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Post Acute Withdrawal Syndrome (PAWS) - The Case For An Integrative and Naturopathic Approach

Updated: Nov 20, 2019

" Parts of the current system are incredibly helpful and even essential... However... there was, and still is a huge gap in the treatment pathway provided to most patients. "

In the first years of my practice, I focused on primary care medicine and those with chronic illnesses. Eczema, digestive disorders, failure to thrive in children, hypothyroidism, chronic migraines - that sort of thing. In 2017 I began performing accelerated detox procedures with my now dear friend and colleague, Barbara Mendrey, MD, in Bothell, WA. Addiction medicine was not anything I had experience with prior to this time.


Together, Dr. M and I provided over 200 accelerated detoxes from opiates (oxycodone, heroin, fentanyl, street combos, methadone, suboxone, etc.), benzodiazepines (valium, clonazepam, etc.), and alcohol. In the clinic we also provided suboxone therapy, Vivitrol (long-acting naltrexone), and other addiction services. I provided an integration of conventional and naturopathic medicine services.


" I saw the needs left unmet and knew immediately that naturopathic medicine and integrative thinking held the answer. "

I gained a deeper understanding of the pharmacology of different addictive substances, more about the nature of addiction itself, and what kinds of pathways existed in the current medical system for addiction and recovery. Parts of the current system are incredibly helpful and vital to many people's success. Medication assisted therapy is one of these often invaluable pieces. However, I quickly realized, there was and still is a huge gap in the treatment pathway provided to most patients. I saw the needs left unmet and knew immediately that naturopathic medicine and integrative thinking held the answer.


Read more on what #PAWS is and why it happens.


"This model is the most effective one we have currently, yet it is incomplete. "




This model is the most effective one we have currently, yet it is incomplete. This model negates the effects that years of substance abuse has on the body. The hormonal, adrenal, and nervous systems take a huge hit, just to name a few. These effects and what the person experiences due them are one of the largest risks for relapse - outside of the most common and deep causes, such as trauma and epigenetics, of course. Despite this, I still don't see these physiologic damages due to long standing substance abuse and dependence commonly addressed.


"We need to rehabilitate and heal the damaged physical and chemical body in order to best show up for the deeper work necessary for self actualization and living life purpose."

The current model in fact doesn't fully take into account that getting clean and sober is not healing. It is the removal of an obstacle to healing and wellness. Once the obstacle is removed is when the healing actually begins. That's where healing and restorative therapies are necessary. We need to rehabilitate and heal the damaged physical and chemical body in order to best show up for the deeper work necessary for self actualization and living life purpose.


"In this time post detox, an integrative and naturopathic medicine approach is needed."

For example - How can we expect a person to do the kind of mental, emotional, and trauma work necessary for success in sobriety, when their body is under or over producing neurotransmitters - their digestive system isn't assimilating - their cortisol levels are inadequate - their testosterone is low - and so on? I can tell you this, you can practice all the skills out there to reduce anxiety and understand where it originates, but if you have sympathetic overdrive (an overactive fight or flight response), you will still have anxiety despite the work and it may become unmanageable. You might even relapse due to this. In the time post detox, an integrative and naturopathic medicine approach is needed.





Naturopathic medicine is focused on restoration of health and bringing balance to the body, mind, emotions and spirit. Addiction being a bio-psycho-social-spiritual disease makes the training and clinical approach of naturopaths ideal members of the care team. NDs have the tools to support these various aspects of care in unique ways. With regards to post acute withdrawal syndrome, naturopaths are equipped with the knowledge of nutrition, physiology, herbalism, and nutraceuticals to get patients through quicker and with less intensity.


When we look at the long term picture, staying healthy as a whole being provides the best recipe for success with not just sobriety but for a joyful life where we actualize our full potential as creative and compassionate humans. Having doctors on our care teams who know how the body heals and how to facilitate that healing doesn't just make sense - it's imperative. Addiction/Substance abuse care should be no different.


Written by: Blake Myers, ND




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