Substance Use

Cocaine Withdrawal

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Cocaine Withdrawal Symptoms, Timeline & Detox Treatment Options

Cocaine is a powerful stimulant made from the coca plant, native to South America. Although cocaine has applications in the medical industry, recreational use is illegal. This drug is highly addictive and often cut with other substances, including fentanyl. In many cases, users are unaware that their cocaine contains synthetic opioids, increasing the risk of an overdose.

Cocaine comes in two primary forms — a powder that people sniff or inject and a rock crystal, better known as crack cocaine, which is smoked. Most often, users take cocaine in binges for a short time, increasing the dose to maintain their high. However, many become easily addicted to this substance following repeated use, causing long-term changes in the brain’s reward circuit. 

If you or your loved one are struggling with cocaine dependence, here’s what you need to know about the withdrawal process. 

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What Are the Symptoms of Cocaine Withdrawal?

Cocaine withdrawal symptoms occur when someone who has developed a physical dependence abruptly stops using the drug. In some cases, even cutting back on your regular dose will initiate cocaine withdrawal symptoms. 

Since cocaine is a stimulant, it shares similar withdrawal symptoms with methamphetamine and amphetamine. 

These symptoms include:

  • Depression 
  • Agitation and irritability 
  • Increased sleep and appetite 
  • Muscle aches 

There are also cases when users develop psychotic symptoms, including disordered thoughts, paranoia, and hallucinations. However, these symptoms typically develop among people who use high doses of stimulants. Under these circumstances, the user may harm themselves or others, which is why antipsychotic medications may be administered. 

In most cases, cocaine withdrawal symptoms are not life-threatening. However, certain users face a higher risk of complications, particularly those who live with an underlying mental health condition. Supervised cocaine withdrawal ensures the safest, most comfortable experience, followed by the support you need to attain abstinence. 

The above symptoms represent acute cocaine withdrawal, followed by a protracted withdrawal phase, which can last weeks, months, or even years. This phase is often referred to as post-acute withdrawal syndrome (PAWS) and is characterized by the following symptoms:

  • Unstable emotions
  • Anxiety
  • Lethargy
  • Poor sleep 
  • Strong cravings 

PAWS is often associated with opioid, alcohol, and benzo withdrawal yet also occurs among cocaine-dependent users. This phase of the withdrawal process is highly psychological, so therapy is strongly recommended. The goal is to provide you with the skills you need to reduce the risk of relapse. 

One of the most significant concerns of cocaine dependence and withdrawal is cravings, particularly concerning relapse risk. Cocaine-related cues trigger intense cravings, even after months or years of abstinence. These cravings are amplified by life stress, which is often a key part of the treatment process. Expert facilities offer holistic treatment options, including those that target ongoing stress, such as meditation practices and behavioral therapy.

What Causes Cocaine Withdrawal?

Cocaine withdrawal typically begins when you develop a tolerance to the drug. Since you need to take higher doses to experience the same effect, creating a vicious cycle of abuse. The more you use, the higher the likelihood of developing dependence. It is this dependence that leads to cocaine withdrawal syndrome. Cocaine dependence continues to be a significant public health problem in the United States and continues to fuel research. 

Your brain’s dopamine system plays a significant role in the reinforcing effects of cocaine. Like other substances of abuse, cocaine hijacks the brain’s reward system, causing spikes in the brain chemical dopamine, known as the “feel-good” chemical. However, several other brain chemicals are involved, making this reinforcing effect is rather complex. For example, cocaine use also has a significant impact on brains chemicals GABA and glutamate. Animal studies show that chronic exposure to cocaine depletes glutamate and elevates GABA. 

Experts in the field agree that addiction is considered a form of dysfunctional learning and memory. The relationship between cocaine use, learning, memory, and addiction involves several brain regions and brain chemicals, making the dynamic complex. 

Focusing on dopamine, when you take cocaine, this drug produces an initial, short-term buildup of dopamine, leading to a rise in euphoria. However, it is the longer-term effects that researchers are interested in concerning dependence and addiction, as these mechanisms influence persistent cravings and the risk of relapse. Scientists have known how brain mechanisms contribute to the cocaine high for decades, but there are still questions surrounding chronic cocaine abuse. 

Some of the questions that continue to be studied include:

  • How does repeated exposure to cocaine make individuals compulsively use the drug even though it costs them their loved ones, jobs, possessions, freedom, and even their lives?
  • Why do people who want to quit for good find it challenging to attain sobriety?
  • Why do chronic cocaine users remain vulnerable to relapse following years of abstinence?

Although researchers do not have all the answers, they have a relatively good understanding of how cocaine affects brain cells. Some of the effects revert to normal fairly quickly, whereas others persist for weeks after cocaine leaves the brain following years of repeated exposure. Some may even be irreversible. 

Your risk for cocaine addiction is largely genetic. Studies show that approximately half of a person’s risk for cocaine addiction is genetic. However, some researchers estimate that about 70% of the vulnerability for developing cocaine dependence is genetically determined. The specific genes that increase your risk are still unknown, but this research is beginning to uncover why some users are more susceptible to addiction than others. 

How Long Does Cocaine Withdrawal Take?

Stimulant withdrawal syndrome begins within 24 hours of last use and most commonly lasts for 3-5 days. 

