A person is attached to a ball and chain with a benzo addiction

Most drugs of abuse have the ability to cause a physical dependence on the substance. This means that when an individual stops taking that substance they will experience a set of withdrawal symptoms. This acute withdrawal syndrome can include symptoms that range from moderate to quite severe discomfort, and typically only last for a few days to weeks.

While this early withdrawal period passes relatively quickly, it typically gives way to another series of withdrawal symptoms known as post-acute withdrawal syndrome (PAWS). Here we discuss the post-acute withdrawal syndrome caused by benzodiazepine (Xanax, Valium, Ativan, Klonopin, etc) abuse.

What is Benzodiazepine post-acute withdrawal syndrome (PAWS)?

While the most extreme benzodiazepine (Benzo) withdrawal symptoms tend to subside A man stands and thinks about his benzo addictionwithin two weeks, a variety of typically less severe general withdrawal symptoms can persist for months at a time.

These symptoms, collectively, are known as Post-Acute Withdrawal Syndrome, or PAWS for short.

The severity of post-acute withdrawal syndrome is usually not nearly as intense as the early acute withdrawal period. Post-acute withdrawal absolutely can, however, be one of the more difficulties hurdles to overcome on the road to long-term sobriety. Thus, recognizing the symptoms of post-acute withdrawal syndrome and understanding that these symptoms are perfectly normal is crucial to achieving long-term sobriety.

So, what are the symptoms of Benzodiazepine Post-acute Withdrawal Syndrome (PAWS)?

The following symptoms occur from benzodiazepine post-acute withdrawal syndrome-

  • Rebound anxiety (the return of greater anxiety symptoms after withdrawal from a certain substance that you have experienced beforehand)
  • Depression
  • Disturbances in sleep patterns
  • Fatigue
  • Dysphoria (feeling sad or down)
  • Irritability
  • Continuation of other acute-withdrawal syndromes

Some physiological symptoms produced by benzodiazepine PAWS can even mimic the following disorders-

  • Agitated depression
  • Generalized anxiety
  • Panic disorders
  • Obsessive-compulsive disorders
  • Schizophrenia

How long does Benzodiazepine post-acute withdrawal syndrome last for?

The acute-withdrawal phase for most benzodiazepines lasts approximately 1-4 weeks cold turkey, or 3-5 weeks with tapering. (1) Unfortunately, there is no clear-cut timetable for how long the post-acute withdrawal syndrome caused by benzodiazepines lasts for. The duration of PAWS varies greatly amongst users depending on a number of different factors.

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First, each benzodiazepine has a different half-life (length of time it lasts in the user’s system), which can affect how long PAWS lasts for. Next, the longer an individual abuses benzodiazepines, the longer it will take for the brain to heal.

While the duration of benzodiazepine PAWS varies for each person, it typically lasts for a number of months before dissipating completely.

What causes post-acute withdrawal syndrome (PAWS) symptoms to form?

Chronic abuse of certain addictive drugs and alcohol is the main reason for post-acute withdrawal syndrome developing. Alcohol and many mind-altering substances can cause adaptive changes in the brain including molecular, cellular, and neurocircuitry changes.

The result of these changes often has profound affects on the individual’s emotions and behaviors. (1) (2) Drug and alcohol addiction, for example, causes changes in the brain’s reward pathway that may cause the brains own natural reward system to be affected. (3) These changes may last for weeks or months, and are the primary reason that post-acute withdrawal syndrome occurs.

So what can be done about Benzodiazepine PAWS?

Benzodiazepine-induced post-acute withdrawal syndrome is a major roadblock in achieving long-term sobriety. There are, however, several techniques to combating PAWS. First, it is important to recognize that benzodiazepine PAWS are completely normal for those in early recovery and that they do not last forever.

This knowledge is important to prevent feelings of hopelessness and fear that the symptoms will last forever. Second, it is crucial to find healthy ways to combat the rebound anxiety that typically accompanies the benzodiazepine PAWS.

These can include joining a recovery fellowship, therapy, and healthy hobbies/activities that reduce anxiety. Above all, abstinence and time are the greatest cures for benzodiazepine post-acute withdrawal syndrome. Furthermore, there is no better time to remember the classic recovery slogan related to these feelings – this too shall pass.

Final Note

This article is intended for those considering a new way of life, free of the pain of drug and alcohol addiction. For more information on recovery and anyone seeking help with addiction and substance abuse problems, please call True Recovery at (844) 744-8783 or visit us online.

Sources

  1. https://web.archive.org/web/20180924130630/https://store.samhsa.gov/shin/content/SMA10-4554/SMA10-4554.pdf
  2. https://www.ncbi.nlm.nih.gov/pubmed/12359667
  3. https://www.annualreviews.org/doi/abs/10.1146/annurev.ne.19.030196.001535?journalCode=neuro