Student will demonstrate an Understanding of Post Acute Withdrawal Syndrome and its

effect on their struggles with relapse.

Post Acute Withdrawal - PAW

Definition:

A normal, predictable period of stress when thealcoholic/addict undergoes experiences thatpropel one to “use” despite sincere and honestefforts to maintain sobriety. (18 – 24 months)

Physiological (Body) hunger for alcohol, pills, drugs leadsTo psychological (Mind) discomfort or emotional inebriation which produces a specific behavior. Recovering person will experience several of all of these “flare-ups” with varying intensity for a period of 3 – 5 days at a time, and periodically over a two-year period during recovery.

PAW-Symptoms of Internal Dysfunction

• Inability to think clearly1. Can’t solve simple problems2. Same thoughts keep repeating themselves3. Mind goes blank4. Can’t concentrate on anything for very long5. Can’t make mind up about what to do next6. Make bad decisions even when I know better

• Can’t Manage Feelings and Emotions1. Feel too much; overly sensitive2. Feel nothing; emotionally numb3. Don’t really know what I am feeling4. Feel like I am going crazy as I feel the “wrong” thing5. Mood Swings6. Feel down in the dumps7. Feel worried, but stuff these feelings8. Have fears that I can’t explain9. Overreact in ways not like me

• Memory Problems1. I can’t remember things I’ve learned for more than 20 minutes2. I can’t remember important things from my past3. Sometimes I remember; other times I can’t4. Feel cut off from my memories5. Make bad decisions because I can’t remember things

• Difficulty in Managing Stress1. Don’t realize when I am stressed2. Can’t relax when I do feel stressed3. Hard to relax even when doing things that should help (exercise)4. Feel like I am going to collapse, physically or emotionally

• Difficulty in Sleeping Restfully1. Can’t fall asleep2. Have unusual or disturbing dreams3. Wake up often and can’t get back to sleep4. Wake up feeling tired5. Feel sleepy at the wrong times of the day6. Sleep around the clock for one or more days

• Difficulty with Physical Coordination1. Lose balance at times2. Feel dizzy3. Eye-hand coordination “off”4. Have slow reflexes5. Clumsy6. Accident-prone

• Shame, Guilt, and Hopelessness

1. Feel like I am emotionally disturbed2. Feel like something is wrong with me; I am no good3. Feel guilty because I think I am not doing what I should do4. Won’t talk about things that bother me with others5. Cover-up my warning signs6. Dishonest at times to hide my shame7. Can’t handle things8. Feel that it is hopeless for me to stay clean and sober

Remember:

Progression is un-dramatic, difficult to notice, the individual is not consciously aware of its onset. It creeps up on you UNLESS you know what to look for:

1. Bored; restless; anxious; depressed2. Difficulty in eating and sleeping3. Altered behavior patterns; irritability4. Fight or flight5. Cut people off; skip meetings; dream of drinking or using6. The fall; drink; pop; chip; alibi system takes over7. Congratulations! Begin again