What Causes Comedown from Drugs, and How Do You Cope?

What is a Drug Comedown?

A drug comedown occurs as the effects of a drug wear off. Users describe the feeling as coming down because it happens as the high feeling from the drug dissipates. 

Comedowns vary from person to person, based on the drug and the amount of that drug used. This phase is also different based on how long a person has used the drug throughout their life, as well as the overall health of their body. 

The comedown is a pleasant or unpleasant experience depending on whether it was a good or bad high. If a drug triggers feelings of discomfort, delusion, or anxiousness, often called a “bad trip,” the comedown is good. If a user enjoyed the high, the comedown is a disappointment.

What Causes a Comedown?

The comedown is caused by the effects of a drug wearing off. This includes mental, physical, and emotional symptoms associated with the drug.

Many frequently used drugs trigger an initial sense of euphoria. This might be an initial rush and/or a few hours of pleasant feelings. Drugs change brain chemistry, causing it to release feel-good chemicals like serotonin, norepinephrine, and dopamine. 

As the body begins metabolizing the drug, its effects gradually wear off. This gradual transition from inebriated to drug-free is a part of the comedown.

The Crash

The crash is an intense feeling of exhaustion after using drugs. This is more prevalent in stimulants such as cocaine, meth, and even high doses of caffeine.

A crash is typically the last stage before you go into withdrawal. It can last much longer than the original high because the body needs more time to recover from the effects of the drug.

The crash can have negative effects. Symptoms of a drug crash include:

• Agitation and irritability
• Restlessness
• Increased blood pressure
• Increased body temperature
• Intense cravings
• Mood swings
• Exhaustion
• Depression
• Suicidal thoughts
• Increased appetite

The Rebound

The rebound effect, or homeostasis, happens when the body tries to return to normal. It does this by creating physical symptoms that are the opposite of what was experienced while on the drug.

For example, the rebound effect of a sedative increases agitation, which causes you to take more sedatives to calm down. This feedback loop can worsen, causing you to develop an addiction or dependence on the substance.

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What to Expect During a Comedown 

The comedown experience varies from person to person and from experience to experience. If the high was pleasant, comedown tends to feel disappointing. Some people even develop anxiety or depression during a comedown.

If someone suffers a bad trip and their high was unpleasant, the comedown is a relief. The experience also varies based on the drug used, the amount of the drug ingested, and the length of time someone has used a drug.

People struggling with the comedown phase often take another dose of the same drug or another drug to avoid the effects of the comedown. This makes the eventual comedown worse and, for some, establishes a cycle of drug use that leads to addiction throughout their life.

Symptoms of a Comedown

In general, symptoms of the comedown phase for most drugs include:

• Anxiety
• Paranoia
• Mood swings
• Depression
• Headaches
• Dizziness
• Exhaustion
• Fatigue
• Insomnia
• Nausea
• Aches and pains
• Drug cravings
• Diarrhea
• Respiratory changes
• Cardiovascular changes

Many of these symptoms are similar to what someone experiences during the detoxification phase of recovery. These symptoms are intensified when a substance is mixed with other drugs.

However, you might experience additional symptoms depending on the drug you've taken:

Cocaine

Additional symptoms include:

• Panic attacks
• Restlessness
• Increased appetite
• Agitation 
• Difficulty concentrating
• Nightmares
• Suicidal thoughts
• Hallucinations

Meth

Additional symptoms include:

• Sadness
• Lack of motivation
• Lethargy
• Jaw pain
• Dehydration

Adderal

Additional symptoms include:

• Agitation 
• Irritability
• Panic
• Increased appetite

Ecstasy/MDMA

Additional symptoms include

• Irritability
• Sleep problems
• Memory and focus problems
• Decreased appetite
• Decreased interest in sex

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How Long Do Comedowns Last? 

The comedown lasts as long as it takes for the effects of the chemicals in the drug to wear off, which varies from a few hours to a few days. The length of a comedown can also depend on the frequency of use, the type of drug, and the amount taken.

For long-term drug abusers, comedown may come and go, taking a serious toll on one's mental health. The more drugs someone uses, the more unpleasant the comedown.

It’s one of the riskiest periods for those attempting sobriety and involves a great deal of risk of relapse. 

