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Post Acute Withdrawal Syndrome: Causes, Symptoms, Treatment

Individuals that have used any potent drug, particularly for a long-term and/or at high doses are known to experience significant short-term withdrawal symptoms.  These symptoms may include things like dizziness, headaches, nausea, and vomiting.  Over time, they usually lessen in severity as the nervous system and physiology adjusts to function without the presence of the drug.

Unfortunately, for many people the withdrawal period is not limited to a short-term.  After the first couple weeks of discontinuation, individuals may find that their symptoms fail to lessen in severity for weeks, months, or in rare cases – years beyond when they were told they should be fully recovered from withdrawal.  To add to their frustration, many medical professionals either fail to inform their patients or completely dismiss the possibility of protracted withdrawals.

This adds to the patient’s anxiety and often leads them to perceive that something more serious is wrong (e.g. a brain tumor) when their dizziness persists for months.  Although it is important to always get a medical and neurological screening to rule out the possibility of something more serious, if symptoms emerge upon discontinuation from a drug – they are usually a result of withdrawal.

What is post-acute withdrawal syndrome (PAWS)?

Post-acute withdrawal syndrome (PAWS) refers to withdrawal symptoms that persist for an extended duration following drug discontinuation.  Post-acute withdrawals are most commonly referenced among individuals discontinuing opioids.  This is due to the fact that during opiate withdrawal, individuals often endure intense short-term symptoms and think that their withdrawals will be over after they “weather the storm.”

In many cases, the short-term symptoms lessen, but never seem to go away.  In some cases, new symptoms may emerge and a person experiences long-term functional impairment.  This long-term impairment may last for weeks, but often persists for months – and in some cases years – beyond the expected date of recovery.

The condition is not limited to those discontinuing opioids, it commonly occurs among those discontinuing alcohol, benzodiazepines, antidepressants, antipsychotics, and other psychoactive drugs.  Although “post-acute withdrawal syndrome” is not recognized by the Diagnostic Statistical Manual of Mental Disorders (DSM) or by any medical associations, to deny or dismiss its existence is short-sighted.

  • Source: https://www.ncbi.nlm.nih.gov/pubmed/8097618

Factors influencing Post-Acute Withdrawal Syndrome (PAWS)

If you are experiencing or have experienced post-acute withdrawal syndrome, it is important to consider the factors that may have influenced its duration.  The factors listed below may play a role in influencing both the severity and number of symptoms you experience.

1. Time Span

In general, the longer the duration over which you’ve taken a drug, the greater the severity of withdrawal.  Those that have been medicated for years, discontinue a drug, and expect to feel back to 100% within weeks are often deluded.  Over a long-term, the drug has made changes to your physiology and brain that take a very long time to recover.

In fact, sometimes the recovery period may be longer than the term over which you used the drug.  If you’ve been taking an antidepressant for 10 years, decide to stop, and hope that you’ll feel normal in just a couple weeks is completely misguided.  Whatever chemical you had been supplying your body with for a long-term will result in a temporary deficiency upon discontinuation.

It can take awhile for your body (a complex system) to repair all of the changes that were made by the drug and re-learn how to manufacture an endogenous supply of neurotransmitters, hormones, etc.  Those that had taken opioids for a long-term often experience “PAWS” because their body needs to re-learn how to manufacture its own, endogenous endorphins rather than rely on a synthetic drug.

2. Frequency

Most individuals experiencing post-acute withdrawal syndrome are likely to have taken their drug on a daily basis or multiple times per day.  The greater the frequency over which you took a particular drug, the more likely you’ll be to experience post-acute withdrawals.  Someone who takes a drug once per week has a virtually zero percent chance of experiencing post-acute withdrawals.

This is due to the fact that most of the  week a person is functioning without the drug.  However, a person taking a benzodiazepine 4 times per day has essentially become both psychologically and physically adapted to the drug in order to function.  Removing the drug from a person’s daily regimen, especially when used at a high frequency over an extended period of time is very likely to result in protracted or post-acute withdrawals.

If your body and nervous system have completely adapted to a drug that you’ve been administering at a high frequency for a long-term, it will probably take awhile to not only reverse changes made by that substance, but also restore homeostatic functioning.  Those taking drugs that are active for 24 hours are at increased risk for post-acute withdrawal syndrome.

3. Dosage

The effect of a drug is often dictated by the dosage administered.  Taking the minimal effective dose is much less likely to result in a post-acute withdrawal than taking the maximum dose or a supratherapeutic dose.  Certain drugs like opioids, benzodiazepines, and psychostimulants are associated with rapid-tolerance development.

This means that individuals often become tolerant to the effects of medically acceptable doses and find that they no longer offer any therapeutic benefit.  At this point, an individual will find that they cannot function without the drug, but aren’t getting any benefit with their current dose.  Some doctors and/or patients may end up taking supratherapeutic (higher than recommended doses) of drugs due to tolerance building.

These high doses produce even greater physiological change, resulting in more temporary relief.  Before a patient knows it, they’ve dug themselves into an even deeper hole with this high dose.  Discontinuing from supratherapeutic doses is regarded as the most difficult and most likely to produce post-acute withdrawal syndrome – especially if discontinued cold turkey.

4. Tapering vs. Cold Turkey

To minimize potential of experiencing post-acute withdrawal syndrome, it is always recommended to follow a tapering protocol.  The speed by which you taper should be calculated based on your individual circumstances, the drug you’ve been taking, how long you’ve been taking it, and your dosage.  As a general rule of thumb for antidepressants, dosing should be reduced by 10% per month, sometimes slower or quicker depending on the individual.

If you quit a drug cold turkey, your risk for post-acute withdrawal syndrome increases.  This may be due to the fact that you were taking a high dose, and instead of allowing your nervous system to gradually adapt to receiving less of the drug, you strip the entire drug completely.  By stripping your nervous system of a drug, it may experience shock and potential chaos.

A metaphor comes to mind associated with strength training.  Think of tapering as gradually adding weight each week to help you get stronger.  These gradual increases allows for slow adaptations.  If you simply stop the drug cold turkey, it would be like loading up maximum plates on the bench press – it’s a lot tougher on your nervous system and you haven’t adapted to this weight.

To minimize the potential for post-acute withdrawal syndrome, it is always recommended to gradually taper off of whatever drug or substance you’ve been ingesting.  This will allow your nervous system to slowly adapt to the changes rather than leaving it overwhelmed.

5. Individual factors

In some cases, two people may take the exact same drug, at the same dose, for the same period of time.  However, one person may experience a withdrawal period that lasts 3 months, while another may experience a withdrawal period that lasts 9 months.  What explains the difference between these two people? Individual factors.

Other factors that may influence the occurrence of post-acute withdrawal syndrome include: other drugs / supplements, environment, diet, genetics, exercise, stress, sleep, etc.  If a person is taking supplements or other pharmaceutical medications, it may blunt their withdrawal symptoms.  If a person is in a healthy environment, eating an optimal diet, practicing stress reduction, and getting quality sleep – they may recover quicker than a person in a polar opposite scenario.

It is also important to consider the fact that some people may have slightly superior genetics for recovery than others.  Certain genetics may result in less severe withdrawal symptoms and promote quicker healing following long-term exposure to an exogenous substance.

What drugs cause post-acute withdrawal syndrome?

Drugs that have a significant effect on brain functioning are most likely to result in post-acute withdrawal syndrome.  That said, theoretically any substance ingested over a long-term could result in noticeable protracted discontinuation effects.  Below is a list of the drugs that are most commonly associated with post-acute withdrawals.

Alcohol: Protracted discontinuation effects have been associated with alcohol withdrawal since the 1990s.  Although properly tapering off of alcohol may mitigate the potential of experiencing protracted symptoms, many people report withdrawal symptoms months after their last drink.  It may take awhile for certain individuals to fully recover following a period of alcohol abuse or chronic alcohol consumption.

