Unraveling the Obscurity of Post Acute Withdrawal

Post Acute Withdrawal is the leading cause of drug and alcohol relapse but is still a relatively obscure condition in the addiction treatment industry. Consequently many addicts receive inadequate treatment that inevitably results in repeated relapse episodes - some lasting for months or years at a time. Despite the easy dissemination of information that is possible in today's instant-communications-enabled world, post acute withdrawal (PAWS) has yet to receive the public focus it deserves, and there are 4 primary reasons for this:

1.) Draconian Attitudes and Substance Abuse Concepts

Surprisingly, there are still many people - including those who work in the field of addiction and alcoholism treatment - that do not subscribe to the disease concept of addiction. Instead, these people believe that addiction is a moral issue that boils down to a lack of will power. Therefore, any conditions related to addiction are often not taken seriously by this group - especially a condition like PAWS, which could be viewed as an excuse to relapse.

2.) Revolving Doors of many Drug Rehab Centers

Some, but not all rehab centers are primarily profit-driven. In theory this is a potential conflict of interest considering that if all addicts were "cured" by treatment the first time around and education programs were effective at preventing new addicts, then for-profit rehabs would go out of business. These types of rehab centers are sometimes not conce
ed with the long term success of their patients; instead the goal is to get them through treatment as quickly as possible in order to open up the next bed at the facility.

Additionally, some treatment centers are so overloaded with patients that they cannot hope to provide thorough treatment. High burn-out rates exist among staff which adds to the "revolving door" effect of many rehab programs. Whether through ineffectiveness or a concentration on profits, critical components of treatment are missed in these situations, including education and ongoing treatment/resources for post acute withdrawal.

3.) Little to no Community Education

Community education programs have not made PAWS a focus. Instead, most programs work by dealing with immediate problems; i.e. helping drug addicts and their families get detox and other acute treatment, as well as programs designed to keep people off drugs in the first place. Relapse prevention programs - the topics of which rarely reach the public - are almost exclusively offered by treatment centers during active therapies.

In fact, even 12 Step programs fail to address the often severe symptoms of PAWS and instead focus on religious and spiritual goals that do little to alleviate or explain direct symptoms and urges to use drugs or drink. While these types of programs and other therapies may be an important part of treatment overall, long term recovery success requires education and management of PAWS symptoms. This is especially important considering that PAWS can manifest in addicts even decades after getting clean.

4.) Post Acute Withdrawal: A Burgeoning Concept

Perhaps more than any other issue, the fact that post acute withdrawal is a relatively new concept is the most likely reason for the less-than-ideal integration of this theory in the addiction treatment and prevention communities. As scientists and researchers have uncovered new information related to the way the brain works, we have come to understand more about the disease of addiction and recognize that PAWS is in fact an "inactive" phase of addiction with one primary symptom; a lingering and compelling urge to return to substance abuse.

It is only through public education about this condition that we will be able to help addicts and their families overcome the ravages of the disease of addiction and alcoholism. Additionally, ongoing therapies and support networks for people in recovery should incorporate the concept of PAWS and provide management strategies and therapy options for those that need it.

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