Cocaine Withdrawal Symptoms, Timeline and Treatment

Though cocaine withdrawal may not be as physically intense as withdrawal from other drugs, 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
  • Slowed thinking
  • Slowed activity or physical fatigue after activity
  • Exhaustion
  • Restlessness
  • Inability to experience sexual arousal
  • Anhedonia, or the inability to feel pleasure
  • Depression or anxiety
  • Suicidal thoughts or actions
  • Vivid, unpleasant dreams or nightmares
  • Physical symptoms, such as chills, tremors, muscle aches, and nerve pain
  • Increased craving for cocaine
  • Increased appetite

When Is Medical Detox Necessary?

While cocaine detox may be completed on an outpatient basis, medical detox is recommended in some instances. For example, if a person has relapsed during past withdrawal attempts, the 24-hour supervision afforded by medical detox can prove invaluable. In addition, if the person suffers from any co-occurring mental health disorders, medical detox followed by comprehensive inpatient addiction treatment can effectively address both withdrawal management and mental health treatment needs.Learn more about insurance coverage and verify your insurance with AAC

One of the more problematic withdrawal effects associated with acute stimulant withdrawal is an increased risk of suicide. People who attempt to stop cocaine use after addiction has taken hold can suffer from severe depression and mood swings, including thoughts of suicide. With regular cocaine use, the brain adapts to the consistently elevated dopamine activity associated with the drug. Over time, the reward circuit is disrupted and becomes less sensitive to dopamine, per the National Institute on Drug Abuse. At this point, a person often needs increasingly large amounts of cocaine to feel good; without it, they may feel profoundly 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 Timeline

The symptoms of acute cocaine withdrawal often resolve after about 7-10 days. However, like with many drugs, cravings for cocaine may persist for longer periods of time and could develop suddenly, years after individuals have gotten sober. Cocaine has a relatively short half-life and, in people with significant dependence, 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 may be relatively short in duration. People who have used cocaine for years may continue to suffer lingering withdrawal symptoms for weeks, perhaps in part due to a buildup of the drug in their bodies.
  2. Average dose used: People who’ve used very large amounts may experience more intense withdrawal symptoms than someone who used lower doses.
  3. Polysubstance dependence: Someone who has developed physiological dependence to 2 or more drugs may experience withdrawal symptoms related to both, potentially complicating the course of withdrawal and worsening the experience for the detoxing person.
  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 medical or mental health issues: If an individual suffers from any co-occurring medical conditions such as cardiovascular disease or mental health issues, such as depression, anxiety, an eating disorder, or personality disorder, the withdrawal process from cocaine could be more complicated. The same is true for those suffering from polydrug addictions.