Cocaine Withdrawal: Symptoms, Timeline, and Treatment

Cocaine is an addictive drug. With repeated cocaine use, someone may develop a physiological dependence and experience an associated withdrawal syndrome if they try to stop using cocaine. Cocaine withdrawal symptoms can vary in severity between individuals depending on multiple factors.³

This page will discuss the causes and symptoms of cocaine withdrawal and treatment options for stimulant addiction.

Cocaine Withdrawal Symptoms

Acute cocaine withdrawal symptoms may include:³

• Anxiety.
• Irritability.
• Depression.
• Poor concentration.
• Slowed thoughts and movements.
• Fatigue.
• Changes in sleep patterns (e.g., hypersomnia, or increased sleeping).
• Increased appetite.
• Cocaine cravings.
• Paranoia.

Though stimulant withdrawal does not usually involve severe physical symptoms (nor does it present immediate medical dangers to a patient), some individuals may be at risk for experiencing a significantly debilitating dysphoria (i.e., depression and overwhelmingly negative thoughts and feelings). This profound dysphoric period could, in some cases, be associated with suicidal thoughts or attempts and could also lead to a patient relapsing on cocaine.³

While many of the symptoms of cocaine withdrawal begin to resolve within several days after quitting, some people may have a more protracted or prolonged course of withdrawal and continue to experience troublesome withdrawal symptoms for several weeks.^3,4 Protracted withdrawal is the presence of substance-specific signs and symptoms of withdrawal that persist well beyond the time frame expected after someone stops using the substance.⁴

The severity of a person’s withdrawal symptoms can vary widely among individuals. These symptoms are influenced by many factors, such as their age and general health, the amount of cocaine they used, and how long they have been using. Other factors include the route of administration and whether there were other substances being used along with the cocaine.³

Withdrawal symptoms can be intense to the point that they lead people to use again simply to seek relief from the pain and discomfort of withdrawal.⁴

What Causes Cocaine Withdrawal?

Cocaine withdrawal is commonly experienced by those who become dependent on this drug. Dependence on cocaine develops when someone uses cocaine over an extended period and begins to rely on this drug to function normally.

Cocaine dependence can develop at different rates in different people; genetics might play a significant role in how quickly someone becomes dependent on cocaine after their initial use of this drug.

Some of the phenomena of both cocaine dependence and withdrawal can be explained by the drug’s impact on dopamine neurotransmission within the brain. Cocaine use can dramatically increase the activity of the chemical messenger dopamine within brain circuits involved with motivation and reward.¹

Cocaine-related increases in dopamine activity strongly reinforce continued use of the drug. However, over time and with repeated use, the brain of someone who uses cocaine adapts to the excess dopamine in its system, gradually becoming less sensitive to the effects of cocaine, causing them to require increasing amounts of the drug to avoid the onset of withdrawal symptoms, such as depression and insomnia.¹

Additionally, cocaine is characterized as having an “explosive risk” for dependence, meaning that the time it takes someone to become dependent on cocaine after initial experimentation is faster than many other drugs.⁵

How Long Does Cocaine Withdrawal Last?

The onset of withdrawal symptoms for cocaine may depend on the type of cocaine that someone uses. For instance, regular crack cocaine use is associated with relatively faster onset of cocaine withdrawal symptoms, on the order of hours after it was last used. In general, acute cocaine withdrawal symptoms might last around 3-4 days.³ However, some symptoms of cocaine withdrawal can persist for 3-4 weeks in certain people.³

The severity and duration of longer lasting or more protracted withdrawal symptoms may differ between individuals. For example, one study evaluating recovery progress in those who suffer from cocaine addiction found that impulse control had not improved–even after 4 weeks of abstinence.⁶

More significant cases of cocaine withdrawal can increase a person’s risk for relapse. One study found that patients who scored high on a cocaine withdrawal severity test were four times more likely to resume cocaine use than those with low scores.⁷

Cocaine Withdrawal Management

Though stimulant withdrawal may not always be severe, it can still be unpleasant for someone enduring it—and could complicate their attempts at recovery.

Symptoms of stimulant withdrawal are often treated with rest, exercise, and a healthy diet. If someone suffers from severe or persistent depression during their withdrawal period, they may benefit from antidepressant treatment and additional psychiatric attention. During withdrawal from cocaine, someone’s drug cravings will likely be quite intense, and therefore they’re at a high risk of relapse. Behavioral therapeutic interventions, such as cognitive-behavioral therapy, contingency management, and relapse prevention techniques can help address these issues.⁷

Cocaine Withdrawal Medications

No medications currently exist that are proven to effectively manage stimulant withdrawal. Though some researchers have investigated the efficacy of medications such as modafinil and amantadine for their potential benefit in managing cocaine withdrawal, none of these agents are currently FDA-approved for such use.³

However, as part of a withdrawal management program, a patient’s treatment team can administer various medications for symptomatic relief of issues (such as headache and insomnia) to keep the patient comfortable during their early recovery.³

Researchers remain active in the field of pharmacotherapeutic options working to discover how to best treat a variety of substance use disorders, with stimulant use disorders being among these potential targets.

Cocaine Addiction Treatment

Cocaine addiction treatment can provide a person in recovery with focused behavioral therapy, peer support, and other psychosocial interventions through inpatient treatment or outpatient care.³

Left untreated, cocaine addiction can be devastating to a person’s health and wellbeing. However, with proper treatment, people can recover from even severe substance use disorders and cocaine addiction.

There is help available, and you don’t have to recover from cocaine addiction alone. Call to speak to an admissions navigator today and begin getting immediate support for your stimulant recovery.