Antidepressants: Individuals taking antidepressants may experience post-acute withdrawals, especially if they discontinue “cold turkey.”  Most popular antidepressants like SSRIs and SNRIs inhibit reuptake of the neurotransmitter serotonin.  This reuptake is helpful over the short-term, but after awhile the drug stops working; this is due to tolerance.  When a person discontinues antidepressants, their brain has to deal with the backlash of low serotonin and sort out an antidepressant-induced chemical imbalance – which can take a long time.

Antipsychotics: These drugs function primarily as dopamine receptor antagonists, meaning they bind to the receptors and inhibit stimulation from dopamine.  This leads to a reduction in many of the positive symptoms of schizophrenia. They also elicit a broad range of effects on neurotransmission.  When discontinued, withdrawal symptoms may linger for months (or years) before a person fully recovers.

Benzodiazepines: These primarily enhance the effect of GABA neurotransmission, leading to sedation and relaxation.  Although they are the most potent anxiolytics, tolerance is rapidly established on benzodiazepines, leading users to end up on high doses.  Should a person attempt to discontinue, they must taper as to avoid seizures and death.  Even after tapering, withdrawal symptoms are often protracted, sometimes lasting years before full recovery is made.

Opioids: Regardless of whether you used illicit or pharmaceutical opioids, you may experience post-acute withdrawal syndrome following the acute-stage of withdrawal.  Although the acute stage of withdrawal is regarded as the most severe, the functional impairment associated with protracted withdrawal may be difficult to cope with.  The “PAWS” associated with discontinuation of opioids and opioid-related drugs may be due to reduced endogenous production of endorphins.

Psychostimulants: Those using psychostimulants for a long-term often build tolerance, end up taking high doses, and experience acute discontinuation effects.  The acute symptoms are often followed by an extended post-acute withdrawal syndrome that persists for months after their last pill.  This is due to downregulation of receptors and low dopamine stores that must be replenished.  It can take a long time before the brain increases dopamine levels and receptor density.

Steroids: Anyone that’s been on corticosteroids for a long-term knows that the withdrawal can be serious.  There are people that have taken drugs like Prednisone for years, attempt to discontinue, only to find that they experience protracted withdrawals.  These protracted withdrawals may persist for years, often leading some patients to abandon the idea of considering withdrawal.  For more information read various accounts of Prednisone withdrawal.

  • Source: https://www.ncbi.nlm.nih.gov/pubmed/8040915
  • Source: https://www.ncbi.nlm.nih.gov/pubmed/1675688

What causes post-acute withdrawal syndrome?

It is difficult to pinpoint the specifics behind each individual case of post-acute withdrawal syndrome.  Some potential causes include: homeostatic adjustment, neural pathway adaptations, neurotransmitter levels, physiological adaptations, receptor densities, and stress.

  • Homeostatic adjustment: Upon discontinuation of any drug or substance, the body attempts to function without it.  It may have become well-adapted to receiving the chemical that it had been getting each day, but when the supply was cut, it still needed to function.  It is attempting to restore biological homeostasis, which can take a long-term and be quite uncomfortable.
  • Neural pathways: The neural pathways that you had used on the drug may be rendered relatively useless without the drug.  New neural pathways are formed anytime a stimulus (including a drug is introduced).  When the drug supply is cut, these neural pathways become weaker, leading you to form new neural pathways without the chemicals that you’ve been ingesting.
  • Neurotransmitter levels: It is thought that most individuals experiencing PAWS have abnormal levels of certain neurotransmitters.  These may be directly related to the neurotransmitters that were targeted by the drug they had been taking.  For example, long-term amphetamine usage may have depleted certain dopamine stores.
  • Physiological adaptations: The body is a complex system and to think otherwise is foolish. The longer you’ve taken a drug, the greater the number of physiological adaptations have taken place.  This includes your gut bacteria, hormones, neurotransmitters, digestion, etc.  During post-acute withdrawal syndrome, these adaptations must readjust and revert back to homeostasis, which can take a long time.
  • Receptor densities: The densities of certain neurotransmitters may have been altered as a result of your drug use.  For example, someone taking the drug Adderall may experience a dowregulation of dopamine receptors due to excess dopaminergic stimulation while on the drug.  It can take an extended period of time before dopamine receptor density increases.
  • Stress: One of the biggest culprits for post-acute withdrawal syndrome is that of stress.  Many people become stressed because their withdrawal symptoms are highly severe and protracted, leading them to believe they have a more serious disease.  To exacerbate things, their doctor tells them that withdrawal shouldn’t last longer than a week or two.  High stress can extend withdrawal, impede recovery, and amplify the intensity of symptoms.

Post-acute withdrawal syndrome mechanisms

The specific mechanisms responsible for post-acute withdrawal syndrome are generally a result of the particular drug that a person is withdrawing from.  A person experiencing PAWS from benzodiazepines may exhibit deficiencies in the neurotransmission of GABA, whereas a person experiencing PAWS from opioids likely has abnormally low levels of endorphins.  If you want to pinpoint some specific mechanisms behind your PAWS, just look at the drug(s) that you were taking.

If you were taking an SSRI antidepressant, chances are that your brain is now failing to produce as much serotonin as it was getting while you were on the drug.  In fact, your pre-drug baseline level of serotonin was likely greater than following your discontinuation.  This is due to the fact that your brain became reliant on the drug for its serotonin supply and now needs to work harder to manufacture that particular neurotransmitter.

If you were taking multiple drugs, the mechanisms behind your PAWS may get more complicated.  Theoretically it could be possible that someone taking high doses of amphetamines and high doses of opioids simultaneously over a long-term may exhibit PAWS as a result of both drugs.  In this case, a dopaminergic depression as well as an endorphin depression may be experienced.

Post Acute Withdrawal Syndrome (Symptoms)

Below is a list of some common symptoms you may experience if you’re dealing with post-acute withdrawal syndrome.  Keep in mind that the number of symptoms, type of symptoms, and intensity of symptoms – are all subject to individual variation.  Many symptoms may reflect the specific type of drug that you’ve discontinued.

Also understand that symptoms may appear on an intermittent basis.  In other words, you may feel well for a couple days, and then experience dizziness the next day.  Certain symptoms may be more bothersome than others and nearly all symptoms can be exacerbated by stress.

