Many of us have successfully managed to get past the acute opioid withdrawal phase, only to realize that the struggle was far from being over.
Next comes the second phase of withdrawal, which is called Post-Acute Withdrawal Syndrome (PAWS).
To accurately and simply define PAWS, let’s break down the meaning of each individual word:
- Post – “After”
- Acute – “Very serious or dangerous; requiring serious attention or action”
- Withdrawal – “The discontinuance of administration or use of a drug”
- Syndrome – “A group of symptoms”
Simply put, Post-Acute Withdrawal Syndrome is a group of symptoms that occur after an individual has gone through the serious withdrawal phase induced by the discontinuation of drugs, which results from a combination of damage to the nervous system caused by alcohol or drugs and the psychosocial stress of coping with life without drugs or alcohol.
Table of Contents
Common Symptoms of PAWS
There is a wide range of symptoms an individual might experience during PAWS. The symptoms and severity will vary from person to person due to many different biological, psychological, social, and lifestyle variables.
Common symptoms of PAWS are:
- Inability to think clearly
- Memory problems
- Emotional overreactions or numbness
- Physical coordination problems
- Stress sensitivity
- Increased susceptibility to emotional and physical pain
- Gastrointestinal (GI) issues
- Intense cravings to use opiates
- Drug dreams
- Anhedonia (the inability to experience pleasure; pleasure deafness)
Increasing GABA During PAWS
Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter that humans create naturally. GABA acts as a “mental relaxant” and lowers the activity of neurons in the brain and central nervous system (CNS).
GABA is kind of like ‘brakes for the brain’.
When a person has optimal levels of GABA, they get the following effects:
- Sound Sleep
- Alleviation of Pain
- Balanced Mood
Benzodiazepines (commonly referred to as benzos) are a class of anxiolytic drugs that increase the brain’s levels of GABA.
Perhaps you’ve heard of (or even taken) benzos like Valium, Xanax, Klonopin, or Ativan?
If you’ve tried them before, then you know how relaxing they can be.
I had a bottle of Valium when I quit opiates.
And having these pills was the main reason I was able to make it through the entire 8 weeks of PAWS after I quit heroin over 8 years ago.
Normally I cave in and give up when the symptoms are too difficult for me to handle.
While benzos can offer a lot of anxiolytic, antidepressant, and sleep support when taken PRN during PAWS, some people can’t get them, and others simply don’t want to take more drugs that often come with side effects and risk for addiction.
Thus, here is where ‘Nature’s Favorite Benzos’ can come in handy.
And my favorite way to use these during PAWS is by drinking herbal teas.
Specifically, the following herbal teas (which increase GABA naturally):
- Chamomile Tea
- Passionflower Tea
- Kava Root Tea
- Lemon Balm Tea
Let’s begin covering the myriad and wonderful benefits of these benzo-like herbs by starting off with chamomile…
Chamomile is one of the most ancient medicinal herbs known to mankind. Chamomile is a flower that’s a member of the daisy family.
It is native to Europe, Africa, and Asia, where it’s been used for medicinal purposes for centuries.
Nowadays chamomile is also grown in North America.
While professional herbalists like my mom and dad could name off several hundreds of herbs, the average person only knows of a few.
And almost everyone has heard of chamomile.
Chamomile is probably the most well-known and widely used herb here in the US, where millions of people have used chamomile for its many health-promoting benefits.
Some of the most commonly sought-after benefits of chamomile are as follows:
- Reduces Stress
- Treats Insomnia
- Boosts Immunity
- Reduces Muscle Spasms
- Relieves Period Pain
- Soothes Stomach Pain
- Aids Digestion
- Promotes Mental Well-Being
- Lightens Complexion
Chamomile Medicinal Properties
Chamomile’s wide range of health benefits is due to it containing various bioactive phytochemicals. The dried flowers of chamomile contain many terpenoids and flavonoids contributing to its medicinal properties.
The main constituents of the flowers include several phenolic compounds.
Primarily the following flavonoids and their glucosides:
The main mechanism of action from chamomile that I’m going to focus on in this article is the herb’s ability to bind to GABA receptors in the brain, as this is the action that helps to relieve post-acute withdrawal symptoms.
The chemical component responsible for chamomile’s anti-anxiety and anti-insomnia benefits is Apigenin. Apigenin calms down the mind and body because it binds to GABA receptors, thereby increasing GABA levels in the brain.
Passionflower is a beautiful flowering plant that has a long history of use among Native Americans in North America and European colonists.
Throughout history as well as the present day, passionflower has been used to treat a number of health conditions.
Presently, there are around 14 conditions passionflower has been used for, but for the purposes of this article, I will concentrate solely on how it can help ease symptoms of PAWS.
Passionflower has been shown to be helpful for:
- Gastrointestinal (GI) upset due to narcotic drug withdrawal
- Opioid withdrawal
- Nervousness and excitability
- High blood pressure
- Pain relief
Passionflower increases brain levels of GABA, so it’s mentally and physically relaxing to the overactive CNS caused by recently quitting opioids.
Plus… passionflower contains monoamine oxidase (MAO) inhibitors harmaline and harmine.
This herbal tea also contains several flavonoids that are MAO inhibitors, including apigenin, kaempferol, and quercetin.
MAOs are enzymes that break down neurotransmitters and stop their messaging activity.
Passionflower’s MAO inhibitors boost the following mood-boosting chemicals in the brain:
- Serotonin – Makes you feel emotionally relaxed.
- Norepinephrine – Increases energy, fights fatigue, fights depression, helps the body respond to stress.
