Cocaine Withdrawal & Detox

It is important to have a plan in place to avoid relapse after cocaine withdrawal. Despite the withdrawal, a person is still at risk due to the addiction. It is also essential to keep in mind that no relapse strategy is entirely effective. Living a sober life requires vigilance, and an effort to keep the risk of relapse as low as possible.
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Cocaine Withdrawal Overview: 

Cocaine is an addictive stimulant drug. Someone who develops a physical dependence on the drug will experience withdrawal symptoms if they stop using it. Cocaine withdrawal symptoms can range from mild to severe. In some cases, it will take a person’s body days, weeks, or longer to recover from cocaine addiction.

Graphic human body showing symptoms.

Cocaine Withdrawal Symptoms

Symptoms of withdrawal from cocaine are similar to those associated with any drug, especially other stimulant drugs. Cocaine withdrawal produces both psychological and physical symptoms. If you are physically dependent on cocaine and you stop taking it, you are likely to experience:

Cravings

Once you stop using cocaine, you will feel a desire to take more and crave the drug. This desire is fueled by the desire to ward off the unpleasant feelings of not having the drug in your system and not experiencing the pleasurable high. 

The body needs time to adjust to functioning without cocaine. This period of adjustment is difficult, and many people relapse because of cravings.

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Mood Changes

Most cocaine users experience feelings of depression, anxiety, and irritability during the withdrawal process. In more extreme cases, suicidal thoughts and ideations may occur as well. 

Fatigue

Fatigue is caused by a combination of “crashing” after a cocaine high and from a long-term lack of sleep. Cocaine is a stimulant that causes you to feel alert and awake, so most people sleep less when taking it.

During withdrawal, your body will need to adjust and return to a regular sleeping pattern. Unfortunately, despite being tired, many people withdrawing from cocaine struggle to sleep. They experience: 

  • Insomnia
  • Vivid nightmares
  • Oversleeping
  • Struggle to establish a steady sleeping schedule

Increased Appetite

Most people taking cocaine do not have a steady eating schedule. Cocaine suppresses a person’s appetite. Once they stop using the drug, their appetite starts to return to normal. It is crucial to avoid overeating during withdrawal and instead eat small, healthy meals.

Sluggishness

Cocaine withdrawal might cause you to feel sluggish or slow. Some people also experience agitation.

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Cocaine Withdrawal Timeline

Symptoms of cocaine withdrawal vary from person to person. For most, cocaine withdrawal occurs in three phases, and each phase produces different side effects. These phases are as follows:

Crash

This phase begins within a few hours of the last dose of cocaine. Symptoms include irritability, anxiety, exhaustion, and extreme hunger.

Withdrawal

The proper withdrawal phase can last up to 10 weeks. Most people experience anxiety, irritability, lethargy, and depression during this phase. They lack concentration and tend to have an erratic sleep schedule. Cravings are intense during this phase.

Extinction

This is the final phase of cocaine withdrawal, and it can last up to 28 weeks. Cravings still arise, and dysphoria (a state of unease) is also an issue.

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How to Withdrawal from Cocaine (Detoxification)

Detoxing from cocaine on your own is risky. Withdrawal symptoms can be dangerous, and medically-supervised detox ensures you receive the care and support you need during this difficult transition.

Inpatient treatment (rehab) is common for those with severe cocaine addiction. It provides round-the-clock medical support and removes someone from their usual triggers and alleviates the real-world temptations to use cocaine.

There is no FDA-approved medication for cocaine withdrawal. Some medications ease specific symptoms, as well as things you can do to reduce the unpleasantness of withdrawal. Overall, the best strategy is to establish a healthy lifestyle that includes nutritious food, exercise, and a healthy sleeping schedule. You can begin to build healthy habits during detox and continue as you recover.