  • Anhedonia: Many people report that they don’t feel the same interest in life during PAWS compared to while they were on a medication or even pre-medication.  It is especially common for individuals to experience prolonged anhedonia or inability to experience pleasure during post-acute amphetamine discontinuation.  This anhedonia often stems from reduced production of neurotransmitters that help us experience pleasure.
  • Anxiety: It is also very common to experience post-acute anxiety upon discontinuation of any medication.  This post-acute anxiety is very common among benzodiazepine users who may note a severe spike in nervousness following medication discontinuation.  In the case of benzo users, this is a result of decreased GABA functioning.
  • Cognitive impairment: Some people feel as if they’re experiencing permanent brain damage as a result of the drug that they had discontinued.  This is due to the fact that they aren’t able to think clearly and their cognitive performance is compromised.  Although the cognitive impairment is not usually permanent, it can be frustrating to put up with poor executive functioning for months or years while your brain heals.
  • Concentration problems: Most people will note that they cannot organize their thoughts or focus.  Their concentration seems as if it has no hope of ever returning.  This incessant “brain fog” is usually caused by neurotransmitter deficiencies, particularly dopamine.  This is especially common among those who’ve used psychostimulants for a long-term and then discontinue only to find that their concentration is worse than before they took the medication.
  • Cravings: During the post-acute phase of withdrawal, it is very common for people to experience cravings.  They may crave the drug that they discontinued because they dislike the way they feel without it.  They may also experience psychological cravings if they had withdrawn from one of the most addictive drugs (e.g. heroin).  Cravings generally become less frequent the longer a person has remained abstinent from the drug that they discontinued.
  • Depersonalization: Sometimes depersonalization may last for months or a full year during post-acute withdrawal.  This is characterized as feeling unlike your “normal” self.  You may feel as if you’re completely “numb” or as if your soul has been extracted only to never return.  This is a result of neurotransmitter deficiencies and can be exacerbated by stress.
  • Depression: It is common to experience a severe, moderate, or even low-grade depression during post-acute withdrawal.  If you were taking an antidepressant, there are ways to distinguish withdrawal symptoms from the original mental illness returning.  Many people will experience some depression during post-acute withdrawal syndrome, regardless of whether they were depressed prior to using the drug that they’ve discontinued.
  • Emotional instability: You may find yourself increasingly angry or irritable during post-acute withdrawal.  This may be related to dysfunctional neurotransmission and stress.  If you feel as though every little thing triggers anxiety, anger, or irritability, just know that this is fairly normal.  Over time it will usually subside, and can be mitigated with stress reduction exercises.
  • Fatigue: Many people experience such extreme fatigue after withdrawal from a drug, that they may actually fit diagnostic criteria for chronic fatigue syndrome.  This fatigue may persist for months following discontinuation of the medication and result in excess daytime sleepiness.
  • Hypochondria: Since you are experiencing post-acute withdrawals, you may actually become a hypochondriac.  Not only are you hypersensitive to every little sensation you experience, but your doctor may have told you that there’s “no way you’re still withdrawing.”  Being told this is harmful due to the fact that it often leads to obsessing over the possibility that you may have some undiagnosed rare disease; after all, you still have these wicked symptoms.
  • Hypersensitivity: Most people will report that lights are still too bright, sounds are too loud, and every tactile sensation is overwhelmingly painful.  If you feel hypersensitive and as if you’d rather live in a bubble than function in the “real world” this is normal.  Your nervous system is healing and is delicate to every little sensation.
  • Insomnia: The most common impediment to sleep is that of insomnia.  You may experience overwhelming insomnia characterized by an inability to fall asleep at night and/or an inability to stay asleep.  As your brain continues to restore neurotransmitters, receptors, and parasympathetic activation, the insomnia should subside.
  • Memory impairment: There is evidence that using benzodiazepines can cause dementia.  That said, many people will experience some degree of memory impairment when they discontinue a drug.  While memory impairment is most associated with benzodiazpines, it can occur during a protracted withdrawal phase from any drug.  Over time, your memory should improve and the impairment will become less noticeable.
  • Motivational deficits: Many people experience avolition or lack of motivation to complete work or school-related tasks upon discontinuation of their drug.  The avolition may persist for months or up to a year after they’ve been abstinent.  This often goes hand-in-hand with the PAWS symptom of fatigue.
  • Obsessive-compulsive behaviors: Your thoughts may become obsessive and difficult to control.  In fact, you may feel as if you’ve developed OCD during post-acute withdrawals.  The obsessive-compulsive thoughts and behaviors may be a result of neurotransmitter abnormalities and are commonly associated with PAWS stemming from benzodiazepines.
  • Panic attacks: Your nervous system feels shredded and you’re dealing with cortisol spikes.  Your sympathetic nervous system dominating your parasympathetic functioning and epinephrine levels are through the roof.  When your sympathetic nervous system is dominant and your neurotransmitters are at suboptimal levels, panic attacks may ensue.
  • Social withdrawal: Many individuals withdraw from socializing as a result of post-acute withdrawal syndrome.  Not only are they feeling anxious, depressed, emotionally unstable, and tired – they may feel as if they cannot even hold a conversation.  Forcing yourself to interact with others in a low stress environment can actually expedite recovery.
  • Suicidal thoughts: If you’re experiencing suicidal thoughts, it is recommended to work with a professional.  A psychotherapist can be great for teaching you how to cope with these thoughts, but further intervention may be necessary.  In my own experience, these thoughts were persistent for months after my withdrawal and took awhile before they lessened in severity.

Post-Acute Withdrawal Syndrome Treatment

If you want to reduce both the severity and number of symptoms you’re experiencing during withdrawal, you have some options.  You could consult a psychiatrist, work with a psychotherapist, make healthy behavior changes (e.g. stress reduction), and consider supplementation.

  • CBT: If you are dealing with post-acute withdrawal syndrome, a smart intervention is that of cognitive behavioral therapy.  CBT will help you identify dysfunctional thinking and make behavioral changes to optimize your recovery.  A licensed psychotherapist or psychologist may also provide you with much-needed emotional support during PAWS.
  • Exercise: Partaking in light exercise such as daily walking may help speed recovery.  Some exercise is known to promote healing, whereas too much exercise (e.g. excessive cardio) is a bad idea and will likely impede recovery.
  • Nutrition: If you are shoveling down refined grains, processed foods, and sugars – PAWS may be exacerbated.  Eat plenty of vegetables, healthy fats (e.g. MCT Oil), some protein, with some healthy carbohydrates and fruits.  Making dietary adjustments can significantly reduce the intensity of your post-acute withdrawal syndrome.
  • Pharmaceutical drugs: There may be some pharmaceutical drugs that could be prescribed to help mitigate post-acute withdrawal syndrome.  You may want to work with a psychiatrist or specialist to help you come up with a treatment protocol.  For example: Flumazenil has been thought to help with protracted benzodiazepine withdrawal and Acamprosate may help with certain post-acute alcohol discontinuation symptoms.
  • Sleep: It may be tough to sleep during PAWS as lingering insomnia is a common symptom.  There are many natural supplements like melatonin that may provide some benefit.  Try to go to bed at the same time each night, and wake up the same time each morning – this helps your circadian rhythm.
  • Stress reduction: Perhaps the most important treatment for PAWS is that of stress reduction.  If you can manage to reduce your stress level and avoid freaking out each time you notice a symptom, you’ll likely have an easier time coping.  For stress reduction, I’d recommend using an emWave2 or taking up a meditation practice for 20 minutes per day.  This will help shut off your sympathetic nervous system and promote relaxation.
  • Supplementation: There are many supplements that you could take during PAWS to help lessen symptoms and expedite recovery.  I’ve written about the best supplements for antidepressant withdrawal, many of which also can be used during withdrawal from other drugs.  I’d avoid a multivitamin and focus on nutrition and select supplements that you may need.  A blood test may be advisable to help determine the most beneficial supplements.
  • Tapering protocol: If you withdrew from a drug too quickly, you may want to go back on the drug, stabilize, and conduct a slower taper.  Follow a tapering protocol, but make adjustments based on how you feel.  Realize that some discomfort is inevitable with each consecutive dosage reduction.  That said, a slower taper has potential to reduce the severity of your PAWS.

How long does post acute withdrawal syndrome last?

Everyone wants to know how long post-acute withdrawal syndrome will last, but there’s no definitive answer.  There have been cases of individuals in the comments section of this site reporting that their post-acute withdrawal syndrome persisted for years.  For most people, post-acute withdrawal syndrome will last somewhere between 6 months and 4 years.

A majority of post-acute withdrawal symptoms will clear up within the first year of discontinuation.  That said, if someone was on a high dose of a drug for a long-term and didn’t properly taper, they may end up dealing with a much longer withdrawal period. A majority of individuals will notice that symptoms tend to fade in time.

Some individuals may notice that certain symptoms such as “brain zaps” may persist for years after drug usage.  In these cases, nutritional, supplemental, and other physiological interventions may be advised.  It is also important to consider the fact that exposure to stress, trauma, or unexpected life changes may extend the duration of post-acute withdrawal syndrome.

My Personal Experience with PAWS

I unknowingly had my first experience with PAWS following Paxil withdrawal.  At the time I was 15 years old, and my doctor told me that my withdrawal from this medication shouldn’t last more than a couple weeks.  The acute withdrawal was horrific, but I noticed several months after taking Paxil that I still felt absolutely awful.

