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  • BDD Moderators: Keif’ Richards | negrogesic

Misc PAWS doubts...

It’s real….I think the reason opiates have such a high relapse rate is cause of how long it takes to get back to feeling “normal” and knowing a opiate will make you feel great
 
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I firmly believe in PAWS symptoms and I firmly believe in relapses. And yes, I always relapsed at about the 3 week mark. My body was over it but my mind was still screaming bloody murder. PAWS is worse than the physical part. For me.

Thank God those days are over. Drugs were absolutely the best and the worst parts of my life. Friggin' ironic.
 
Pumpkin2021 said:
I firmly believe in PAWS symptoms and I firmly believe in relapses. And yes, I always relapsed at about the 3 week mark. My body was over it but my mind was still screaming bloody murder. PAWS is worse than the physical part. For me.

Thank God those days are over. Drugs were absolutely the best and the worst parts of my life. Friggin' ironic.
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Exactly, I think the main problem is we want to feel normal, but for so long being high was our normal, so even when the body 0s itself that not normal for us, it takes time to readjust what you perceive as normal…or atleast IMO
 
Certainly real.

The key to beating post acute withdrawal is via heavy exercise, at least as far as opioids are concerned. It works really well. Its how I beat high dose methadone.

Post acute benzo withdrawal is a bit trickier and more treatment resistant. I know nothing worked for me really. Acute benzo withdrawal can last a year. Sort of unclear when it ever really stops. I feel like I'm forever in post acute benzo withdrawal due to two very heavy withdrawal syndromes. I think I have a bit of PTSD from benzo withdrawal, I get flashbacks every once in while where I can sort of feel the delusional parasitosis again (like a physical sense of invisible spider webs like stuff emerging from my finger nails). During benzo withdrawal I've experienced severe delusion parasitosis where I was convinced I was infested with some sort of parasites, like a mite infestation of some sort and some sort of internal parasites as well. Even went to doctors etc. I was also taking 120mg/day of methylphenidate on top of it the worst of it which added a stimulant psychosis ontop of it. Sheer horror. Hard to snap back fully when you've gone so far off the deep end. When the brain experiences states of such extreme panic it sort of gets scarred in a way.

A promising treatment for post acute benzo withdrawal is flumazenil, a benzodiazepine receptor antagonist. I wish I had had access to it but it is hard to come by and tricky to use. I wonder if i could benefit from it now. Occasionally I still take benzodiazepines every once and a while and a single dose puts in me into nasty place for 5 days after.

The post acute withdrawal phenomenon is particularly severe with benzodiazepine withdrawal given the structural changes that occur in the brain. In a homeostatic attempt to deal with the presence of benzodiazepines the body down-regulates a great number of these associated receptors and they are sort of reabsorbed. When they are eventually called back after benzodiazepines are no longer present they are expressed differently genetically and are less efficient at enhancing GABA. These changes in gene expressions can be permanent. Essentially, it's brain damage. Thus I'm quite a bit more anxious than I ever was.

Its quite distressing because if I take a benzo now its as if I feel normal, not paralyzed, and start taking alot of actions. All the things I've been avoiding I start facing.
 
PAWS is real in my experience and is cyclical. I mean lingering WD symptoms seem to last forever, but I personally get surges about every 30 days. I also went to basically the best rehab one could go to and its also what they taught. PAWS is real, mimics Acute withdrawal and typically happens at 30 days, 60 days, 90 days; so on and so on
 
It's real as fuck and visible at receptor level, I know too little yet to provide a detailed description but I'd say it's related to changes in dopamine (down: anhedonia, amotivation), dynorphin (up: somehow mediates stress) and we have the biomarker DeltaFosB which takes ages to go down to baseline again -> possibly the same duration like PAWS symptoms. Maybe epigenetic changes. Also there's kindling, every withdrawal becoming a bit more painful than the last one. This is mediated by NMDA receptors/glutamate and we have antagonists for it.

Would say there is little difference between PAWS + "excuses" for relapsing.

Good thing is there are things one can do against, before I abused it (double edged sword), DXM was very effective.
 