Some of the medications used during cocaine withdrawal include:

  • Anticonvulsant drugs which block the euphoria produced by cocaine and reduce cravings. 
  • Modafinil is used to treat narcolepsy by  enhancing glutamate-neurotransmission. Modafinil treats cocaine dependence by ameliorating glutamate depletion seen in chronic cocaine users. Research shows it also blocks the euphoric effects of cocaine and could be effective for relapse prevention.
  • Propranolol is a beta-blocker that relieves symptoms of anxiety and depression. Beta-blockers might also be able to reduce some of the rewarding properties of cocaine.
  • Baclofen might lower dopamine levels and cocaine cravings when it is released into the nucleus accumbens.
  • Tiagabine and Topiramate reduce the risk of relapse
  • Disulfiram blocks the enzymatic degradation of cocaine and dopamine which makes cocaine high less appealing and also increasing the anxiety associated with taking it. 
  • TA-CD is a vaccine that prevents cocaine from crossing the blood-brain barrier making it less appealing. It works by stimulating the production of cocaine-specific antibodies and preventing them from entering the brain.

Medical studies are ongoing to examine the effects and safety of these drugs to help in treating cocaine withdrawal.

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After Cocaine Detox 

Cocaine changes your brain chemistry, making it one of the most difficult drug addictions to overcome. Relapse is common but preventable. 

Participating in long-term care, including individual and group counseling is one of the most effective ways to stay sober after cocaine detox. Cognitive Behavioral Therapy (CBT), when combined with other treatments, is very effective for long-term abstinence. 

Other addiction treatment options include:

  • Long-term residential or inpatient treatment programs that allow you to focus exclusively on recovery
  • Partial hospitalization programs (PHP) provide detox monitoring, medical care, education, and therapy for several hours a week without overnight care 
  • Intensive outpatient programs (IOP) that off comprehensive support without removing you from your day-to-day life

Preventing Relapse of Cocaine Addiction

It is important to have a plan in place to avoid relapse after cocaine withdrawal. Despite the withdrawal, a person is still at risk due to the addiction. It is also essential to keep in mind that no relapse strategy is entirely effective. Living a sober life requires vigilance, and an effort to keep the risk of relapse as low as possible. 

Some strategies that can help you or your loved one prevent relapse include:

  • Having a positive attitude and focusing on self-control
  • Attending 12-step meetings or other peer groups focused on recovery and avoiding relapse
  • Working on building self-confidence and enjoying a sober life
  • Avoiding people who use cocaine or who are a negative influence on your sobriety
  • Identifying things that trigger cocaine use and learning to manage them in a healthy manner
  • Attending therapy sessions to improve your mental health

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Resources

“What You Can Expect From Cocaine Withdrawal.” Verywell Mind, www.verywellmind.com/what-to-expect-from-cocaine-withdrawal-21990.

Karila, Laurent, et al. “New Treatments for Cocaine Dependence: A Focused Review.” International Journal of Neuropsychopharmacology, vol. 11, no. 3, 1 May 2008, pp. 425–438, academic.oup.com/ijnp/article/11/3/425/761455, 10.1017/S1461145707008097.

National Institute on Drug Abuse. “How Is Cocaine Addiction Treated?” Drugabuse.Gov, 2018, www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers.

Day, Jo Ann. “Settings for Substance Abuse Treatment at Johns Hopkins.” Www.Hopkinsmedicine.Org, www.hopkinsmedicine.org/substance_abuse_center/treatment/settings.html.

Siniscalchi, Antonio, et al. “The Role of Topiramate in the Management of Cocaine Addiction: A Possible Therapeutic Option.” Current Neuropharmacology, vol. 13, no. 6, 1 Dec. 2015, pp. 815–818, www.ncbi.nlm.nih.gov/pmc/articles/PMC4759320/, 10.2174/1570159X13666150729222643.

Negus, S Stevens, and Jack Henningfield. “Agonist Medications for the Treatment of Cocaine Use Disorder.” Neuropsychopharmacology, vol. 40, no. 8, 11 Dec. 2014, pp. 1815–1825, 10.1038/npp.2014.322.

Kampman, Kyle M. “New Medications for the Treatment of Cocaine Dependence.” Psychiatry (Edgmont), vol. 2, no. 12, 1 Dec. 2005, pp. 44–48, www.ncbi.nlm.nih.gov/pmc/articles/PMC2994240/.

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Updated on: June 24, 2020
Author
Addiction Group Staff
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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