PAWS – Post-acute withdrawal

Tellin’ It Like It Is

From a reader on another site (used with permission).  No comment required.

I was addicted to Crystal Meth for a solid six months – That may not sound like much, but it only takes a little to hurt you. At the time it seemed like fun and just something to do but it was so much more then that. It consumed my entire life and turned me into someone/something I didn't want to be. I would look at myself in the mirror and just hate the person looking back at me with every fiber of my being. I knew I needed to quit but I just couldn't deal with the withdrawals.

I reached my peak of use on October 27th of this year. I was celebrating my birthday with a few buddies and what went from a round of use turned into a 13 hour binge. It ended with me lying on the couch for the next 48 hours writhing in pain. I felt like my body was contorted; my heart was racing, everything looked off-balance, I couldn't eat, I couldn't sleep, and I literally felt like I was dying. And that was the last time I used.

I've been clean ever since and it has been rough. A couple weeks after that PAWS [Post-acute Withdrawal Syndrome] started setting in and it has been hellish to say the least. I have my good days and my miserable ones, but I just keep looking at the future and remembering it will get better. And to top this all off… I'm only 19.

Questions From Newcomers: Is it possible to have a healthy life right after detox?

The smart-aleck answer to the question “Is it possible to have a healthy life right after detox” is “What…are you kidding?”  However, the straight answer is “What do you mean by ‘healthy?’”

When it comes to recovery, we speak of at least two kinds of health: physical, and emotional.  Some folks would add spiritual health (which has nothing to do with religion) to that list.  We need to remember that our bodies and minds were subject to the effects of chemicals more-or-less continuously for months — in most cases, for years.  Major changes took place due to the effects of drugs on our brains, as well as their effects on other body systems, especially in the case of alcohol.  It would be unreasonable to expect these changes to reverse and return to normal overnight.  Just as it took years to create the problems, so may it take months to recover from them.  The good news is that it rarely takes anywhere near as long for repairs as it took to do the damage, and improvements begin to show up relatively soon if we’re patient.

Our physical health depends on what condition we were when we came to detox (young, older, fit, couch potato, etc.), what residual effects we may experience from the drugs (post-acute withdrawal), and what other health problems we brought with us.  Many, if not most, addicts suffer from a variety of problems that can range from cirrhosis of the liver and/or viral hepatitis to diabetes, malnutrition, or general poor physical conditioning — often several issues of varying severity that need to be addressed.  Even those of us who styled ourselves athletes during our addiction may find that the reorganization of our internal chemistry leaves us with less get up and go than we figured, or that the drugs were covering up some condition that is revealed by a physical exam when we’re sober.  These things aren’t inevitable, but the possibility of some problems should be anticipated.

Mentally and emotionally, most of us addicts (alcohol is a drug, and alcoholics are addicts) find that for the first few weeks and months we run the gamut of emotions, from manic highs — where we believe recovery is the most wonderful thing that could happen to anyone — to bouts of depression and the thought “If this is all there is, I might as well use.”

But there is good news!  For one thing, though we may feel lousy, physically and emotionally, these things slowly improve if we stay clean and sober and work on a program of recovery.  Furthermore, we have the assurance that, even though it may seem as though it’s happening at a snail’s pace, people who remain abstinent and take care of themselves otherwise always improve eventually.  For us addicts, accustomed to feeling good in a matter of minutes whenever we feel like it, these periods may seem endless.  But they are not, and periods of feeling good eventually occur, increasing in frequency and quality as the repairs take place and we get back into the swing of living.

As time passes, we begin not only to feel better, but to think about getting back to what we perceive as our normal lives.  We want to clean up some of the messes we made, right some of the wrongs, find jobs, begin to save a little money, and try to earn the respect and trust of others.  These improvements are immensely aided by the support and help of other recovering people.  Put succinctly, people who go to meetings and develop a support system, learning to follow directions and do the next healthy thing, tend to recover if they persevere.  Those who don’t rarely remain clean and sober for long.

So the answer is that it is possible to live a healthier life immediately after detox.  A healthy life may be further down the road, but it is attainable.  Millions of people have gotten through the first weeks and months of abstinence, and achieved lasting sobriety.  The secrets are, first, to want it more than anything else, and second to stick with it and — as they say — wait for the miracle.

What about wine used in cooking? How dangerous is it for alcoholics?

Wow — this is a week for good questions!  A reader writes that he had a fancy meal, and then discovered that wine had been used in making the sauce.  He was concerned that it could complicate his recovery.  Here's my answer.  (The “PAWS” comment refers to post-acute withdrawal syndrome, problems and discomfort that arise as our bodies are recovering from the ordeal of addiction.  I'll be writing more about that in posts to come.)


This is an issue that needs more attention than it gets. First of all, you can relax regarding the PAWS. The likelihood of that tiny amount of alcohol contributing to any extension of your PAWS is remote, especially since it was consumed with food. Likewise, your sobriety is intact; it was not your intention to use and, indeed, it is impossible to avoid alcohol entirely — although that does not absolve us from remaining vigilant.

It is quite true that cooking alcohol, especially when used in sauces, does not evaporate completely in most cases. However, unless the sauce is reduced at extremely low temperatures, most of it is removed. Since, however, we can’t be sure of that — or that the chef didn’t taste it and decide it needed another touch after the fact — we need to be careful.

I believe that this is mostly a matter of intent and due diligence: we do what we can to avoid knowingly ingesting any alcohol, and deal with each issue if and when it comes to our attention. Having asked about alcohol in the sauce, and having done your due diligence, your attitude alone would indicate that your head’s in the right place and that you’re going to be OK. If someone had handed you a beverage and you’d chugged without even smelling it, that’s a “whole ‘nother smoke,” as they used to say in the Marlboro commercials.

Yes, it’s a good — a very good — idea to avoid alcohol in food if it is possible to do so. But remember this: we relapse in our heads, not in our bellies. The state of mind that leads to using any drug is just as important as the physical act — in this sort of case, even more so. As I’ve written dozens of times before, relapse comes before the drink.

To take another example, let’s say you’re at a wedding, and inadvertently get hold of the spiked punch. Maybe you’re distracted and take a swallow without smelling it and making sure — no question, you took a drink! But did you relapse? Of course not! It was an accident, or at worst simple carelessness — a lesson, not a tragedy.  You jack up your due diligence, step up your meetings for a while, talk about it, stay in touch with people in the program, do a good Tenth Step and get on with life. Stuff happens. If you’d intentionally taken a glass of champagne to toast the happy couple, “just this once” — well, I think you can see the difference there without further from me.

We're not responsible for our addiction, but we're sure as heck responsible for our recovery.