That article is not very well done. And shitty that it's showing up in searches. Just what we need, more non-addicts thinking addicts just lack willpower,

PAWS is certainly real, and easily explainable. Chronic dependence downregulates receptors so that without the drug you're used to, neurotransmitter levels are insufficient for homeostasis. Rebuilding receptor density through upregulation takes time, and the time is takes is longer, the longer and more severely you've been addicted. Furthermore, particularly with GABA receptors and particularly with benzos, . A longtime addict's brain is different than it was before, and different from a non-addict's brain, in that comparatively very minor use after recovering homeostasis will lead to dependence again. Long-term dependence produces semi-permanent and in some cases permanent changes in the brain. Thus, it's more and more difficult for addicts to feel normal without drugs, even increasingly longer after acute withdrawal ceases.

Acute withdrawal sucks and it's the most severe part, but it is not the most difficult to deal with. The most difficult part to deal with is the long-term maintaining of sobriety, and a big part of the reason it is so difficult is because it takes the brain a long time to fully recover, and in some cases, it never really does.

Fortunately, there are lifestyle changes you can make to help yourself greatly, which a lot of people do not do. Studies and experience show that daily exercise helps tremendously in recovering homeostasis and feeling good without drugs, particularly for opiate addicts. Proper nutrition also helps, and equally if not more important is changing your activities and habits to replace the hole left by drugs. One should seek to eliminate sources of pain that often cause drug addiction in the first place, and also to find hobbies to fill one's time with that provide natural methods of feeling satisfaction and joy.
 
Xorkoth said:
Studies and experience show that daily exercise helps tremendously in recovering homeostasis and feeling good without drugs, particularly for opiate addicts.
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Opioids downregulate hormone production, and exercise works against that. Wondering whether women get less lasting PAWS from opioids than men, if this is another reason why in rehab 90% were male. But I don't yet understand the hormones.

Fully agree to your post @Xorkoth. Had I known that it is not the withdrawal and avoiding it which really fuels addiction.relapse but just feeling shitty... then I hadn't started opioid maintenance for sure. The withdrawal is actually pretty easy and painless to manage but it's JUST A FUCKING LIE that opioids only cause like 1-2 weeks of hell, the real thing is PAWS. These people educating teens about addictions and stuff should teach this, that you will never be same again. Still I think it should be possible to reverse everything but this'd need access to a lab and stuff.
 
I think PAWS is real but not a given. And I will say I am very happy no literature had info on this when I was younger. I uually had the opposite. After being a slave to opiates and quitting a few weeks later I was happy as hell I took the bull by the horns. Felt sort of powerful. Not a slave anymore and not feeling guilty. So really I never had heard of PAWS before. But the downregulation explained above makes a lot of sense and physical explanation of what could happen. So I can see this affecting people for sure and needs to be addressed. But I do think the info should include that it is not a given and some people don't experience it. And for the people that do some strategy to keep at staying off opiates while going through that tough time. I do know a few people that felt worse off opiates for a few months. Others felt better after a month.

I also think one of the biggest positive things I could do after I quit an opiate was scheduling a travel vacation about 2-3 months after a kick. One time I went to Costa Rica 95 days after a poppy pod withdrawal and had the best time of my life. That withdrawal was very bad for about a month. So really I think we needc activities that mask possible PAWS symptoms like that exercise and travel.
 
JackARoe said:
I also think one of the biggest positive things I could do after I quit an opiate was scheduling a travel vacation about 2-3 months after a kick. One time I went to Costa Rica 95 days after a poppy pod withdrawal and had the best time of my life. That withdrawal was very bad for about a month. So really I think we needc activities that mask possible PAWS symptoms like that exercise and travel.
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Yeah I think you nailed it there. You have to focus on something else and be active, that gives your brain something else to focus on and natural dopamine and endorphins and such to help restore balance. Working out, travel, sex, anything that makes you feel excited and positive and healthy. Sounds like whenever you got off opiates you took the opportunity to take hold of your life and do something positive or cool. Which is great. :) That's what I did when I quit my 10 year really bad addiction phase.
 
This is like questioning if long term brain damage is real after a concussion. Of course it is, but it may not always be perceptible or diagnosable or exist at all. It's not so black and white, but it's not shadow and mirrors either.

PAWS is both psychological and physical, and very real.

Also... like in the matrix... your brain makes it real. Brain connections can be altered simply by repeated concerted thought... mind over matter... your body, including your brain, will always follow the mind to the best of it's ability... thought can also be influenced by physical limitation. I went off on a tangent, sorry.
 
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