There is a simple yet loaded question that gets asked time and time again following detox. How long is this going to last? The lingering anxiety, the unpredictable sleep, and the brain fog that zaps motivation. It’s a series of symptoms that can be uncomfortable and scary if you don’t know why they’re happening. But it’s all part of Post Acute Withdrawal Syndrome, commonly referred to as PAWS.
PAWS refers to the ongoing psychological and neurological symptoms that continue after acute withdrawal ends. While detox clears substances from the body, the brain needs much more time to restore balance to the systems that regulate mood, stress, sleep, memory, and motivation.
There is no single PAWS timeline that applies to everyone. The duration depends on a multitude of factors like how long the substance was used, how heavily it was used, whether multiple substances were involved, overall health, and whether recovery is supported by structured treatment. What matters most is knowing that PAWS does improve with time and consistency, even when progress feels uneven.
Alcohol related PAWS is one of the most studied and most common. Alcohol affects GABA, glutamate, and dopamine systems, which play a central role in calm, stress response, and reward.
For many people, alcohol PAWS symptoms begin one to three weeks after detox. Common symptoms include anxiety, irritability, sleep disruption, low mood, brain fog, and difficulty handling stress. These symptoms can fluctuate.
Most people see noticeable improvement within three to six months. For those with long histories of heavy drinking, symptoms can persist in milder waves for up to a year. The good news is that emotional regulation and cognitive clarity typically continue to improve with sustained sobriety, therapy, and structure.
Opioids strongly affect the brain’s reward and pain regulation systems. After detox, the brain must relearn how to produce and respond to natural endorphins.
PAWS symptoms following opioid use often include low energy, depression, sleep problems, anxiety, and reduced stress tolerance. These symptoms can begin within weeks of detox and are often most intense during the first two to four months.
Many people experience significant improvement by six months, though some symptoms such as low motivation or sleep irregularities may linger longer. Consistent treatment, mental health support, and routine play a critical role in stabilizing recovery during this phase.
Benzodiazepines such as Xanax, Valium, or Ativan can produce one of the longest PAWS timelines. These medications deeply affect the nervous system and are often prescribed long term, which increases dependence.
PAWS symptoms after benzodiazepine use can include heightened anxiety, panic, sleep disturbances, sensory sensitivity, and difficulty concentrating. Symptoms may begin during tapering or shortly after discontinuation.
For some individuals, PAWS symptoms can last six to twelve months, and in rare cases longer. Gradual tapering under medical supervision and ongoing therapeutic support are essential to reduce symptom severity and prevent relapse.
Stimulants such as cocaine or methamphetamine heavily impact dopamine production and motivation pathways. When use stops, dopamine levels may remain low for an extended period.
PAWS symptoms often include depression, fatigue, lack of pleasure, poor concentration, and cravings. These symptoms may appear within weeks after detox and can feel discouraging without education.
Most people see gradual improvement over three to six months, though motivation and emotional balance may take longer to fully stabilize. Healthy routines, physical activity, and therapeutic support significantly aid recovery.
PAWS becomes most dangerous when it is unexpected. Many relapses occur not because someone wants to return to substances, but because they want relief from discomfort they do not understand.
When people expect to feel normal immediately after detox, lingering symptoms can feel alarming. Anxiety may feel personal. Low mood may feel permanent. Cravings may feel like failure. Education reframes these experiences as temporary and manageable.
At Serenity Park Recovery Center, clients learn to anticipate PAWS and develop strategies to navigate it safely. This preparation reduces fear and strengthens long term recovery outcomes.
While PAWS cannot be rushed, its intensity and duration can be reduced. Consistent sleep schedules, proper nutrition, regular movement, stress management, and daily structure all support nervous system regulation.
Therapy is especially important. Evidence based approaches help regulate emotions, manage stress, and challenge thought patterns that intensify PAWS symptoms. Connection also matters. Isolation tends to worsen symptoms, while support stabilizes them.
Most importantly, patience matters. Brain healing happens gradually, even when progress feels slow.
PAWS does not last forever and for a lot of people, they may not even notice it. While timelines vary by substance and individual history, the trajectory is always toward improvement with sustained sobriety and support.
If you or someone you love is struggling with symptoms after detox, Serenity Park Recovery Center in Arkansas offers comprehensive treatment designed to support both acute withdrawal and the long road of healing that follows.