Many of the problems associated with early sobriety do not stem directly from psychoactive substances. Instead, they are associated with physical and psychological changes that occur after the substances leave the body. When a person regularly uses psychoactive drugs, the brain undergoes physical changes to cope with the presence of the drugs in the body. When drugs are removed from the body, the brain craves the drugs it is accustomed to, and as the brain attempts to rebalance itself without the presence of psychoactive drugs, the person often experiences feelings of confusion, pain, and discomfort. Symptoms that occur immediately after stopping drug use are called acute withdrawal. But the symptoms often don't stop at acute withdrawal. After the body has made the first adjustments to the absence of drugs, the changes that have occurred in the brain still need time to return to their original state. During this time, a series of symptoms known as post-acute withdrawal syndrome (PAWS) begin to appear. In the book Uppers, Downers, All Arounders, published by CNS Productions, authors Darryl Inaba and William Cohen define PAWS as "a group of emotional and physical symptoms that appear after major withdrawal symptoms have subsided" (Inaba & Cohen , 2011). for Inaba and Cohen, PAWS is the result of damage to brain neurons combined with the psychological stress of living a drug- and alcohol-free life (Inaba & Cohen, 2011). PAW symptoms typically last six to 18 months, but can sometimes last up to ten years. The main symptoms of PAWS include sleep disturbances, memory problems, inability to think clearly, emotional overreaction or numbness, physical coordination problems, and hello… an option. I have always believed that with knowledge comes choices and this motto is especially useful in situations where choices seem limited as they do during PAWS. Treatment centers should implement mandatory PAWS training that includes teaching about the reasons and symptoms of PAWS, the length of time a person can expect to be at risk of contracting PAWS, the high risk of potential relapse that exists during PAWS and how to manage it. recognize, manage and control PAWS symptoms as soon as they appear so that relapses do not occur and continued recovery prevails. Works CitedGorski, T.T., & Miller, M. (1986). Staying Sober: A Guide to Relapse Prevention. New Providence, NJ: Independence Press. Inaba, D. S., & Cohen, W. E. (2011). Uppers, lowers, all-rounders. (7th ed.). Medford, OR: CNS Productions, Inc.