Cocaine Withdrawal Symptoms, Timeline and Treatment

Cocaine withdrawal is not as intense as withdrawal from other drugs, but it does come with its own set of challenges.
Withdrawal from certain substances, like alcohol and benzodiazepines, can involve severe physical withdrawal symptoms; however, cocaine detox brings most psychological withdrawal symptoms.

Symptoms of cocaine withdrawal include:

  • Difficulty concentrating
  • Fatigue or exhaustion
  • Anhedonia, or the inability to feel pleasure
  • Inability to experience sexual arousal
  • Depression or anxiety
  • Physical symptoms, such as chills, tremors, muscle aches, and nerve pain
  • Suicidal thoughts or actions
  • Increased craving for cocaine
  • Increased appetite
  • Vivid, unpleasant dreams or nightmares
  • Slowed activity, or physical fatigue after activity
  • Slower thinking
  • Restlessness
cocaine withdrawal signs

When Is Medical Detox Necessary?

While cocaine detox can often be completed on an outpatient basis, medical detox is recommended in some instances. If a person has relapsed during past withdrawal attempts, the 24-hour supervision afforded by medical detox is recommended. In addition, if the person suffers from any co-occurring mental health disorder, medical detox followed by comprehensive inpatient addiction treatment is recommended.

One of the most problematic potential withdrawal symptoms is an increased risk of suicide. People who attempt to stop cocaine use after addiction has taken hold can suffer from intense depression and mood swings, including thoughts of suicide. With regular cocaine use, their brains have grown accustomed to a continual flood of “happy” neurotransmitters. Since cocaine prevents dopamine from being reabsorbed, per the National Institute on Drug Abuse, dopamine then floods the brain, resulting in the “high” associated with cocaine use. When the brain no longer experiences that euphoric high, depression can set in.

If a person has any history of depression or suicidal thoughts, medical detox is generally recommended to ensure safety throughout the withdrawal process.

Withdrawal Timeline

Withdrawal symptoms from cocaine typically resolve after about 7-10 days. However, like with many drugs, cravings for cocaine can occur suddenly, years after individuals have purged cocaine from their bodies.

Cocaine has a very short half-life for a drug, so withdrawal symptoms can begin as soon as 90 minutes after the last dose. The timeline for withdrawal symptoms varies depending on the individual. Here are some factors that may influence the timeline for cocaine withdrawal:

  1. Length of use: For people who abuse cocaine for a short period of time, withdrawal symptoms are more likely be shorter in duration. People who have used cocaine for years may continue to suffer lingering withdrawal symptoms for weeks, due to a buildup of the drug in their bodies.
  2. Size of dose: People who used large amounts of cocaine will likely suffer withdrawal symptoms for a longer period of time because their brains are used to experiencing a longer or more intense “high.”
  3. Drug purity: When a drug is “cut” with fillers, the user actually takes in less of the drug. For people who used very pure cocaine, withdrawal symptoms may last longer.
  4. Environment: If cocaine was used a means of escape from a stressful environment, stress may trigger the urge to use again. As a result, environmental factors that lead to stress – such as relationship issues, work troubles, or other factors – may lead to intense cravings for cocaine, complicating the psychological withdrawal process.
  5. Co-occurring mental health disorder: If an individual suffers from any co-occurring mental health disorder, such as depression, anxiety, an eating disorder, or personality disorder, the withdrawal process from cocaine will be complicated. The same is true for those suffering from polydrug addictions. Oftentimes, the withdrawal timeline is lengthened as a result.

Medications and Treatments for Cocaine Withdrawal

PillsCurrently, there are no FDA-approved medications to specifically treat cocaine withdrawal. However, there are some promising medications that may help individuals overcome cocaine addiction and work through withdrawal symptoms.

Some medical research on animals has shown that both buprenorphine and naltrexone may offer some assistance for people in cocaine withdrawal. Both of these medications are approved to treat other types of addictions, but findings relevant to cocaine abuse and addiction are in the very early stages.

One study suggested that propranolol might have a beneficial effect for those suffering from cocaine withdrawal. This beta blocker has been approved to treat heart problems like hypertension and angina, and it is often prescribed to treat anxiety and related psychological problems. One of the major concerns with cocaine withdrawal is the risk of a person developing serious anxiety and depression, which could lead to suicide. If anxiety and restlessness are reduced, then the individual could potentially overcome other withdrawal symptoms more easily.
Other psychological medications to treat depression and anxiety could be useful for people undergoing cocaine withdrawal, as it could level their moods and reduce depression. They could be particularly helpful for people whose withdrawal symptoms last longer than 7-10 days. However, medical professionals should consider these cases individually and carefully monitor patients for side effects, further addictive behaviors, and psychological changes that are detrimental to the overall goal of managing the addiction.

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