Even a year after taking Paxil, I reported dizziness, headaches, hypersensitivity, and was socially withdrawn.  Since the doctor said that I shouldn’t be experiencing withdrawal, I figured I must’ve been going crazy and that he must be right because he’s the professional.  In reality, he was just going off of cherry-picked information given to him by the pharmaceutical reps.

It wasn’t until years later that people realized there was even such thing as “antidepressant withdrawal.”  To make things worse, I would eventually end up going through Xanax withdrawal (the extended-release version) and my all-time worst nightmare of Cymbalta withdrawal.  Withdrawal from the Cymbalta left me to experience a depersonalization and pushed me into a state of hypochondria that lasted years.

Without the help of a highly skilled therapist, I may have actually convinced myself that there was no such thing as PAWS, that my withdrawal symptoms were “all in my head,” and that my doctor was omniscient.  Thankfully I survived PAWS coupled with PTSD which was the toughest thing I had ever done; my full recovery took well over 5 years from the combination.  Had I not come to the realization that I was experiencing post-acute withdrawal syndrome, I may still be playing antidepressant roulette and making myself more mentally ill.

Have you experienced post-acute withdrawal syndrome?

If you’ve experienced post-acute withdrawal syndrome, feel free to share your experience in the comments section below.  Mention the drug(s) you discontinued, how quickly you tapered, and how long your post-acute withdrawal syndrome lasted.  Keep in mind that the duration and symptoms associated with post-acute withdrawal syndrome (PAWS) is subject to significant individual variation.

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{ 36 comments… add one }
  • Nettie September 26, 2015, 3:28 pm

    I tried three times in five years to come off Prozac and could not tolerate the horrible withdrawals that were worse than anything I ever experienced before going on it. The problem is that I took it for 21 years and it has now been 3 and a half since the last and final time. I still suffer from intense anxiety like I have never known before medication and insomnia has been very persistent.

    The worst part is that others notice I am anxious , and with their lack of knowledge they try to fix me. It makes it worse. I am a former psychiatric nurse and left the profession because I lost faith in the drugs we were giving. I wish I could support others. Finding a doctor who is updated on this truth in an economy and culture of advertising this stuff is next to impossible.

    The massive ignorance of professionals is the most disturbing part. There just is no support for coming off. Thank you for this article and I only hope that others will listen to you. Thank you.

    • Caring Professional January 25, 2016, 7:09 pm

      Your awful experience underscores how important it is that Psychiatrists and ONLY Psychiatrists EVER prescribe psychoactive medication. Our current method of “family doctors” and even nurse prescribers simply tossing bottle after bottle of whatever new “miracle drug” the pharma rep (lowest life form on the planet) is offering the best perks for at people is slow murder. The currently accepted practice is absolutely contributing to the increased rate of suicides in this country.

      No GP or NP has the expertise of a Psychiatrist. For the time being insurance execs (in a tie for lowest life form) are just going to have to bite the bullet and pay up and stop treating people in chronic pain like lepers and treat psychiatric illness like any other…by executive order if necessary. It’s not as if it’s not all part of the same human being. I was on percocet every 6 hours for 10 years for severe nerve pain. I recognized the signs of impending physical tolerance and took what I thought to be the responsible step of going to a pain clinic for assistance in taking an opioid vacation.

      I was prescribed Subutex to prevent withdrawals and to my utter shock it worked beautifully…until clinic policy dictated they no longer prescribe it. Just like that Advanced Pain Management in Green Bay WI cut me off all meds… cold turkey… through no fault or compliance issue on my part. That was 3 years ago and I still feel as if I am in semi-acute withdrawals. Of course the pain has me bedridden and unable to work.

      To top it all off, despite the fact that I was a perfect patient, passed every excessively frequent and expensive drug screen, suffered every useless injection insurance would pay for and VOLUNTEERED to take a med vacation rather than starting the increased dosage cycle, the pain clinic had me designated as a DRUG ABUSER to ensure reimbursement for the Subutex…which doesn’t even contain Naloxone like Suboxone for abusers does.

      I’d have happily paid cash for the generic, but I suspect they wanted to close out all other options for me so they would be my only choice. So-called medical care in this country exists in the Dark Ages.

      • CrohnsRN May 12, 2016, 12:47 am

        Caring Professional- Same type situation here. I am a RN, too, unable to work now due to chronic pain and hospitalization. Crohn’s Disease. Chronic pain, on heavy pain meds, and the hospital I worked at is where I am always PT at. My the pain team at my hospital started labeling me as a drug seeker (because I am a thin younger woman with short, thinning hair, and 2 visible tattoos and I require the dosage of someone 2x my size due to drug tolerance). God be with you and much love.

      • Sue June 5, 2016, 10:07 pm

        I’m from the Green Bay/De Pere area. It actually took 3 trips to the ER before there was a hint of the fact that they knew what was happening to me. The last time I went in, I was given a diagnoses of some of the symptoms that I had presented with, and when I was being discharged, I was given a small hint about what was really going on. Full blown PAW Syndrome!

        I was told to call my orthopedic surgeon, because he was the one prescribing the pain meds I am taking. The PAWS is actually from the benzodiazepines I took for years and years. I was given a smaller dose to begin with, then the dose was doubled to a high dose taken everyday for years. When I finally realized what I was going through, I had sensations of electricity running through my body.

        It’s far from tingling,! It’s actually painful. I have total numbness in my feet, and being a diabetic, it’s putting me at danger for amputation, if I miss something going on with my feet. All 5 senses have been affected to the point where I can no longer taste or smell. My vision, hearing and sense of touch are extremely reduced.

        This all was caused by a family practitioner who insisted I stop taking the meds, but admitted she didn’t know how to wean me off, so she just asked her psychiatrist “friend”, someone who hadn’t even met me! She never asked how long I took the meds at the dose I was taking them. I’m having protracted problems with this, and I don’t know where to turn.

        There’s so many other horrible symptoms involved, and I need to know if there’s any help available. Please, if anyone has useful suggestions please email me at mymollie17[@]yahoo.com Thank you.

    • tara November 30, 2016, 12:19 am

      Prozac is 94% Fluoride. Funny, when Communist warmonger’s administered Fluoride, to render their inmates docile & dumbed down, it was considered crime against humanity. When doctors prescribe Fluoride & municipalities add it to our water supplies, it’s labeled as “good for your teeth” and as “medicine”. How can Fluoride alleviate depression? It cannot but it can and does knock down a person’s IQ.

  • Adam January 3, 2016, 6:30 am

    So glad to come across this website. This is an excellent article on PAWS. I was addicted to clonazepam combined with alcohol and opiates. I went completely crazy for a good 9 months trying to get clean. Stayed sober for several years, only to find myself having relapsed with alcohol and now battling PAWS worse than before.

    It’s brain damage people, that’s the truth plain and simple. I have over a year sober this time around and while I’m definitely getting better, I still have a ways to go. Battling fatigue, anxiety, depression daily. Never again will I consume drugs or alcohol in any form. I pray for everyone experiencing this to find the help they need and the courage to continue.

  • Pete Lumb January 5, 2016, 11:05 am

    Thanks for this article. I notice that there is no shortage of information about PAWS on the Internet yet despite being surrounded by alcohol and drug workers and several visits to the GP no-one has really given these problems a name. I have been quite sure that the length of time and amount of alcohol I have consumed may well be a cause of my exhaustion and muscle pain (among other symptoms), but no-one has actually mentioned this presumably quite well known syndrome. naturally this has made me feel that I have some mysterious illness. Perhaps this is it!

  • Katie Allman January 17, 2016, 10:43 pm

    I am currently experiencing PAWS. I live with severe anxiety, social withdrawal, memory loss, inability to think clearly, insomnia, depression, fatigue, etc. I do not feel “normal” and don’t remember the last time I did. I cannot relax no matter what I do. I have experienced panic attacks and feel like I am failing at life right now. I don’t feel safe. I’m on edge every second I’m awake.

