Post Acute Withdrawal Syndrome

A Reader Writes About Her PAWS Experience

I got this letter a few days ago. It so closely parallels the article on the Sunrise Detox blog about sugar addiction, and has such a clear outline of the lady’s experiences in early sobriety, that I thought it would be good to publish it here, along with my response. Perhaps some of you folks will be able to relate. The letter is edited for readability and to preserve anonymity, and is being published with the permission of the writer.

I had absolutely no acute withdrawal symptoms when I stopping drinking. In fact, quitting was so easy I never lasted more than 3 months before. I used to do these “stop drinking” bouts twice a year for the last 5 years to cleanse but admittedly, looking back it was because I had a problem with alcohol. It's been over 100 days now. I quit on January 1st.

I'm 46 and I have been drinking since 17. I was a heavy drinker who was always sensitive to alcohol. I could handle booze until I was 40, when I started drinking a bottle of wine nightly. For me, who was small, that was way too much. No one thought I was having a problem because I was drinking alone, hiding at home.

I had no withdrawal but I seem to now have classic PAWS. [Post-Acute Withdrawal Syndrome – Ed.] Where I used to have mental acuity and a really fast mind, I'm now super confused and tired. My first month was complete rage. I was so bloody angry, where did it come from? I seemed to be intolerant and have no censure about telling people off. It's almost comical.

In a sense it relieves me, I can finally not be polite. I used to be so polite and sweet and nice but chronically depressed as a drunk. I'm now angry, which in my book is better than depression. (Can you believe it, I was sure booze didn't create depression because when I stopped for a month before, I was not less depressed. But now that I’ve accumulated over 4 months and am no longer depressed, I SEE that it was alcohol. I just so wish I had got that realisation sooner…so many years wasted!)

Thankfully, the rage has subsided. I deal with frequent headaches, but my most annoying PAWS symptom is sugar craving. I was on a NO CARBS diet for 8 weeks and it helped, but it was too austere to be a happy place (I'm all about extremes) so I'm back to a good diet, meditate daily, do yoga, I'm doing wonderfully except for the sugar cravings. When I feel like drinking like mad, I allow myself the sugar rush. I guzzle a spoonful of molasses or maple syrup, and you know what? It helps me greatly. My only question is, will it ever diminish? It's a sugar craving exactly like when I have PMS — the exact same urge to have sugar with immediate brain POW relief. So since I don't abuse sugar at all except a daily dose of dark chocolate (1 square) or a tablespoon of maple syrup, i think it can't harm me that much. Better than alcohol.

I don't mind that PAWS takes time. In a way it makes me grateful, it reminds me that I'm weaned from my poison. I'm just happy it's not 1 year for 1 year of booze because I would be in pain for the next 25 years.

Thank you so much for your kind presence. I find that you are very present to us. In spirit, in listening.

“Ruth”

Hi Ruth,

Don't worry about the sugar for now. Next time you go to your doc, request that she order an A1C test to evaluate the way your body is handling glucose. For the time being, stick with the method you've found. You might try smaller amounts of sugar or — perhaps better — some more complex carbs to see how that works. I'm concerned about blood sugar spikes and bottoms, especially in connection with the rage.

Ah, the rage. Hardly surprising that it has surfaced now that the booze is gone. Booze helps us stuff all manner of things, powerful feelings first among them. At some point you'll be ready to take a good look at things in the past that are causing it, perhaps via a 4th and 5th Step, or with a good therapist. For now, don't sweat it, but you will need to explore those issues eventually. (If that caused any kind of reaction besides, “Oh, okay,” it's proof of the premise. Denial ain't just a river in Africa.) If things get too tough, buy an aluminum baseball bat, find some poor undeserving surface, and whale away at it for a bit. Good upper body exercise, too.

How much we drank has less to do with PAWS than how long we drank and how our tolerance for alcohol developed. Along with tolerance came changes in our brain, as our bodies attempted to adapt to the altered levels of neurotransmitters (NT's) caused by the stimulation of the alcohol and/or other drugs. These are permanent changes that involve receptor sites and other minutia. As a small woman, you got the full treatment. Because women produce less of the enzyme that metabolizes alcohol (ethanol dehydrogenase), it stays in your bodies longer, at higher levels than it does in men. Being small merely exaggerated that. More effects for the money is about the only benefit there.

Put simply, PAWS is the symptoms our body experiences during the period when the brain and other bodily systems are returning to an approximation of normal. They include all the things that you mentioned, some others that you didn't, and sometimes depression. Not everyone expresses the same syndrome, but your list fits right in.

PAWS usually lasts for from 8-10 months to two years, depending on a broad range of variables. There is no way to avoid it, but following the suggestions in the article can ameliorate many of the effects, and just knowing that it will gradually get better is a morale booster, too. Expect some swings: good days and worse days, with the good slowly increasing. It's frustrating for us addicts, because we're used to mood changes on demand, but this is better.

Trust me.

Follow the hypoglycemic diet suggested, and stay away from fad and “cleansing” diets. They have no real validity, regardless of how artful the presentation. Remember that those folks are trying to sell things; there's no profit in simple, good nutrition. Recovery is about reality, and there's some for you right there.

Keep on keepin' on!

Bill

Permanent post:

Newly Sober? PAWS Still Has You In Its Claws!

Early recovery can have its rough spots. If you've been having more bad days than good, you might want to take a look at this article. It could make things a lot easier. (Hint: You're not going nuts!)