Take our Addiction Test

Find a therapist to overcome addiction

Post-acute withdrawal syndrome (PAWS) and PTSD share many of the same symptoms.

PTSD is often mistaken for PAWS in addiction treatment contexts.

Treatment professionals should carefully assess for PTSD.

Almost all Americans are familiar with posttraumatic stress disorder (PTSD) and its long-term, sometimes devastating effects on people’s lives—crippling anxiety, depression, disturbing flashbacks, sleep problems, irritability, concentration difficulties, and much, much more.

About 70 percent of U.S. adults have experienced at least one major life trauma. The fact that so many of us experience trauma makes it easier to empathize with the 10 or so percent of people who go on to develop PTSD. This explains why PTSD is far less stigmatized than disorders like schizophrenia, bipolar disorder, and addiction, which far fewer people experience firsthand.

Post-Acute Withdrawal Syndrome

Americans are much less familiar with post-acute withdrawal syndrome (PAWS) than with PTSD. PAWS describes a collection of symptoms that occur after people with addiction quit using and enter recovery. PAWS symptoms, such as anxiety, depression, sleep problems, cravings, cognitive impairment, and irritability, can last for months to years after initial withdrawal from any number of drugs. These include alcohol, benzodiazepines, crack, marijuana, methamphetamine, and opioids.

PAWS isn’t an official medical diagnosis, yet there’s little question it exists. In some cases, physiological causes are well understood. People who are addicted to methamphetamine or crack, for example, can do long-term damage to their brain’s dopamine systems, making it difficult to experience pleasure. Some people’s dopamine systems are so damaged that they experience low-grade depression for life.

In many cases, however, symptoms we attribute to PAWS are caused by PTSD instead. Given so many shared symptoms, differentiating between PAWS and PTSD can be difficult. How are we to distinguish them in practice, where proper........

© Psychology Today