    At this point I do feel like I’m going crazy. My mom finally said to me I think you are suffering from PAWS. I detoxed off 90mg of morphine daily for 2 years back in May. I did it in 5 days at home by myself. Shortly after, I cut Valium cold turkey. I stopped 60mg of cymbalta a few months ago. Lastly, I discontinued 200mg of trazodone daily for insomnia in December. It scares me greatly I that I have screwed up my nervous system so badly that I’ll never get healthy again.

    I do not trust most people and have had pretty horrible experiences with doctors. I have changed my diet and exercise 4-5 times a week. I have been trying to get 8 hours of sleep every night. I’m not sure what else I can do besides ride this out for however long. I just don’t know how much more I can take. It feels like I’m on the verge of a panic attack and that my world is going to fall through my fingers at any moment.

    I live with chronic pain and fear that I will never be without pain and that my body will continue to decline even though I’m only 30 years old. I am a nurse and a single mother to a 6 year old boy. He deserves better and the guilt is eating me alive that I can’t fix this overnight… or if it’s even fixable..

    • Caring Professional January 25, 2016, 7:25 pm

      Katie… I hope you’re feeling better than when this was written. My heart goes out to you. I admire your bravery SO much! You sound physically healthy, aside from the pain which I sincerely hope you have gone to a big city diagnostics center to have looked at. Nurses, as you and I both know, are 40% more likely to develop autoimmune disease than the rest of the population.

      It may well be PAWS and even then they may have some sound advice short of going back on meds, to help with your, in my opinion, too-rapid yet very commendable initial detox. I have heard great things about alternative medicine approaches. Best wishes.

    • Tina July 15, 2016, 4:39 pm

      I also am a nurse I decreased from 85mg to 10mg over several years. I have been on Methadone for about 26 years,I also cold turkeyed. I feel like I am also going crazy. I am scared to death it’s been 50 days Wow Completely drug free, but I feel like I am going crazy. Help any advice please.

    • Lucas March 12, 2017, 4:13 am

      Thanks for your comment. I’m going through the PAWS wringer right now and that help to read. I’m kinda right where you stopped the comment. Hope you are well…

  • Jen January 17, 2016, 10:52 pm

    I was on Effexor for two years and tapered slowly with help from my GP over a year ago. It was a nightmarish week or so of withdrawal symptoms. Brian zaps, hallucinations, dizziness and more. Then it cleared up and I thought I was finished. But suddenly, after a stressful relocation and a series of health scares I am experiencing a host of symptoms over the last 6 weeks that led me to believe I was going crazy.

    I’ve had blood tests, MRI’s and been checked out head to toe with results coming back all clear. My new GP suggested I take Xanax to help with the health anxiety and now I find myself going through Benzo withdrawls as well. I strongly believe that the benzo withdrawal has trigger late onset PAWS and I’ve never been more unhappy. I truly believe that my brain and CNS are severely damaged by these drugs that all my GP’s said were safe to take.

    I am terrified that this is my new normal and I will never return to pre-Effexor me. I am working with a CBT therapist who is interested more in the Mind-Body connection and recovering homeostasis naturally rather than more meds. I will hopefully begin getting acupuncture next week as well as continuing to consume a healthy diet and probiotics. I’m just in disbelief that after over a year after taking my last pill, I am still dealing with this nightmare.

  • Fiona February 20, 2016, 11:19 am

    I was on citalopram for 2 years, I tapered off over 5 months by myself as my GP was suggesting that I could stay on the medication for my life time, the medication was loosing effectiveness and I knew the next step would be dosage increase. The meds did help initially.

    After completion of the taper I had lots of withdrawals (headaches, teeth grinding, nausea, tingly, achy joints & face, foggy brain, obsessive thoughts, anger, depression, anxiety, skin crawling, diarrhea) which lasted 3 months. Physical withdrawals first then mental ones.

    I felt I’d turned a corner about 6 weeks ago. I felt great exercising a lot, doing a lot but then the obsessive thoughts started (about my planned exercise first – I started planing a lot). I’ve noticed a sensitivity/intolerance to alcohol, feel like I’ve a stomach bug, tingly hands & face, aching joints, tiredness, social withdrawal, very poor decision making, dark thoughts and fear.

    I know it will pass.

  • Biggles February 23, 2016, 2:47 am

    Wow, I’m glad I found this site. Since January this year I have weaned of Suboxone which I have been taking for nearly 12 years. On Feb 3rd I was down to 2mg daily and my Doctor said it was ok to stop. I felt good for 2 days and then suddenly I started to ache in my muscles and joints, my nose ran and I sneezed all the time, I felt hot and cold and could not sleep for love nor money.

    I am now on week 3 and I still have muscle aches and very sore joints and it’s just damn difficult to function normally. I hate getting out of bed to face the day but at night the thought of going to bed is just as scary. What makes me really angry is neither my Doctor or case worker told me about any of this.

    Now my case worker thinks I might have PAWS which scares the life out of me. I will be 58 this year and have gone through alcohol withdrawal (20 years ago), Valium withdrawal (5 years ago) and now this. I am starting to think most medico’s know ‘jack’ about any of this. At least you guys know what it’s like.

  • Robert Hammel, R. Psych. February 27, 2016, 4:57 pm

    Amazing to me that the medical community seems to really be in denial as to the long term effects that these drugs can actually have on certain patient’s minds/brains.

  • Ebbie March 2, 2016, 9:57 pm

    Today is 22 days post Suboxone, my last dose was 4 milligrams the morning of February 9. My back was up against the wall when I checked myself into rehab and I was on a FAST ‘taper’ (it wasn’t a taper, it was 12, 8, 8, 8, 4 and I refused the last 2 mg on Feb 10.) I was actually doing really well due to the long half-life and since I wanted off and out of there, I was given Naltrexone (too soon) and the only reason I didn’t kill myself after it kicked in is because I was too damn sick to do it.

    OMG, the worst precipitated withdrawal hell I’ve ever gone through or will EVER go through again in my life. I’m a pain pill addict, I know about the 3 days from hell when you can’t get your hands on anything, but I always bounced back and a week later I was me again. This withdrawal is like nothing else, every day I get up and every day I pray my legs won’t collapse out from under me. I honestly am NOT depressed, I am just physically exhausted.

    The only reason I’m able to work is I rarely leave my desk. My worst symptoms are a constant, low-level, mild under the skin withdrawal, sort of like day 4 after opioids and the aforementioned weakness and exhaustion. Forget food, I can barely get down a few bites. I have to give myself pep talks all day long just to make it at work (you can stand up, you can walk down the hall, you can get a soft drink, get back to your desk and collapse).

    The nurse at my shrink’s office (the one who basically said “busted, off to rehab you go”) told me “you’ll be amazed how much better you’ll feel in 3 weeks – (meaning post-6 weeks) but I have serious doubts. On top of all this, he’s giving me Seroquel for “sleep and depression” and I keep telling him I’m NOT depressed, I have never been depressed, I liked my buzz, what is wrong with that?

    But I’m worried about taking this Seroquel which he just DOUBLED when I told him that restless leg and funky dreams were keeping me up all night. I don’t want to take this antipsychotic drug, I’m not psychotic! But I have to sleep and Benadryl only makes my restless legs and sciatic feel worse. I’m really happy to be out from under the Suboxone thumb, but this prolonged hell is enough to send even sunny me to a tall bridge. I’m reading that I could feel like this for months? Or years?

    Ok, I can probably deal with a few months (although I really don’t want to), but if we’re looking at years, then I’m done with it. I can’t live like this for years. I force myself to get to work 5 days a week and then the weekend comes and I can’t get out of bed. Get up and exercise? Are you kidding? I can barely walk from my bedroom to the kitchen without being extremely winded and then I have to sit on the couch and rest to make it back to my bedroom.

