Post Withdrawal: Do I Need Medication?

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Medication for Post Withdrawal (also referred to as protracted withdrawal or PAWS) is one of the most useful tools for people in recovery. Post-withdrawal often comes with debilitating symptoms for some addicts, and considering that symptoms can last for as long as two years, medication can play an important role in the management of this condition. If you’re suffering from post-acute withdrawal symptoms and you think you need medication, ask yourself the following four questions to determine if pharmaceutical treatment is your best option:

1.) Are the symptoms underlying physical or co-occurring conditions unrelated to post-acute withdrawal?
The first step is to rule out the possibility of an underlying physical condition that could cause symptoms confused with PAWS, such as insomnia due to a sleeping disorder or chronic headaches as a result of exposure to allergens. Additionally, a co-occurring disorder such as bipolar or panic disorder could be to blame for symptoms that would otherwise be attributed to protracted withdrawal.

It’s important to ensure that if medication is required the proper condition is being treated. Therefore, the first step in determining if you need pharmaceutical treatment for PAWS symptoms is to consult with a physician, followed by a psychiatrist.

2.) Mental/Cognitive Symptoms: Do they interfere with your ability to function normally?
Mental and cognitive problems do not present prior to addiction and subsequent withdrawal could indicate a need for further investigation and medication in some cases. This is especially true if these problems cause a significant disruption in your ability to function normally. If an underlying or co-occurring condition has been ruled out, then it’s possible that cognitive troubles are related to PAWS.

In some cases, these types of symptoms (poor attention span, disorganized thoughts, racing thoughts, poor ability to problem-solve, poor or inconsistent memory, etc) are treated with medications that can help bring focus and clarity back to a person’s life. However, there are certain risks involved (as with many medications) and therefore mental and cognitive issues must be a disruptive force and not merely an inconvenience in order to receive pharmaceutical treatment in most cases.

3.) Physical Symptoms: Do they cause severe pain or discomfort or limit your ability to function normally for an extended period of time?
In some cases, the physical symptoms of post-acute withdrawal can be severe. The term Dry Drunk refers to a person who is not intoxicated but physically behaves as if they are. The person may stumble, shake, have difficulty performing simple physical tasks, etc. In such cases, medical evaluation and medication may be required, with a focus for those with a history of repeat relapse episodes on investigating the possibility that the Kindling Effect has set in.

Other physical symptoms related to PAWS include headaches, exhaustion, poor hand to eye coordination, slow reflexes and other difficulties with fine and gross motor skills. However, treating these symptoms with medication may not be the right answer for some people. Physical rehabilitation may be required, or the source could be neurological damage requiring specialist treatment.
Most physical symptoms of protracted withdrawal are successfully managed with a healthy diet, plenty of exercise and some over-the-counter medications on an as-needed basis.

4.) Is the desire for medication an addiction substitution?
The prevailing symptom of post-withdrawal is a strong and persistent desire to use drugs or drink again. In some cases, this compelling need can manifest as a feeling that some type – any type – of medication is needed. Essentially, the addict feels a desire to chemically substitute their addiction. Ruling out this possibility requires honesty on the part of the person in recovery along with professional guidance from a therapist trained in addiction and alcoholism.

These are the four most important questions you should ask if you are experiencing post-acute withdrawal syndrome symptoms and are considering acquiring medication as a form of treatment. However, it’s important to understand the place that medication has for addicts in recovery. Some addicts are naturally drawn to medications as a coping mechanism, while others refuse to take any type of drug out of fear of compromising their recovery program.

A better balance is likely found somewhere in between.

It’s critical that pain and discomfort are managed properly lest they become a trigger for relapse, but at the same time addicts must respect the chemical substances they put into their bodies and recognize the threat of a return to active addiction. This threat is often found in the form of post-acute withdrawal, but whether medication is required or not is a question that can ultimately only be answered by you and your therapist or support network.


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