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Many addicts in recovery wonder when symptoms of post acute withdrawal will end. In fact, it's the most common question related to this condition, but the answer is different for every person. Fortunately, there are a number of factors that a person can successfully influence that will help to reduce both the severity and duration of symptoms. This is especially important to learn considering that many addicts report post acute withdrawal symptoms for more than 2 years. The following will influence how long symptoms last, among other factors.
*Type of Drug
They type of substance used will significantly affect the duration of post acute withdrawal symptoms. Opiates are widely considered to cause the most severe symptoms when the addiction in question was acute and chronic - this is especially true if the addicted opiates were treatment drugs such as Suboxone, Naltrexone or Methadone. Hard-core heroin users and Methadone addicts report long term symptoms lasting for up to 2 years or more in some cases.
Long term alcoholics often struggle with symptoms long after they have completed a drug treatment program. Some former chronic alcoholics report difficulties related to post acute withdrawal for years or even decades after they quit drinking. However, the severity and duration of these symptoms is at least partly dependent on other factors mentioned below.
Drugs with typically shorter post acute withdrawal symptoms include marijuana, hashish, cocaine, ecstasy and benzodiazepines. (Note: while symptoms caused by a former addiction to benzodiazepine aren't thought to last as long as other types of chronic addictions, initial cessation and withdrawal from this class of drugs can be dangerous: consult with medical professionals before detoxing from this substance or from alcohol)
*Nature of Abuse
In general, the more severe and long-lasting the substance abuse and active addiction period is, the longer and more severe post acute withdrawal symptoms will be. For instance, a person who abused heroin chronically for 5 years while switching between other drugs and developing multiple addictions over a period of time will likely have more symptoms (and for longer) than someone who abused cocaine and no or few other drugs for 6 months. Mixing drugs and using drugs at the top of the drug hierarchy (heroin, Fentanyl, etc) typically results in more severe symptoms after detox and withdrawal.
*Duration of Abuse
The longer an addict is in an active state of substance abuse and addiction, the longer post acute withdrawal symptoms generally last. Alcoholics who drank for a decade are more likely to experience symptoms past their first and second year of sobriety than a person who used meth for a year.
*Past Relapses and Withdrawals
The more times a person has withdrawn from a substance and then subsequently relapsed, the more severe and long lasting their post acute withdrawal symptoms will be. This is caused by a condition referred to as the Kindling Effect, where subsequent relapse episodes cause more and more severe symptoms of acute withdrawal syndrome or AWS and correspondingly. The Kindling Effect is in turn caused by a decreasing ability of the brain to handle stress as well as significant changes in individual nerve cells and overall functioning of neuronal wiring in response to damage caused by the interactions of drugs and neurotransmitters.
*State of Health
People who are in good health generally have fewer post acute withdrawal symptoms that clear up more quickly than those in poor health. Often when addicts first get clean they are emaciated, highly stressed and sometimes suffering from a number of drug-abuse or alcoholism related diseases and conditions. This means that they are less physically able to cope with any symptoms that arise than a normal healthy person.
However, addicts that quickly recover physically and take a proactive stance on their health can reduce the severity and duration of any symptoms they might experience.
*Co-Occurring Conditions
People with co-occurring conditions such as schizophrenia, depression, anxiety, mania, bipolar, and others often have a more difficult time with post acute withdrawal than people who do not have a dual diagnosis. This is because many of the symptoms of these conditions mimic or exacerbate symptoms of post acute withdrawal.
Overall people receiving treatment for their co-occurring conditions fare better than people who do not receive treatment or therapies.
*Diet
The healthier the diet of the person in recovery, the stronger their immune system and health will be and therefore the better equipped they'll be to cope with symptoms should they arise, and the less likely it becomes that symptoms will occur for an extended duration.
People with poor diets - especially those who eat diets that are high in fats and sugars - often feel many symptoms for long periods of time because sugar acts on the same neurological processes as drugs of addiction like Oxycontin, morphine and meth.
*Exercise
Exercise is essential for healthy brain functioning and the development of red blood cells - all critical parts of maintaining a healthy body. People who exercise on a regular basis are more likely to be in a better overall state of health and therefore will be less likely to experience long term post acute withdrawal symptoms.
*Environment
For most addicts, environment is everything. Addicts who are recovering in low-stress, supportive and fulfilling environments not only experience few conditioned responses and related triggers to use drugs or drink again, they're also much less likely to experience ongoing symptoms of post acute withdrawal. Conversely, addicts that live in stressful environments with numerous triggers to use are not only more likely to experience chronic and long-lasting symptoms, they're also more likely to relapse and return to drug abuse or drinking.
*Support
Recovering addicts with strong support networks are more likely to fare well with symptoms than those with few or no support connections. A support network is a critical part of recovery from addiction and often means the difference between an addict that relapses repeatedly and one that stays clean for years.
However, it should be noted that a strong support network in recovery doesn't directly impact post acute withdrawal; instead it allows addicts a better opportunity for help in dealing with the symptoms that they do have, making it less likely that they will relapse and consequently decreasing the amount of time that symptoms are experienced.
*Treatment and Therapies
People who are in long-term recovery that actively engage in treatment or various types of therapies stand a much better chance of recovering from post acute withdrawal more rapidly than those that take a passive stance on their recovery. However, it should be noted that for opiate addicts, symptoms of withdrawal and post acute withdrawal may occur while on opiate substitution therapies. Therefore, it's difficult for these people to determine when they can expect a normal return of functioning: first they must stop using all drugs in order to make a complete recovery and a proper evaluation related to symptoms, co-occurring conditions, etc.
*Attitude
It may sound clich, but attitude can mean the difference between a quick recovery and few experiences related to post acute withdrawal and a terrible roller-coaster ride of symptoms that last for years. Attitudes change on a daily basis and of course some days are better than others, but addicts in recovery with a better disposition and attitude tend to fare better than their more negative counterparts.
While all of the above points will influence how long post acute withdrawal symptoms occur for and how severe they are, this is only part of the picture as there are unknown factors that also influence the recovery experience. However, if you are in recovery and you focus on cultivating and nurturing a strong support network, exercise and eat healthy foods and take active part in ongoing treatment and therapies, you'll stand a far better chance of staying clean for life than those who take a less proactive approach.
