In Making Time for Recovery Part 2 we discussed the importance of healthy relationships, support groups and friendships and acquaintances in a daily recovery program. In Part 1 nutrition and exercise and its relation to a strong recovery program from drug addiction or alcoholism was discussed. These vital aspects of a daily recovery program must be balanced with conscious and deliberate management of clinical symptoms of the disease of addiction. This primarily includes addressing relapse triggers such as Post Acute Withdrawal Syndrome (also referred to as PAWS) and Denial.
3.) Managing symptoms and triggers
Post Acute Withdrawal Syndrome / PAWS
Symptoms of Post Acute Withdrawal Syndrome are widely considered to be the leading cause of relapse in recovering addicts and alcoholics. Therefore, management of PAWS is critical in order to prevent these relapse events, as the dangers of returning to a life of substance abuse or alcoholism are very real and very severe.
Post Acute Withdrawal Syndrome occurs after a person has completed detox. The intensity, duration and type of symptoms vary greatly from person to person but include the following;
- Inability to think critically
- Inability to solve simple problems
- Memory problems
- Low self-esteem
- Inappropriate emotional responses
- Strong cravings to use drugs or drink
These issues and others like them can cause a person in recovery to turn to drugs again as a method of self-medication:
“These symptoms, post-acute withdrawal, tend to be affective in nature and subacute and often precede relapse. Negative affective states, including negative emotions such as elements of anger, frustration, sadness, anxiety, and guilt, are the leading precipitants of relapse” (1)
Management of these symptoms as part of a daily recovery program includes the need for rigorous, regular self-assessment, treatment via individual counseling or psychotherapy, and management with medications where appropriate.
It’s important to note that addressing the daily recovery practices mentioned in Parts 1 and 2 of this article series will significantly reduce the frequency, duration and severity of the symptoms of Post Acute Withdrawal Syndrome. By maintaining healthy relationships, nurturing support networks, eating right and exercising, PAWS can be effectively mitigated and greatly reduce the likelihood of relapse.
Denial is the self defense mechanism of addiction. It not only fools the addict into believing things that clearly are not true, it also causes the addict to outwardly deny the existence or severity of the problem to others. And when it comes to a daily recovery program, denial may also cause a person to doubt their own abilities to stay clean.
Like management of PAWS symptoms, denial must be treated with self-assessments, various therapies and medication when needed. But while the treatments for each are similar, these two conditions are separate, distinct aspects that could independently or in combination threaten the health of a recovery program. The main distinction here is that denial is purely a mental state, while PAWS can be physical, emotional, and mental.
To learn more about what it takes to work on a daily recovery plan, please see part 4 of this article series. In it we’ll discuss the spiritual aspects of a recovery from addiction or alcoholism program.
If you or someone you love has recently relapsed or you need help for a drug problem, please call the number at the top of your screen for a free, confidential consultation right now. We are a group of addiction experts whose primary mission is to help you put your Recovery First.
(1) Koob, George F. Ph.D Dynamics of Neuronal Circuits in Addiction: Reward, Antireward, and Emotional Memory 05/11/2009 National Center for Biotechnology Information