PAWS is not some cute AA acronym that stands for something like Please Act Wisely Sober; PAWS is actually a diagnostic term for a set of symptoms called Post Acute Withdrawal Syndrome that can occur for a long time after you put down the alcohol or other addictive drugs. Research has suggested that up to 95% of recovering alcoholics and addicts when tested show the presence of brain dysfunction.
Essentially, that is PAWS – symptoms from a dysfunction in the nervous system after quitting booze and drugs. Not to be confused with Wet Brain Syndrome, PAWS is a temporary condition. Do not panic, this too shall pass! However, you can take positive action to help get through it faster and with more ease!
Symptoms of PAWS
When you first detox off alcohol and/or drugs, acute withdrawal is experienced. After a week or two of continuous abstinence from alcohol and drugs, Post Acute Withdrawal Syndrome may be experienced and can last for 3 months to 2 years into sobriety. For most people, PAWS is regenerative - meaning over time and with proper care the symptoms will diminish and damage can be repaired.
Symptoms of PAWS can include difficulty solving simple problems, reacting either overemotionally or having emotional numbness, sleep disturbances, memory problems, inability to think clearly at times, difficulty managing stress, and sometimes problems with physical coordination may present as well.
The cognitive symptoms can lead to diminished self-esteem as well. Note, not all of these symptoms may occur and each does not happen constantly but rather periodically. The severity and length of occurrence of PAWS varies individually; it does not look the same for everyone.
What Causes PAWS
Damage to nervous system from the alcohol and/or drugs causes the physiological nature of PAWS, in combination with the other component of PAWS which is the emotional stress of having to deal with life without the old coping mechanism of drugs or alcohol. How much brain dysfunction your addiction has caused + how much psychosocial stress you experience in sobriety = the severity of PAWS. With proper care, it can be reversed.
Taking Action Against PAWS
“… and courage to change the things I can.” This is one of those things you can take positive action to help get through it more rapidly and in a healthier manner. PAWS causes symptoms that are not particularly conducive to your sobriety. In fact, recent research supports the belief that PAWS can contribute to incidents of relapse.
As part of a relapse prevention strategy, it is important to address the physical aspects of your alcoholism which includes taking proactive steps to treat PAWS. Your first couple years sober are difficult enough without the added challenges of PAWS symptoms like sleep disturbances and trouble thinking clearly.
Education is always a good start (Education leads to proper Action which leads to Results!). Getting a better understanding about PAWS can ease some of the anxiety and confusion, and help prevent self-esteem problems that can result in the absence of such awareness.
Next, find healthy ways to manage your stress. Stress can be caused by PAWS and also stress exacerbates the symptoms of PAWS so stress management is key. Working the 12 steps with a sponsor is not only the best method for relapse prevention in general, but also a great component to stress management. Meditation is highly recommended. Find what works for you, it can be as simple as setting time for deep breathing daily. Specific nutritional recommendations can really give you the edge on managing stress as well.
Last but not least, get educated about ways to improve your physical health most specifically in terms of your nervous system. If you do just one thing physically to support your nervous system, supplement with a high quality B vitamin Complex. Bill Wilson, A.A. founder, was a big proponent of supplementing with B vitamins to support recovery!
You are not powerless against PAWS. Post Acute Withdrawal Syndrome can be treated by applying the recommended actions listed above, and you can enjoy a long healthier life sober!
Wernicke-Korsakoff Syndrome, alcoholic encephalopathy (brain damage), Korsakoff psychosis, Wernicke’s disease… all these names refer to what is most commonly called by people in recovery as “Wet Brain”. What’s the real story with Wet Brain Syndrome?
You have probably heard the scary stories about the dangers of LSD - people who dropped acid one too many times or had a bad trip just once who would then suffer random hallucinations and psychotic episodes the rest of their life despite never doing acid again. Perhaps the closest thing to that phenomenon of acid flashbacks for alcoholics would be Wet Brain Syndrome since it involves neurological damage and symptoms that can last long after putting the plug in the jug.
When “partying” back in the active days, despite maybe a few jokes about killing brain cells, rarely do heavy drinkers think the alcohol could slowly cause such very serious neurological impairment as is the case with Wernicke-Korsakoff Syndrome. And much like the disease of alcoholism itself, wet brain can sneak up on the heavy drinker, as it develops gradually.
