Quitting opiates hits your body hard. They disrupt how your brain processes pain, pleasure, and motivation, which makes detox, especially post-acute withdrawal syndrome (PAWS), uniquely intense.
Many people feel blindsided by PAWS. The brutal first week of detox ends, yet the awful feelings continue. Don’t feel discouraged; it’s a common part of an opiate detox process. Professional support can help during this rough patch, when relapse might feel tempting.
Learn About PAWS Withdrawal
The early part of standard substance use withdrawal often includes shakiness, sweating, and other uncomfortable effects. PAWS can happen next and feel like a mental rollercoaster, but not everyone experiences it or has long-lasting, intense symptoms.
Opiates take over your brain’s natural endorphin system, flooding your system with artificial feel-good chemicals. Over time, natural endorphin production reduces. When quitting, PAWS reflects the slow return to regular function. This relearning period includes difficult-to-manage emotions since they can feel raw and unregulated.
Many people describe feeling empty, numb, or having wild mood swings. It can affect thinking, emotions, and motivation, adding extra challenges to recovery. That’s why it’s advisable to choose medical detox over white-knuckling it at home, so you have support and guidance to help you stay on track.
What Is PAWS Like When Detoxing From Opiates?
Once the early detox physical symptoms have ceased, like vomiting and body aches, other side effects usually start:
- Uncontrollable mood swings
- Feeling jumpy or worried without cause, then numb minutes later
- Sleep problems (sleeping 14 hours one night and none the next)
- No energy to do anything, even hobbies you used to love
- Brain fog that makes simple tasks like paying bills feel confusing
- Cravings can feel physical, like restlessness and discomfort, often without clear triggers
With PAWS, good days can make it feel like withdrawals are over, then bad days can hit and make you think your brain is irreparable. These ups and downs can also confuse loved ones who might’ve seen you as healing. Don’t let these waves make you lose sight of your sobriety goals; these are part of your ongoing journey of healing.
How Long Does Withdrawal Last?
Early warning signals of opiate withdrawal typically start within a day after you’ve last used. These first symptoms can include a runny nose, noticeable fatigue, and feeling restless. By day three, most people struggle with muscle pain, stomach problems, and desperate cravings.
The worst physical symptoms usually wrap up after 7–10 days. PAWS can follow and linger for any time between several weeks and months. For many, post-acute withdrawal symptoms peak around 2–12 weeks after quitting and slowly improve. Rarely, symptoms can continue even a year later, especially if underlying mental health challenges are present.
Your timeline depends on:
- Type of opiates (e.g., heroin may lead to longer PAWS)
- Duration and dose (longer, heavier use means longer recovery)
- Overall health (your body needs strength to heal)
- Support system (having people helps)
Signs You Might Need Extra Support
If you or a loved one notices the following, it might be time to seek help:
- Old friends you used to do drugs with suddenly seem interesting again
- Dark thoughts are getting scarier
- Daily tasks like showering feel impossible for days straight
- Sleeplessness, despite real attempts
- Panic attacks occur often without any trigger
- Cutting contact with people who care because explaining feels exhausting
Many push through these signs, thinking asking for help means defeat. But, sometimes, you need an additional helping hand to get through the difficult parts and prevent relapse, which is okay.
Ways to Manage PAWS During Opiate Addiction Treatment
The hardest part of PAWS is the uncertainty about when it ends, which can cause you to assume the worst: that you might never feel better. The truth is that thousands have walked this exact path before and made it through to the other side. Here’s what can help:
- Medication: Naltrexone, typically given after initial opiate detox, can help reduce cravings and support brain recovery during post-acute withdrawal. Medication forms part of long-term plans under medical supervision and supports later-stage recovery.
- Talking it out: Group therapy shows you’re not alone when others share their similar PAWS experiences. One-on-one sessions tackle your specific triggers and trauma that fueled opiate use in the first place.
- Healthy habits and routines: Sleeping regular hours, eating protein and vegetables, drinking enough water, and regular exercise go a long way. Your brain can rebuild itself using nutrients and sleep.
- Full opiate treatment programs: These are tailored to meet your needs and recovery goals, including a regimen of therapies and methods to suit your situation.
Find Healing in Life After Opiate Detox
Nobody recovers in a perfect linear way; the path can sometimes swerve. Some mornings, you might feel amazing, and others might feel full of doubt and incite thoughts about using again. Both are normal parts of healing, not signs of failure or that relapse is inevitable. Truthfully, setbacks happen to almost everyone in recovery.
Professional help changes everything. With the right expert team providing backup, getting clean is more manageable. Through treatment and commitment, your brain can slowly begin to heal from the deep impacts of opiate use. Each day sober builds toward a life worth staying clean for, even on the days when post-acute withdrawal syndrome might make brighter days seem impossible.
