This too shall pass . . .

Post Acute Withdrawal from Non-Narcotics?


Post acute withdrawal from non narcoticsPost Acute Withdrawal is the primary cause of relapse among drug addicts and alcoholics, but does this sometimes-crippling condition apply to non-narcotic conditions? With more and more compulsive behaviors being classified as addictions, medical conditions once thought to be solely associated with drug addiction – like Acute and Post Acute Withdrawal – are now being applied to what were once considered nothing more than a lack of willpower.

What is Post Acute Withdrawal?

Post Acute Withdrawal consists of a wide range of symptoms that appear in recovering drug addicts and alcoholics after the 2nd week of abstinence. These symptoms range from cognitive and intellectual impairments, gross and fine motor skills limitations and fluctuations, sleeping problems, emotional irrationality and physical symptoms like headaches and migraines, restless leg syndrome, muscle aches, nausea, exhaustion and many others.

Post acute withdrawal is caused by three factors related to substance abuse:

1.) Survival Response

Mankind evolved with a built-in survival mechanism in the brain that sends a wave of good feelings when a “survival behavior” takes place; eating, sex, sleeping, companionship, etc. Drugs interfere in this process in a way that the brain considers the “high” to be necessary for survival. Because this survival function is designed to reward and compel similar survival behaviors, a response develops where certain stimulus can trigger the brain to call for the repetition of the behavior – especially drug and alcohol use.

2.) Conditioned Response

Conditioned response can be summarized as subconscious training that occurs when we repeat certain actions in the same or similar environments and with the same or similar signals. Just as Pavlov trained his dogs to produce a biological response – salivation – simply upon the ringing of a bell, so too do addicts develop a biological response in the form of drug craving after repeating the same or similar substance abuse behaviors.

3.) Physiological Response

Substance abuse causes physical changes in the structure of the brain – changes that never fully return to normal once they occur. These changes can cause a host of physical symptoms – most notably a reduced ability of the body to handle stress, which can manifest in many different types of symptoms; especially a strong and irrational urge to use drugs or alcohol again despite the risk of severe consequences.

How does this apply to conditions other than drug addiction or alcoholism?

Drugs and alcohol cause a disruption in neurotransmitters that result in intense feelings of euphoria. Other compulsive behaviors like the ones outlined below also cause interference in the transmission or release of feel- good neurotransmitters like dopamine or serotonin. Consequently, a person can in theory become addicted to virtually anything that makes them feel good, provided it stimulates the pleasure and reward center of the brain and central nervous system.

Today we see this in the following types of compulsive and addictive behaviors:

*Gambling Addiction
*Sex and Porn Addiction
*Internet and Video Games Addiction
*Food/Eating Addiction
*Exercise Addiction

However, some people question whether these types of behaviors actually produce symptoms of post acute withdrawal once arrested. While no direct study has been conducted in this regard to date, there is anecdotal evidence that suggests compulsive gamblers, sex addicts and others with addictive disorders suffer from varying degrees of post acute withdrawal, including symptoms that appear months after cessation. From the Squidoo Lens on Post Acute Withdrawal Syndrome by Debbie Davis, interactions on the lens include comments from people who suggest they are suffering from PAWS related to compulsive behaviors:

From user James on 10/15/2012:

“What I eventually discovered was that I was addicted to pornography and masturbation and the chemical high that I get from orgasm. I’ve been at this addiction for a solid 8 years and have now realized that my brain has rewired itself in an awful way. I’ve been fighting the addiction now for a month and a half and have experienced very severe withdrawal symptoms: suicidal depression, mood swings, anxious about nothing in particular, tiredness/laziness, inability to concentrate, self-imposed isolation, crying for no reason etc.”

From user Gerrit on 07/16/2012:

“I am addicted to [gaming on the] Internet. I stopped online gaming 6 [months] ago and have been clean. Triggers [give me] bad PAWS [symptoms]. I fear many people here may game too and don’t know how addictive it is; yes gaming and porn together are as addictive as Drugs and Alcohol, [especially] to those who become easily addicted.”

And for those who ponder the validity of lesser substances causing post acute withdrawal:

From user Jayson on 08/37/2012:

“I am now on day 23 consuming zero caffeine, but I still don’t feel like my old [self]. I get anxious out of nowhere; I can’t seem to control my thoughts which lead to stress and eventually anxiety. I’m developing all sorts of phobias and my energy levels fluctuate.”

***Comments have been edited for spelling and grammar***

So what’s the Difference?

While it is possible that post acute withdrawal can be caused by the above or by other compulsive and addictive behaviors, there are 2 primary differences between post acute withdrawal symptoms related to narcotics or alcohol and similar symptoms related to most other compulsive behaviors:

1.) Severity of Symptoms

PAWS symptoms for recovering drug addicts and alcoholics are severe and sometimes debilitating, often requiring medication, intensive treatment or medical/psychiatric monitoring, and in some cases may last for ten years or more.

2.) Consequences of Relapse

The consequences of relapse for drug addicts and alcoholics are acute and include disease, violence, suicide, imprisonment and death.


Some people who have particularly troubling cases of gambling, sex, internet/gaming or other behavioral addictions may suffer from post acute withdrawal syndrome. However, we must be careful to make the distinction that when it comes to addiction to drugs or alcohol and subsequent cases of related post acute withdrawal; the issue is always one of life and death; whereas with other addictive behaviors this is rarely the case.



Reference: Davis, Debbie Post Acute Withdrawal Syndrome Squidoo

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