Symptoms of Wet Brain
In reality a much better comparison of Wet Brain would be to Alzheimer’s. Dementia, short term memory loss, and confabulation (false memories) characterize wet brain syndrome. Also, Wet Brain aka Wernicke-Korsakoff Syndrome, typically includes problems related to eye movements, balance and gait, and loss of coordination.
Some of these symptoms resemble drunkenness; like with the acid flashbacks, despite absence of the drug, the neurological effects can prevail long after the initial damage was inflicted. Other signs include fatigue, irritability, and sleep disturbances. Late stage Wernicke-Korsakoff syndrome can even result in coma and death.
If you are in early in sobriety, sometimes concerns of Wet Brain are confused with actually suffering from PAWS. PAWS stands for Post Acute Withdrawl Syndrome which can include symptoms such as inability to think clearly, memory problems, sleep disturbances, emotional overreactions or numbness, sensitivity to stress, and problems with coordination.
PAWS is temporary, whereas Wet Brain is typically more permanent. Experts suggest PAWS starts a week or two after abstaining from alcohol and can last for 3 months to 2 years into sobriety!
What Causes Wet Brain
Wet brain is caused by gradual brain damage from thiamin (vitamin B1) deficiency. For alcoholics, this syndrome technically known as Wernicke-Korsakoff, develops gradually as a result of a deficiency of thiamin which leads to brain function decline and even neuron death. Chronic excessive alcohol consumption leads to a multitude of vitamin deficiencies, including that of vitamin B1 a.k.a. thiamin.
Thiamin plays a crucial role in glucose metabolism, and anything that inhibits the crucial creation of glucose (which the brain relies on to function) can thus cause the brain to rapidly decline in function. Active alcoholics typically have a poor diet which contributes to vitamin and mineral deficiencies, however even with healthy eating habits the heavy drinking will interfere with absorption of thiamin.
Can Non-Alcoholics Get Wernicke-Korsakoff Syndrome
While wet brain is mainly associated with alcoholism, sometimes non-drinkers can develop Wernicke’s disease as well. There are other ways to become thiamin deficient and therefore susceptible to Wernicke-Korsakoff syndrome, as with the following conditions: severe malnourishment, Chron’s disease, stomach surgery (gastric bypass or stapling), eating disorders involving starvation or vomiting, and even side-effects of chemotherapy.
Can Wet Brain Be Treated
The successful treatment of wet brain depends mainly on the stage of its progression. Early onset of wet brain can be treated and often reversed entirely if caught in time. Anyone exhibiting signs of Wernicke-Korsakoff Syndrome should be given thiamin immediately. Doctors typically administer thiamin intravenously at first.
For those looking to supplement on their own, the closest thing to IV is taking a supplement in an isotonic form (for 90-95% absorption, versus 100% with IV, and as little as 20-30% with tablet supplements). In this case, it is recommended to take a B complex supplement rather than choose an individual B vitamin as the various Bs work synergistically together.
Late stage wet brain may be referred to as “Korsakoff psychosis” due to the serious permanent nature of its symptoms. Unfortunately, in its later stages the disease is not reversible.
Patients with Wernicke-Korsakoff Syndrome are sometimes treated with medications used for Alzheimer’s disease when thiamine treatments are ineffective. For those seeking a natural approach to support their cognitive health may check out Cognitin, a cognitive support formula.
Cognitin contains the antioxidants acetyl L-Carnitine and alpha lipoic acid (both very beneficial to brain function), and contains vinpocetine (derived from periwinkle extract) which has been used for decades around the world to treat Alzheimer’s and dementia, and is becoming more widely used for general cognitive support.
Do All Recovering Alcoholics Have Some Brain Damage?
On a more subtle level, it is probable that all recovering alcoholics have suffered various degrees of cognitive impairment over the course of active drinking years. With this in mind, even the younger and seemingly healthier recovering alcoholics who have no fear of wet brain can benefit from supplementing with a quality vitamin B complex in sobriety (see related article). In fact, researchers have found that supplementing with thiamin (part of B Complex) can also help prevent the development of Wernicke-Korsakoff Syndrome a.k.a. Wet Brain in heavy drinkers.