    This isn’t something I can push through and take a quick jaunt around the block. This is something I have to push hard so I can get paid. The rest of the time is about recovering. If I had known all this, I’m not sure what decisions I would have made in the last 10 years. Don’t worry, I’m not suicidal, I would never do that to my family, but for the first time in my life it is no longer a mystery to my why people feel it is the only solution.

    Until this withdrawal hell, it was a totally alien concept to me. That is how awful this is. I have to get better, being clean and sober is about being free. And right now I’m living in the prison of my body.

    • Mae Whrite July 20, 2016, 8:06 pm

      Were you on Seroquel before trying to withdraw from the pain meds? Seroquel is a seriously dangerous med that should be reserved for serious mental illness and not withdrawal symptoms. The best way to withdraw from opiates is to withdraw your dose over time, say by 20% of your previous dose every 1 – 2 months instead of going basically cold turkey over only 3 weeks and now getting you addicted to a med worse than the opiates.

      I’m so sorry this happened to you my friend. You think the opiates are bad? Wait till the day you try to withdraw from the Seroquel in only a few months. But, now they have you where they want you. Drugged to a “money making” antipsychotic.

  • terry holden March 14, 2016, 3:24 pm

    I to got off suboxone 5 weeks ago and am still completely exhausted. I can’t keep up with my apartment, and have trouble even washing my hair. I have been clean for 13 months and that’s all I can do is go to meetings, right now on a daily basis. Please respond if you feel the same way. I need support.

  • Lynny Bishop April 9, 2016, 9:46 pm

    Oh my goodness, suddenly my recent neurological problems are making sense. I’ve lived with chronic back pain for 22 years, taking every opiate invented over the years… Two years ago, I was prescribed 490 medications per month, codeine, and an over the counter pain relief paradex, gabapentin, seroquel, amitriptyline, some sort of sleeping pills, and a host of side-effects medications.

    I was suicidal, and when the doctor told me If I stopped taking my medications it would kill me, I went home and went cold turkey off them all hoping it would kill me. The first week or 10 days were pretty bad, but obviously I lived, and initially I felt really good, the chronic back pain I had been taking everything for, was actually way less than it had been while taking everything… Every few months since, combined with highly stressful life situations, I would have the weird symptoms, very much like side effects of taking the drugs, I’d feel crappy for a month or two, then be really good for a couple months, in the good times.

    I would notice some positive change something about my eating habits, or life situation, then suddenly I would find myself depressed, body zaps, walking like I was drunk, pain flare ups, vision problems, waking up blind, which lasted for only a few hours, then my sight would come back suddenly, or suddenly having fuzzy or blurry vision, just like I put on prescription glasses, when I didn’t need them, again lasting only a few hours. I asked the doctor about the temporary blindness, he said it was a symptom of PTSD. None of these things happened all at once, but often just one thing, sometimes two or three symptoms at the same time.

    A few weeks ago, I started going to the gym, for the first time in 22 years, at first the exercise program went very well, I was getting up a good sweat, and feeling awesome after… I started eating raw food around the same time, and was losing weight, then after the 3rd time, I started getting extremely painful muscles at night, over the next week or so, all the other symptoms I listed above bombarded me. As well as anxiety, panic attacks, tingling throughout body, and feeling like burning hot needles were poking me in body.

    I said I felt like someone had a voodoo doll of me, and I was going crazy, various friends said I just didn’t want to get fit, so was making things up. Since walking is an issue for me, I was actually really enjoying going to the gym, so kept going, and am still going, but these symptoms are still there, so I cut the amount of exercise down, but sticking with it. The stress in my life as also at an all-time high, with a medical insurance company deciding on a payout.

    My point about the gym, I’m losing weight and building muscle, and I know that some medication (benzo’s) store in body fat, it only makes sense that other do to, along with the stress in my life, this PAWS makes a lot of sense to me. Frankly PAWS its a better diagnosis than the MS or Parkinson’s that’s been suggested… I wasn’t willing to be tested for either disease, since I wouldn’t take any medication that’s prescribed anyway.

    But now I might do the tests just to rule them out, and I’ll just keep chugging away with the gym and diet changes, and all the time thinking this too will pass.

  • Sabine Baumann April 13, 2016, 12:41 pm

    I am tapering off of 200 mg sertraline and it has been far from easy. I have all the lovely symptoms – insert sarcasm here – and my Doc has been no help. When I saw him last he said to continue taking the 50 mg I tapered down to and continue that for another 2 weeks!! Then 2 weeks on 25 mg until finished.

    I told him point blank that I would be on the 50 for as long as it will take me to stabilize and then I would go to 25 mg. My symptoms are horrible, I am so tired, no motivation whatsoever. My hubby got fed up last night – and he is fully supportive of me weaning off of this crap – and told me to go to bed, since I do not seem to be able to function without my 12 hours or so. That was after I raised my voice to him for no reason whatsoever.

    As I am typing this I feel like crying, because I don’t want to fight yet the idea of doing anything at all is too much. My body hurts, it is a bone deep ache and I do not think it will go away anytime soon. Thank you for letting me rant. I wish I had stopped this drug a very long time ago. I have been taking it for 23 years, and I shudder to think of the damage it has done to my brain and body.

  • Nettie May 8, 2016, 6:01 pm

    To Caring Professional: I suspect you may be a psychiatrist and I need to clarify that all of my antidepressants were prescribed by psychiatrists. However, they are the ones who never seem to have a plan to take people off, believing all things psychiatric are permanent and no cure really possible. But mistakes happen. I received a misdiagnosis.

    This is quite clear now and antidepressants are given for everything from smoking cessation, test anxiety, and many other normal life experiences. My work made it clear that I never had anything really wrong with me, only a very bad and sexually abusive psychoanalysis. When I went to other psychiatrist to talk it out, I got drugged.

    No psychiatrist would help me taper off. I would not recommend a psychiatrist for anything. Sorry if I insult you. Read the research! There is still no genetic evidence of anything.

  • Manda May 10, 2016, 6:15 pm

    I took lorazepam for 39 days. Low dose as prescribed. Very severe after-effects for many years. 29 years later I still have depression, slight fractured feeling (like mild version of the acute ‘brain zaps’), tinnitus, and inability to relax: which I did not have before. Totally wrecked my mental well-being.

    I don’t want to worry anyone. Some people are not affected. No one knows the percentages. But prescribers should want to know and stop sticking their heads in the sand – if they care about their patients.

  • Nettie May 10, 2016, 6:59 pm

    To Sabine: I am well studied on antidepressant withdrawal and am a medical professional. I would like to kindly suggest tapering even more slowly. Going down in two week intervals may be to fast. Many authorities suggest going down in partial doses over one to even three month intervals to minimize the side effects you describe. Please beware, though some doctors are learning, most are not well versed on how to taper because it has been a very short time when a doctor even entertained helping someone get off of the drug. Good luck.

  • Ava Schlueter May 21, 2016, 1:07 pm

    I’ve been off methadone for 10 weeks and I am still vomiting every morning, around when my body expects its dose from my clinic…crazy, huh? Although I essentially cold turkeyed by going into rehab I never expected this to last this long. It was so bad even a few weeks ago I went to the ER twice and had an endoscopy by a GI doctor. Everything was normal. It really can last months I don’t care what anyone says. So if this is happening to you, you’re not alone.

  • Dell June 24, 2016, 10:12 pm

    Hi, I recently just got off tramadol 50 mg, I was taking about 10-15 tabs a day for 6 years. I went to rehab 90 days ago and got clean. It’s been 90 days and I still feel horrible physically an even worse mentally. I feel as though I’m loosing my mind? I don’t feel normal at all. Different symptoms all the time.

    I feel like I’m dying physically an feel as if I fried my brain. I sure hope it’s all PAWS symptoms that will eventually will subside. I’ve been to Doc and have had blood tests, CT scans, X-ray’s and all come back normal. I haven’t had a brain scan through… I’m really hoping I can feel normal again.

