Recovery is a lifelong process, because the decision to remain sober is one that has to be made every day anew. Many people think that the “hard part” of addiction recovery will end after a limited time in a rehab center, and that life will return to normal after the toxic substances have been removed from the body. While this initial stage of “acute withdrawal” is a significant step, it is not the end of recovery.
After detoxification, there are often further, residual cravings and discomfort that can last long after the substances have left the body. Post-acute withdrawal syndrome (PAW) may vary in intensity from person to person, dependent on a lot of factors, but can be prepared for among all former users in the recovery process. After years of brutalizing your body through substance abuse, it can take time for yourself to heal and reorient itself toward sobriety.
What to Expect:
In general, the longer and more intense your substance use, the more severe and long-lasting your post-acute withdrawal may be. Sensations may include low energy, difficulty concentrating, a lack of enthusiasm, disrupted sleep, anxiety, irritability, anger, and depression. Sensations may come and go with varying degrees of intensity.
While some moments may allow you to feel relatively good and free of the pull of addiction, at other times, you may feel intensely frustrated or anxious, wondering how you’re going to be able to make it through the day. Generally, the roller-coaster like fluctuation of emotions starts to slow down.
While at first it felt like your emotions were changing every minute, eventually you will be able to go a few weeks or months without feeling any withdrawal symptoms. But, without warning, you may suddenly feel low energy levels or frustrated thoughts that seem to come from nowhere, lasting a few days, and then leaving just as suddenly.
Drugs saturate the brain with endorphins and dopamine, chemicals that your brain produces naturally to feel happy, relaxed, and excited about life. The all-consuming highs of drug or excessive alcohol abuse are caused by a higher degree of these chemicals coming into the brain than would come about in any other activity.
Over time, the brain begins to compensate by decreasing the amount of these neurotransmitters it responds to naturally. This means that normal activities that would otherwise give pleasure aren’t felt powerfully enough to change your mood. Your level may even dip to levels below feeling “normal.” This can be a hard time to endure, but if you hold on and maintain your sobriety, the brain will begin to start responding to normal levels of endorphins between four weeks and six months.
Post-acute withdrawal generally lasts two years after secession of use. Being caught off guard can make it harder to deal with and make you vulnerable for relapse. Being prepared can help you find the strength to endure. You will get through this, and end up stronger and sober on the other side.
Be patient with yourself, reminding yourself that recovery takes time. Enjoy your days without symptoms, and recognize when things start to get harder. Be gentle with yourself, and don’t try to do too much on the harder days. Take care of yourself, and make your recovery your priority, so that you can focus on caring for yourself until you make it through. This means having some introspective moments where you think about what you can handle.
Give yourself lots of breaks, and be gentle and gracious with yourself. When your energy levels feel low, it’s ok to not take on or do too much, but just rest until the feelings go away.