອນອອກ.

ຜູ້ຊ່ຽວຊານດ້ານການຟື້ນຟູກ່າວວ່າຜູ້ປ່ວຍທີ່ບໍ່ໄດ້ຮັບການປິ່ນປົວຈາກການດື່ມເຫຼົ້າແລະອາຈຽນໂດຍທົ່ວໄປມັກຈະໄດ້ຮັບການຖອນຄືນຈາກ 6 ຫາ 24 ເດືອນ. ຢ່າງໃດກໍຕາມ, ມີລາຍງານຂອງຄົນທີ່ບໍ່ມັກກິນ benzodiazepines ຜູ້ທີ່ສາມາດມີອາການບາງຢ່າງ 10 ປີຕໍ່ມາ.

«ອາການຂອງ PAWS ມັກຈະເຕີບໃຫຍ່ຂຶ້ນໃນລະດັບສູງສຸດໃນໄລຍະສາມຫາຫົກເດືອນຫຼັງຈາກການບໍ່ນັບຖືເລີ່ມຕົ້ນ», Gorski ກ່າວ. «ຄວາມເສຍຫາຍແມ່ນປົກກະຕິແລ້ວກັບຄືນໄປບ່ອນ, ຊຶ່ງຫມາຍຄວາມວ່າອາການທີ່ສໍາຄັນຈະຫາຍໄປໃນເວລາຫາກການປິ່ນປົວທີ່ເຫມາະສົມແມ່ນໄດ້ຮັບ. ດັ່ງນັ້ນ ບໍ່ຈໍາເປັນຕ້ອງຢ້ານ .»


DeSoto CB, et al «Symptomatology in Alcoholics at Stage of Abstinence.» ການດື່ມເຫຼົ້າ: ການຄົ້ນຄ້ວາທາງການແພດແລະການທົດລອງ 2007 ກັນຍາ

Kiefer F, et al «ການພົວພັນຂອງ plasma atrial natriuretic peptide ໃນການຖອນເຫຼົ້າ prolonged.» Acta Psychiatrica Scandinavica ມັງກອນ 2002

Satel SL, et al «ການຖອນເງິນຈາກຢາເສບຕິດຄວນຈະຖືກລວມຢູ່ໃນ DSM-IV?» American Journal of Psychiatry ເມສາ 2006


Relapse Prevention (3 Stages of Relapse & Recovery)

Is PAWS Real or Just Another Relapse Excuse?

Whether new to sobriety or sober for many years, relapsing is always a possibility. It is vital to understand the stages of relapse and which factors may put you at risk.

Understanding relapse prevention techniques and knowing how to help yourself is critical for a successful, long-term recovery. Additionally, creating a relapse prevention plan for alcoholism can help you maintain sobriety and avoid relapsing.

The National Institute on Alcohol Abuse and Alcoholism estimates that 90 percent of people recovering from alcohol use disorder will experience at least one relapse within the first four years following treatment.


The 3 Stages of Relapse

A relapse typically doesn’t occur as a spur-of-the-moment event. In most cases, there are three main stages of relapsing. Understanding these stages, and what to do when they occur, can help stop a relapse before it takes effect.

The 3 stages of relapse include: 

1. Emotional Relapse

During an emotional relapse, a person is not consciously thinking about drinking. However, their emotions and behaviors are setting the stage for a relapse.

During this stage, denial plays a big role. Many of the signs that occur during emotional relapse are also symptoms of post-acute withdrawal (PAWS). To help minimize the risk of relapse, it is important to recognize that many of the uncomfortable feelings you experience in early addiction recovery could be symptoms of PAWS.

Symptoms of PAWS include:

  • Foggy thinking/trouble remembering
  • Urges and cravings
  • Irritability or hostility
  • Sleep disturbances, such as insomnia or vivid dreams
  • Fatigue
  • Issues with fine motor coordination
  • Stress sensitivity
  • Anxiety or panic
  • Depression
  • Lack of initiative
  • Impaired ability to focus
  • Mood swings

Emotional relapse warning signs include:

  • Anxiety
  • Restlessness
  • Intolerance
  • Discontent
  • Anger and irritability
  • Defensiveness
  • Mood swings
  • Bottling up emotions
  • Isolation and not asking for help
  • Not attending support groups (or attending and not sharing)
  • Poor self-care (not eating, sleeping, or practicing good personal hygiene)

During an emotional relapse, the main goal should focus on self-care. The acronym HALT– hungry, angry, lonely, and tired–is an important thing to keep in mind during this stage.