    I haven’t slept a solid 8 hours since I was on the meds. Actually I tried tapering 2 months prior to rehab so it’s been almost 6 month’s since I’ve slept a full 8 hours. Can anybody please give me any input or advice as to what I’m experiencing. Greatly appreciated… Dell.

  • Nick July 19, 2016, 11:41 pm

    Why would intense exercise impede recovery? I walk daily for cardio, but I do pretty intense weight lifting sessions 3 times a week. It keeps me motivated and gives me a sense of accomplishment. Should I not be lifting weights?

    • Mae Whrite July 20, 2016, 8:10 pm

      Because your entire central nervous system is in free fall right now and your adrenal glands are overworked. Exercise is an added “stress” to every organ in your body. It’s like going out jogging for an hour when you have the flu, you’ll feel worse for the next week then if you had rested properly until your body recovered from the adrenal stress you under. The best thing to do is wait until your 24 hour cortisol urine levels are back to normal.

  • Charles Watkins August 15, 2016, 12:54 pm

    Hi. I am so glad I found this website. I have looked high and low for answers. I am 60 and have basically drank my entire life, the last 20 heavily. I have been taking Antabuse for the last 3 months. It works. The cravings are still there, but the memory of “testing” the drug a year ago and feeling like I was going to die, keeps me straight, along with my wife inspecting the pill each night.

    I problem is that I have been having headaches daily. Not the throbbing type, but more of a dull pain, nothing major. My psychiatrist put me on Gabapentin. 300MG twice a day. I did not like it. My mouth tasted funny and I gained about 5 pounds in one week. I have gone back to just taking a low dose aspirin when the pain occurs. It seems to work and I only take maybe four a day. My point is, thank you for your clarification.

    I know, through self diagnosis, and reading your articles on Post Acute Withdraw, that my brain has been effected. My memory and attention span is not quite normal, but through abstinence, it can return. There can be a light at the end of the tunnel, and it just might not be a choo choo train. Thanks.

  • Gee September 19, 2016, 1:08 am

    This is exactly what I’m going through however im experiencing this prolonged withdrawal from tapering slowly! I still have 50mg til I’m off methadone. I’m stuck as I never seem to settle. It’s been 6 months since I’ve come down 5mg and I am still sick.

  • Susan W. September 19, 2016, 1:09 am

    Hello. Just wanted to give some hope and advice. I was on Benzos, Antidepressants, Opiates, and alcohol for 16 years. Daily doses, all prescribed, except alcohol. Five years ago, I decided to quit Paxil and switched over to Prozac 20mg. I tapered the prozac slowly over the course of a year, finally opening a 10mg. capsule dumping out half for about a month, then 1/4 for a month, then skipping a day every five days for a month, then 3 weeks and so on until done. I had no withdrawal.

    I was taken off Valium 20mg. cold turkey. This was horrible. I suffered extreme panic and insomnia, brain fog, tingling extremities, head pressure, etc. However, these symptoms came in waves with periods of normality. I did heal after 18 months, but was functioning by six months. I suggest Gaba and L-theanine to help with the anxiety. Most important of all, meditation and restorative yoga. I also used sleep and anxiety hypnosis every night. It worked, but you have to do these things everyday.

    Next, I decided to kick the alcohol to the curb. I tapered using beer. Just make a plan and stick to it. I had fatigue for about a month afterwards and some brain fog that would come and go. Anxiety got bad for the first four months off, so kept doing what I did for benzo withdrawal.

    Finally, I decided to quit the Oxycodone 6O mg. per day. I cut my dose down to 40 mg. with no problem and kept cutting about 10% of my dose every two weeks. I finally cold turkeyed off at 20mg. It was hard but doable. I still have recurring withdrawal symptoms that come and go 5 weeks later, but I have all the confidence that I will be back to normal. I do not believe it will take years, at least I hope not.

    Good luck to all who have been poly-drugged by physicians who have been lied to by the drug companies. Money truly is the root of all evil.

  • Josh September 23, 2016, 11:30 pm

    I took 10mg norco for four years. During the final year I was taking 30 of them a day. I’m a 33 year old general contractor and am conditioned for very labor intensive work for at least 8 hours a day. I quit cold turkey. Sleep was impossible the first few weeks getting an hour or so each day and eating was very minimal. Tried working but things I would normally do without thinking where confusing and overwhelming.

    First anxiety I had ever felt ensued after about a month standing in line at a grocery store. For 6 months my motivation was dead and I had brain fog. Daily diarrhea was a constant for 8 months. Also after 8 months the skin on the back of my hands is thin and always dry which I relate to a lot less physical movement and circulation but was scary that they seemed to turn from healthy thick skin to alligator skin within a week.

    It’s now been 11 months and I still have on and off weeks where I’m feeling good or totally unmotivated and do nothing. Last few weeks my dry skin seems to be continuing up for arms and to upper arms. I don’t seem to retain water like I used to still. I used to drink a gallon or more a day and now I drink less than half that and pee it out right away.

    Maybe my body still trying to cleanse itself? I never had the urge for a relapse but my withdraws are definitely still affecting me. I always figured it would take a good year to get my old self back but it seems it may be longer. Society seems to be recognizing slowly that opioids are a big issue today.

    Doctors don’t seem to know much about withdrawal symptoms or duration but I wouldn’t expect them to know what a parapet wall was either because it’s not in their practice. You can never know if the dog will bite you unless you pet it. Most doctor aren’t junkies so they’ll never know. Top leading research on everything comes from people who experience themselves only.

  • carrie November 1, 2016, 8:53 pm

    Hi, I am suffering with PAWS. I have had chronic nerve pain for the past 10 years and was on Fentanyl, Lyrica, Nortriptyline and Cymbalta. I started going off my medications in January 2015 and finished in March 2016. Starting with the Fentanyl. These medications worked well in the beginning but were not helping after 9 years of being on them.

    It is now November 2016 and I have high anxiety, insomnia, fatigue and dizziness plus eczema. I feel highly stressed and for the first time in my life feel I don’t have control of my body. You feel like you are going crazy. I have done well over the years with meditation, relaxation and wellness to help control my pain but I am struggling to do the same with PAWS.

    I try to do all the right things but it doesn’t seem to do be working. I am watching foods that I eat now as well. I am sure time will eventually help take care of this but it has been a real struggle. luckily I have a good support system. Just no that you are not alone and hang in there.

  • tara November 30, 2016, 12:56 am

    When I was in the 2nd grade, I developed tracheal bronchitis. This condition caused a constant croupy cough and re-occurred for years. First, my pediatrician gave me codeine cough syrup. The prescribed giant-sized-bottles of the tiny, round pure codeine pills. I’d take it for weeks at a time. I’ll never forget the 1st time, I felt opiate withdrawal.The bottles contained so many pills, I could easily take 10-15 at a time without my mother noticing.

    I now needed them to function in elementary school. After a car crash & neck surgery, I was given percocet & other opioids. Then Oxycontin came to the USA and entered into my life. My dr told me that I would not become hooked that it was a ‘wonderful drug’ that didn’t cause addiction! After 8 years? I tried to get off the pills. Soaked in sweat, covered in chills, my legs would give out & I’d collapse to the floor when I tried to walk.

    Spent the next 5 years on (up to) 130 mgs of Methadone, per day. The withdrawals were even worse. I now had seizures, fainting & suffering that did not go away when I tried to stop. I spent a month of hell-on-earth. The severe pain of withdrawal did not ease up or go away. An addiction specialist told me that my actual DNA had been severely altered/damaged & I’d ‘never feel normal again’ or be able to function without opioids.

    Then Suboxone came to the USA. I went to a sub dr who gave me 5, 8mg subutex, per day. 3 in the AM & 2 in the PM. This drs son was the clinic counselor. He told me that Suboxone/Subutex was literally a ‘miracle drug’. He said, “You’re clean right now. You’re healed and don’t even realize it”. So stupid me, I believed him. I thought if this drug has ‘healed me’ then why keep taking it.