- Epinephrine – Increases energy, fights fatigue, fights depression, helps the body respond to stress.
- Dopamine – Responsible for feelings of pleasure and enjoyment in life.
Passionflower for Opioid Withdrawal
In a study from 2001, 65 opioid-dependent participants were assigned randomly to two groups. One group received clonidine plus a placebo, while the other group received clonidine plus passionflower extract.
The maximum daily dose of clonidine was 0.8 mg in three divided doses, with a fixed daily dose of 60 drops of passionflower extract.
- Both protocols were equally effective in treating the physical symptoms of withdrawal.
- Researches observed that the passionflower + clonidine group showed a significant superiority over clonidine alone in the management of mental symptoms.
Lemon Balm Tea
Lemon balm, Melissa officinalis, balm, common balm, or balm mint, is a perennial herbaceous plant in the mint family Lamiaceae.
Native to south-central Europe, the Mediterranean Basin, Iran, and Central Asia, it has been cultivated since at least the 16th century as an ornamental plant, for its oil (used in perfumery), and its many virtues.
It is now naturalized in the Americas and around the globe.
The leaves are used as an herb, in teas, and also as a flavoring agent.
Lemon balm is also strategically grown to attract bees for honey production.
According to Greek mythology, Melissa was a nymph who discovered and taught the use of honey. She was one of the nymph nurses of Zeus as a baby, but rather than feeding him milk, Melissa fed him, honey, hence the genus name Melissa (Greek for “honey bee”).
Lemon balm can help in a several different ways during PAWS.
Lemon balm protects brain cells and supports brain health and function. Antioxidants such as eugenol in lemon balm detain free radicals before they can attack brain cells.
Rosmarinic acid, which is a key compound in lemon balm, is also beneficial in this regard.
Members of the mint family such as peppermint, rosemary, and lemon balm generally act as cerebral vasodilators, which means they open the blood flow to the brain, providing more oxygen and glucose to brain cells.
If the brain doesn’t get enough blood, it can quickly affect brain function.
Animal studies show that, when provided shortly after such an episode, lemon balm appears to be protective of the brain.
Lemon balm also improves memory and brain function by binding to nicotinic and muscarinic receptors in the brain.
Both of these types of receptors are activated by acetylcholine, a neurotransmitter that plays roles in enhancing memory and alertness.
Relaxation & Sleep
Lemon balm increases GABA by inhibiting GABA transaminase, an enzyme that breaks it down.
Various studies have shown lemon balm to be effective at treating stress:
- Rat studies show GABA producing a calming effect, improving mood, and reducing stress levels.
- In a pilot trial, lemon balm completely eliminated anxiety in 14 people with stress.
- Also, a combination of lemon balm and valerian root significantly reduced anxiety in 24 healthy volunteers.
If you have difficulty falling asleep, you will find an ally in lemon balm.
Studies show it encourages restful sleep:
- Evidence shows children sleep more peacefully throughout the night with lemon balm.
- In a study from 2011, lemon balm was shown to help with mild-to-moderate anxiety disorders and sleep disturbances.
- Another study found that menopausal women suffering from interrupted sleep reported much better rest after taking an extract of lemon balm and valerian.
Pain and Inflammation
An alcohol extract of lemon balm has been found to reduce pain by blocking the arginine-nitric oxide pathway and by increasing acetylcholine levels in mice.
Additionally, studies show that lemon balm reduces inflammation in mice caused by injury by reducing inflammatory proteins TNF-alpha, IL-1, and IL and by lowering oxidative stress.
Stomach Issues & Melancholy
Lemon balm can help soothe digestive issues by preventing gastric ulcers. Lemon balm treats melancholy as well, and really has a wonderful way of uplifting mood when feeling down.
- Post-Acute Withdrawal Syndrome (PAWS) is the second phase of opioid withdrawal that comes immediately after the acute phase.
- PAWS lasts longer than the acute withdrawal, though the symptoms are not as severe.
- PAWS results from the combination of damage drugs have done to the brain and the stress of living life without the drugs we’ve become dependent on.
- Benzodiazepines (commonly referred to as ‘benzos’) such as Xanax, Valium Ativan, and Klonopin are anxiolytic drugs that can help to reduce anxiety, insomnia, stress, and other symptoms of PAWS due to increasing the GABA levels in the brain.
- Benzos often are hard to get prescribed, come with side effects, and can become habit-forming, so not everyone can or even wants to use them while quitting opioids.
- Mother Nature supplies us with several effective ‘Natural Benzo’ herbs, which increase GABA in a mild but effective way, which are non-addictive and typically don’t cause side effects.
- My favorite herbal teas that increase GABA naturally are chamomile, passionflower, and lemon balm.
- My favorite way to take these natural benzo herbs is by drinking them in tea form (although some people prefer to take them in capsules, soft gels, or liquid extracts).
If you enjoyed this article, you’ll love my Ultimate Opioid Recovery System.
It’s my flagship program that teaches you step-by-step how to quit opioids comfortably and successfully and then never relapse again.
Take care, and I wish you the best.
And don’t forget to drink up!
Come to think of it…
A cup of chamomile tea sounds perfect right now, and I’m about to make a fresh cup after finishing this essay. 😉
My name is Ed and I am opiate addict, been an addict for over 2 decades.
Yes there has been some breaks during but only because I was incarcerated.
I am super interested in what you are offering but I do not have money! Been unemployed for a while now , and couch surfing at my dad’s.
I was hoping you could help me with your coaching program free of charge, I could really use your help very much Matt, and I am sure you too would feel better doing this for me! So please be kind and help me with my struggle to get clean! Thank you!