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:
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:
Currently, 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 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.