    The following withdrawal was so intense & so evil, I thought, I would die. My vision & hearing were profoundly affected. Large portions of my memory was gone. I went 8 days with not 1 second of sleep. I can’t even explain how horrible it was. Now, I’m forced to take suboxone every damned day. It takes all of my money & freedom.

    I have no hope for every being freed from these chains. With addiction being both a crime and a disease? Every industry involved is making big bucks. US rehabs are known to be between 3% to 5% effective. While, Ibogaine is perfectly legal and effective in Canada & Mexico (and everywhere else), it’s schedule 1 in the USA. No one has $10,000 (and up) to go to a Cancun rehab.

    Gary Null wrote about the US medical system ruining & taking so many lives awhile back. Now? People are discussing whether the US medical system is actually the #3 OR the #1 killer of American citizens. I quit nursing because of the shame involved with the US medical system. I’ve seen/experienced far too much and cannot participate in these crimes against humanity. Never, ever take their pills.

  • WendyMay November 30, 2016, 9:53 am

    I was on 2 prescriptions of percocet, and then started Suboxone. I switched to methadone for a couple months, then went back on the former, abusing it badly. Was on those, alternately, for 8 months. I had hardly any symptoms for a week, then it hit me big time. Every symptom known to man. It’s been a week and a half since they started.

    I stopped cold turkey. The pain is outrageous. The digestive distress is awful. The chills, fevers, flu symptoms, and weakness… And then I don’t feel like doing anything. All medical professionals are telling me I should be over it by now. And omg, the panic! I don’t feel like it will ever end.

  • K February 6, 2017, 2:31 am

    Thank you for this article, it’s good to finally feel validated after wondering if I’ve been going nuts or coming down with diseases (for which tests always come back normal) for the past year. In 2013 at 23 years old I was diagnosed with generalized anxiety disorder and tried cognitive behavioral therapy for months. Unfortunately I kept falling deeper into the hole of anxiety and depression and couldn’t function, so despite being terrified of antidepressants as my siblings had bad experiences with them, I was desperate for the emotional pain to stop so I started 40 mg celexa in August 2013.

    I was also given gabapentin, propranolol and 1mg lorazepam to take as needed. It helped me a ton for 2 years but I slowly gained weight, had sexual dysfunction and became numb and lethargic so my GP switched me to 60 mg cymbalta August 2016. I had emotional problems during this transition but thought I made it through okay after a couple weeks.

    I started having debilitating migraines every now and then which I never connected with the drug. In December 2015 I started a new stressful job and cried my eyes out every single night for months but I thought it was just my anxiety and never thought it could be a side effect. I was extremely exhausted anxious and depressed and started having unbearable night sweats. The night sweats were the only thing I connected with the drug.

    I started to read about cymbalta and was horrified that I had ever trusted my doctor so much and just popped these pills without doing any research. I talked to my doc about it Feb 2016 and she wanted to switch me to viibryd. I started making the transition and was about 2 days in when I read about viibryd and saw that people felt is was just as terrible as cymbalta.

    At this point I decided I hated my doctor and medications and stupidly went cold turkey. I was in a ton of pain for a month, unbearable nausea and brain zaps and literally could not eat anything that wasn’t a potato for months. I took massive amounts of fish oil to stop the brain zaps. After about a month I figured I was done with withdrawal and ready to move on with my life despite the continued nausea and carb cravings.

    That’s when I had a really painful “UTI” that didn’t culture out. This urinary pain persisted on and off and started to effect my vagina as well. It ruined my life for months, I had a million tests that all came back normal. August 2016 I switched to GAPs diet thinking I might have a candida problem. My pain turned mostly gastrointestinal at this point and is getting worse.

    I went to a GI and they started with blood tests that all came back normal. I’m reluctant to go back for further testing as I do not think they will find anything and it will be a waste of time and money. I’m currently trying to switch back to a normal but healthy diet, get more exercise and meditate but I have a ton of pain that makes it hard to function and I’m very depressed and discouraged and always anxious and wondering what’s wrong with me.

    This past two years of my life has been pure pain and misery and I fear I’ll never feel good again. People constantly told me it couldn’t be withdrawal after a few weeks so I believed them and fell into a hypochondria hole just trying to find answers to stop my pain. After reading this article and many others like it I’m relieved to know that I’m not going crazy and to finally find something that explains all my weird symptoms, but I am discouraged that there’s not a clear answer about how to get over this and end the pain.

    Has anyone else experienced urinary, vaginal and gastrointestinal pain and inflammation in the abdomen after going off SSRIs/SNRIs? It would be nice to know I’m not the only one. I also still have brain zaps, fatigue, sore and achy muscles, migraines, nausea, ear pain, insomnia, blurry vision, brain fog/swimmy head and I get angry and weepy and hopeless.

    I’ve always been prone to really high stress and anxiety and I know that makes the pain worse which makes my anxiety worse and it’s this horrible cycle I can’t get out of. Any advice or validation is much appreciated. I feel positive this is what’s wrong with me but then my anxiety makes me doubt that it could still be this after 1 year?

    Lots of my family and extended family are prone to autoimmune disorders so I worry that this has triggered one in me. I really don’t know what to do. I’m desperate for help and answers. I just need the pain to stop. -k

  • Sean March 4, 2017, 7:24 am

    I was taking Effexor XR for 8 years, started when I was 18 y/o for physical symptoms which were constant migraines without pain, dizziness, and brain fog to a point where I couldn’t concentrate on anything even if my life depended on it. I had these symptoms for 2 years before doctors found out it may have been anxiety, the day after I took the medication for the first time in 2 years I had no symptoms whatsoever and felt great, however after 8 years I felt the medication may have been making me ill because I was getting instantly sick for no reason a few times a week. Then anxiety started to set in and I was very sick in my stomach every morning.

    Caffeine was playing a part so I stopped drinking coffee etc. I also decided I’d try coming off medication without knowing about PAWS. I tapered off 75mgs over 11 months, during this slow taper I never had any acute withdrawal symptoms at all. However I felt my anxiety slowly coming back and getting worse. About 3 months after I came Effexor XR I experienced my very first panic attack which lasted 150 minutes and I was hospitalized as no one knew what was happening and I didn’t either. I just remember being very confused, sick, thinking I was dying and going crazy.

    This I feel was the peak of my PAWS because slowly I stopped having panic attacks, feeling on edge and shaky all the time, constantly nauseous and unable to eat, I had depersonalisation for a few hours each day. Now as I’m writing this it’s 2 months later. I’ve read many sites to get as much of an understanding of PAWS as possible. The symptoms now instead of being constant do now come in waves from a few days to a week. I’m in a bad week at the moment and feel on edge from stress and other symptoms, but I now know it’s my brain recalibrating itself slowly.

    Every doctor I’ve spoken to these past few months are completely clueless when it comes to PAWS, they did suggest CBT which I’m currently attending, but it doesn’t have much of an effect on how I feel. The symptoms I’m getting feel like they’re artificial. I do try to keep myself relaxed as much as possible, I eat a Mediterranean based diet, I exercise for 30-40 minutes a day without pushing myself, get 30 minutes of sun, take fish oil triple strength, I don’t drink or take drugs or smoke and I never have my whole life. The reason why I’m writing this is because I don’t have too many people to talk to and as of right now I’m trying to keep my head above the water because it’s been difficult lately.

    Even though the symptoms since the panic attack have slowly gotten weaker, it’s still very difficult and starts to get me to think in a downward spiral pattern. I think it’s called rumination, but I will pull through a lot easier reading stories of other people knowing I’m not alone. I hope anyone else reading this who is currently going through them can find some strength through these difficult times just so they know that they will get better with time while their brain takes time to heal. Also thanks for the success stories, I need to read them often so I can feel positive.

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