Comedowns for some common drugs include:

Cocaine

Cocaine highs usually last about 6 to 12 hours after ingesting the drug. Cocaine is a fast-acting stimulant, so its "crash" also takes immediate effect. The comedown is unpleasant and begins minutes to hours after the drug leaves the body. 

Symptoms can last hours to days, depending on the intensity and length of the cocaine high. Long-term users of cocaine experience post-acute withdrawal symptoms after the drug wears off and can last weeks or months.

Meth

For people who use meth regularly, the meth comedown begins immediately after the high wears off and lasts between 4 to 12 hours. For occasional users, this comedown will last about 3 to 6 hours.

It’s difficult to tell the difference between withdrawal and comedown for long-term meth users. This is because some users combat it by tweaking.

Tweaking is when a meth user overcompensates to avoid the comedown by using more and more of the drug.  Increasing the dosage doesn’t ward off the comedown and usually leads to frustration and hostility. 

Adderall

Adderall comes in immediate- and extended-release formulations, which increases the time the drug stays active in your system. Adderall comedown, regardless of the version used, takes about 9 to 14 hours. 

Ecstasy/MDMA

Unlike cocaine, ecstasy results in a longer duration of CNS stimulation. Thus, the "crash" may also be observed for a longer time. Ecstasy/MDMA comedown usually lasts about a week.

How to Cope With a Comedown 

The user's experience with the drug affects how they handle a comedown. Here are some tips that can help you during the comedown from the following drugs:

Cocaine

Cocaine triggers intense feelings of euphoria, which wears off as the drug leaves the system. Understanding the symptoms of the comedown from cocaine helps you manage the symptoms better.

Most people experience depression, rapid heartbeat, foggy thinking, increased appetite, and a runny nose during the cocaine comedown.

The best way to deal with a cocaine comedown is to:

• Eat nutritious food
• Rest
• Exercise
• Minimize stress
• Find ways to distract yourself from unpleasant symptoms

Adderall

The only way to deal with a comedown from Adderall is to let it run its course. Symptoms can last from a few days to a few weeks, depending on how long you’ve used the drug.

Eating nutritious food and exercising can help. Vitamin C and cranberry juice can also help to acidify your urine and promote the further elimination of Adderall from the body.

Stick to a regular sleep schedule and do what you can to increase the quality of sleep. This includes keeping your bedroom cool and dark and engaging in relaxing activities before bedtime.

Meth

Meth comedowns are difficult and include intense cravings for the drug. You can ease the symptoms of the comedown phase by:

• Getting enough sleep
• Drinking plenty of water
• Eating a well-balanced diet
• Staying active
• Incorporating holistic therapies into your routine, including yoga, meditation, massage, or acupuncture

MDMA

MDMA or ecstasy comedown can last a few days. There are several things you can do to ease the symptoms, including:

• Drinking water, a sports drink, or orange juice
• Eat nutritious food, including those high in tryptophan
• Sleep
• Take supplements, including magnesium and vitamin C

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When to Seek Professional Help

The comedown phase is often unpleasant, but it is rarely dangerous. However, if you struggle with the comedown phase or you experience it often due to frequent drug use, it’s a sign that recovery or drug rehabilitation is needed. 

However, seeking medical attention is a good idea if you feel ill during a comedown. You might be experiencing a bad reaction to the drug. The best way to deal with a comedown is to get help from a health professional.

Additionally, if you have thoughts of hurting yourself or someone else or any other psychotic symptoms, it’s important to seek support from a doctor. 

Signs of Substance Use Disorder (SUD) & Treatment Options

Experiencing comedown symptoms doesn’t always mean someone has a substance use disorder. Many people experiment with a drug one time and never use it again. However, many drugs have a high risk of abuse and addiction depending on how they affect the user’s brain. 

If you binge use a drug, use it to cope with another issue, such as depression or anxiety, or misuse a prescription drug, it’s appropriate to seek treatment. 

Signs of substance use disorder (SUD) include:

Treatment options for substance use disorder (SUD) include:

• Medically supervised detoxification
• Residential or inpatient treatment programs that offer round-the-clock care and supervision
• Partial hospitalization programs that offer ongoing medical care for several hours a day three to five days a week
• Intensive outpatient programs that offer care for two to four hours a day for at least three days a week
• Individual, group, and family counseling
• Sober living facilities that offer drug- and alcohol-free living environments
• 12-step programs
• Relapse prevention and follow-up care

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