Ask yourself questions , “are you feeling exhausted or mentally drained?” or “are you taking time for yourself?” If the answer to these questions is no, it might be time to take a step back and practice self-care. You might also want to share your feelings with a support group or counselor.  

2. Mental Relapse

During a mental relapse, a person is at war with their mind. A part of them knows they shouldn’t use, while the other part is looking for excuses to use. As this stage progresses, a person’s resistance to alcohol diminishes and their need to escape through alcohol use increases.

Early warning signs of mental relapse include:

  • Thinking about people, places, and things associated with past use
  • Spending time with users
  • Cravings for alcohol
  • Glamorizing past use
  • Minimizing the consequences of their past use
  • Bargaining
  • Lying
  • Thinking of ways that they could better control their alcohol use
  • Looking for opportunities to relapse
  • Planning a relapse

During this stage, it is critical to seek help in order to prevent a relapse. You can do so by talking to non-using friends, attending a meeting, or speaking to a counselor.

You can also find something to distract yourself. It takes 15 minutes for craving urges to go away, so it’s important to stay busy and use coping skills.

3. Physical Relapse

Physical relapse is the act of taking a drink and then using again, as well as the act of driving to the liquor store and purchasing alcohol. If you are unable to address the problems of emotional and mental relapse, it doesn’t take long to progress to physical relapse. For this reason, understanding and recognizing the signs of emotional and mental relapse is crucial.

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The 3 Stages of Alcohol Recovery

Research shows that there are three main stages in the recovery process. Each stage has specific tasks that can assist in preventing alcohol relapse. However, recovery is a personal process, and the length of each stage varies from person to person. The three stages include:

1. Abstinence Stage

The abstinence stage starts immediately after alcohol cessation and can last for one to two years. During this stage, the main focus is fighting cravings and avoiding alcohol use. Other goals of abstinence include personal self-care and development. It is also common for PAWS and relapse to occur during this stage.

2. Repair Stage

The repair stage focuses on repairing the damage caused by alcohol addiction. In many cases, it can last two to three years. During this stage, recovering alcoholics must confront the damage their addiction caused to relationships, their careers, their finances, and how they feel about themselves.

This stage is where a person works to overcome guilt and negative self-labeling in order to move forward.

3. Growth Stage

The growth stage is all about moving forward and typically begins three to five years after alcohol cessation. This is the start of a new lifelong path to sobriety. In some cases, this is the time to address and confront any underlying cause of your initial addiction.

While many may want to address this sooner, they typically do not have the coping skills necessary to do so without increasing their relapse risk.

Some recommended tasks during this stage include:

  • Identify and begin to repair self-destructive patterns and negative thinking
  • Understand how familial patterns and past trauma may have contributed to your use and begin to move forward
  • Set healthy boundaries
  • Give back and try to help others
  • Take time on a regular basis to reevaluate how you are living
  • Take care of yourself in order to keep moving forward

How to Create a Relapse Prevention Plan

Whether on your own, with a rehab counselor, or through your support group, you should create an alcohol relapse prevention plan. While all prevention plans are unique, there are some major points you should always address.

These relapse prevention skills include:

  • Triggers – Begin by creating a list of all possible relapse triggers. These can be people, places, events, or emotions that are tied to alcohol abuse. While you may not know all of your possible triggers at the beginning, it can be a list that evolves over time.
  • Healthy coping skills and preventative tools – Create a list of healthy coping skills and tools you can use when cravings or thoughts of relapse occur. This can include building a healthy support system of friends and family you can turn to. Activities, such as exercising or journal writing, can also provide a distraction when triggering events occur. Another coping skill is to create a list of consequences, should you relapse. Often times, this is enough to redirect your thoughts and get you back on track.
  • Find and participate in a support group – Support from others is a crucial part of relapse prevention. Having the ability to talk to others that understand your recovery process can help. Finding a sponsor or counselor that you can turn to in times of crisis is also beneficial. While 12 Step programs work for many people, other options are available.
  • Lifestyle changes – Recovery involves more than not drinking. For example, you must create a life that makes it easier not to turn to alcohol. Look for new activities and hobbies. Set new career goals. Meet new people and create new social circles that encourage your recovery.
  • Don’t be afraid to ask for help – Recovery is not something you have to do alone. Asking for help is not a sign of failure, but rather a sign that you understand what is happening and that you need assistance. Self-help groups and support groups are a great place to start.

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