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 mostly 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
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 disorders, 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, the brain adapts to an abnormal flood of dopamine. Over time, the reward circuit is disrupted and becomes less sensitive to dopamine, per the National Institute on Drug Abuse. The person then needs more and more cocaine to feel good, and without it, they may feel depressed and dissatisfied with life.
If a person has any history of depression or suicidal thoughts, medical detox is generally recommended to ensure safety throughout the withdrawal process.
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 gotten sober.
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:
- 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.
- Size of dose: People who’ve used very large amounts may experience more intense withdrawal symptoms than someone who used lower doses.
- Polysubstance dependence. Someone who is dependent on 2 or more drugs will experience withdrawal symptoms of both, complicating the clinical withdrawal picture and intensifying the experience for the detoxing person.
- 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.
- 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.