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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.

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

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.

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 the comedown.

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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 the comedown.

If someone suffers a bad trip and their high was unpleasant, 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.

Symptoms of a Comedown

Symptoms of a comedown vary from person to person and from drug to drug.

For example, the comedown from ecstasy or MDMA tends to be flu-like. It happens within a few days of using the drug. Many people refer to this type of comedown as the “mid-week flu” because the drugs are so often used over the weekend in clubs. 

Common physical symptoms include:

  • Nausea
  • Aches
  • Pains
  • Exhaustion

The comedown from cocaine tends to be an uncomfortable experience for users and includes symptoms similar to withdrawal from the drug. Some of them include:

  • Paranoia
  • Depression
  • Exhaustion

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

  • Anxiety
  • Mood swings
  • Depression
  • Headaches
  • Dizziness
  • Exhaustion
  • Fatigue
  • Insomnia
  • Drug cravings
  • Diarrhea
  • Respiratory changes
  • Cardiovascular changes

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

How Long Do Comedowns Last? 

The length of a comedown varies from person to person and is based on the type of drug and how much of that drug was taken. The more drugs someone uses, the more unpleasant the comedown. 

Comedowns for some common drugs include:

Cocaine (Coke)

Cocaine highs usually last about 15 to 30 minutes after ingesting the drug. The comedown is unpleasant and begins within minutes to hours after the drug leaves the body. 

Symptoms include:

  • Depression
  • Exhaustion
  • Drug cravings
  • Anxiety
  • Panic attacks
  • Restlessness
  • Increased appetite
  • Agitation 
  • Mood swings
  • Difficulty concentrating
  • Nightmares
  • Insomnia
  • Suicidal thoughts

These symptoms 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

The meth comedown begins almost immediately after the high wears off. People feel exhausted and irritable. 

Most people experience intense cravings for the drug. Other symptoms include:

  • Sadness
  • Lack of motivation
  • Depression
  • Lethargy
  • Insomnia
  • Anxiety
  • Fatigue
  • Feelings of hopelessness
  • Jaw pain
  • Dehydration
  • Drug cravings

The meth comedown lasts anywhere from four to 12 hours. It’s difficult to tell the difference between withdrawal and comedown for long-term meth users.

Comedown from meth is extremely difficult and 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, though, and usually just leads to frustration and hostility. 

Adderall

Adderall comes in immediate- and extended-release formulations, which increases the amount of time the drug stays active in your system. Adderall comedown, regardless of the version used, takes about 12 hours. 

Symptoms include:

  • Agitation 
  • Irritability
  • Anxiety
  • Panic
  • Fatigue
  • Depression
  • Increased appetite
  • Insomnia

Ecstasy/MDMA

Meth comedown usually lasts about a week. Symptoms include:

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

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How to Cope With a Comedown 

Experience of the user with the drug also plays a role. These tips 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 helps. 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 right 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

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, if you feel ill during a comedown, seeking medical attention is a good idea. You might be experiencing a bad reaction to the drug.

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 you misuse a prescription drug, it’s appropriate to seek treatment. 

Signs of substance use disorder (SUD) include:

  • Changes in appetite
  • Changes in sleep patterns
  • Deterioration of hygiene
  • Constant runny nose
  • Sudden weight gain or loss
  • Tremors
  • Slurred speech
  • Impaired coordination
  • Relationship struggles related to drug use
  • Engaging in secretive activities
  • Frequent legal problems
  • Sudden change in friends or interests
  • Unexplained need for money
  • Neglecting work and personal responsibilities
  • Engaging in risky activities
  • Loss of control
  • Continuing to use regardless of negative consequences
  • Using drugs to avoid or eliminate withdrawal symptoms
  • Lack of motivation
  • Periods of unusual increased energy
  • Mood swings
  • Fatigue or always feeling tired

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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Resources

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National Institute on Drug Abuse. “MDMA (Ecstasy/Molly).” Drugabuse.gov, 31 Dec. 2017, https://www.drugabuse.gov/publications/drugfacts/mdma-ecstasymolly.

“Warning Signs of Substance and Alcohol Use Disorder | Information for Family and Friends.” Alcohol and Substance Abuse Program, https://www.ihs.gov/asap/familyfriends/warningsignsdrug/.

NIH. “Cocaine.” Drugabuse.gov, 2018, https://www.drugabuse.gov/publications/drugfacts/cocaine.

Grinspoon, Peter MD. “How to Avoid a Relapse When Things Seem out of Control.” Harvard Health, 30 Nov. 2020, https://www.health.harvard.edu/blog/how-to-avoid-a-relapse-when-things-seem-out-of-control-2020113021512

“Treatment Types | Treatment.” Alcohol and Substance Abuse Program, https://www.ihs.gov/asap/treatment/treatmenttypes/.

Mayo Clinic. “Drug Addiction (Substance Use Disorder) - Symptoms and Causes.” Mayo Clinic, 26 Oct. 2017, https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112.

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