Cocaine has a very short half-life of just 1.5 hours. This timeline means that it takes 90 minutes for half of the cocaine in your blood plasma to be eliminated on average. However, research shows that cocaine accumulates in the body with chronic use resulting in prolonged elimination. The cocaine withdrawal process timeline can be affected by several factors, making the detox phase a highly individualized experience. 

For example, the length of time it takes you to complete the cocaine withdrawal process will depend on:

  • Length of use – If you have been using for years, you will likely experience withdrawal symptoms for weeks. Once physical withdrawal symptoms subside, you may experience psychological symptoms for weeks, months, or years. 
  • Dosage – If you take large amounts of cocaine, you may experience more intense withdrawal symptoms than someone who uses lower doses. Variations in dosage may also influence the withdrawal timeline. 
  • Polydrug use – If you often combine several substances of abuse, this will complicate the cocaine withdrawal process. Certain combinations of drugs can also be dangerous when withdrawing, which is why you must work with a professional healthcare team. 
  • Mental health – Co-occurring mental health issues can also complicate the withdrawal process. For example, an anxiety disorder may create more problematic symptoms for longer than anticipated. In this case, you will need to work closely with an expert team to receive ongoing support.

As discussed, PAWS can cause long-term symptoms. The withdrawal process is an ongoing battle that requires years of ongoing treatment and support for some. Having access to a comprehensive, holistic treatment could make all the difference in your ability to achieve long-term sobriety. Your treatment plan will evolve with your growing needs and goals, allowing you to build a healthier, more fulfilling future.  

How to Safely Manage Cocaine Detox

The cocaine withdrawal process is highly individualized, which is why each symptom needs to be monitored based on the user’s history of drug use and medical history. A minority of patients will become extremely agitated and distressed, presenting a potential danger to themselves and others. If such symptoms appear, behavioral management strategies are strongly recommended, which you’ll have access to in a professional treatment facility. Although a highly effective approach, this may not work for some users, so it may be necessary to sedate them short-term using diazepam

Based on the widespread issue of cocaine misuse in the United States, developing new medications to treat cocaine dependence remains a top research priority — and has been a key area of study for decades. For example, bromocriptine, a dopamine agonist used to help treat Parkinson’s Disease, pituitary tumors, malignant syndrome, and type II diabetes was extensively studied years ago. One study focused on twenty-four cocaine addicts who experienced withdrawal symptoms. These participants were studied for six weeks. Half of the group was given bromocriptine, and the other half received a placebo. Significant relief was experienced with bromocriptine almost immediately and continued throughout the cocaine withdrawal process. These results were consistent with the “dopamine-depletion model” of cocaine withdrawal. However, as study designs evolved and new medications were developed, bromocriptine lost traction.

Despite years of research, experts still do not have a truly effective treatment for this serious disease. Progress has been made surrounding psychosocial treatment, which you’ll have access to within a professional treatment center. However, those who require a combination of psychotherapy and medication would benefit from advances in this area of research. Unlike some drugs, such as opioids, there are currently no FDA-approved drugs to treat cocaine withdrawal specifically. 

That said, a greater understanding of the neurobiology of cocaine dependence shows great promise, encouraging several clinical trials. For example, baclofen (a drug used to target cravings) and topiramate (a medication used for relapse prevention) both influence GABA. These medications were developed for other purposes but are now offered to some cocaine-dependent users based on our advancing understanding of how this drug influences specific brain chemicals. 

For example, propranolol, a beta-blocker, may be an effective treatment option for patients experiencing cocaine withdrawal symptoms. This drug class is often prescribed for hypertension and angina but is often used to control agitation and anxiety. When you withdraw from cocaine, you become more sensitive to the effects of adrenalin and noradrenalin, resulting in feelings of restlessness and anxiety. Several clinical trials show that this drug may reduce cocaine craving and anxiety symptoms, helping severely cocaine-dependent users attain a period of initial abstinence. 

During this time, other treatment options should be offered to help the user develop healthier coping strategies while targeting any underlying mental health concerns. If depression and anxiety are of concern, and your withdrawal symptoms last longer than 7-10 days, you may benefit from medication to help address anxiety and mood swings. 

When treating addiction, there are two core goals for medications. The first is to assist the cocaine withdrawal process, and the second is to prevent relapse. Research shows that users with severe cocaine withdrawal symptoms are more likely to drop out of treatment prematurely and are less likely to attain abstinence. These poor outcomes are likely because cocaine-dependent users who experience withdrawal symptoms experience cocaine differently than those who are non-dependent. Each individual also experiences the withdrawal process differently. For this reason, individualized, holistic treatment is essential, which is something the top treatment facilities offer. 

In some cases, users can complete the cocaine withdrawal process through an intensive outpatient program. However, others benefit from an inpatient treatment environment, particularly those who have relapsed in the past, live with a mental health disorder, or are at risk of complications based on their medical history. Regardless of what drug you detox from, your safety is the highest priority. Once you have eliminated cocaine from your system, you can focus on your road to recovery

When to Contact a Medical Professional

The cocaine withdrawal process can seem daunting, but don’t let it hold you back from receiving the treatment you need and deserve. A professional treatment facility will offer evidence-based treatment options to help you achieve ongoing success as you build a healthier future.

If you have tried to overcome your dependence on cocaine in the past and were unsuccessful, know that a professional facility will offer the next steps required to maintain sobriety. Cocaine withdrawal in itself is not a solution. For example, many users require intensive therapy following the withdrawal period, so cognitive-behavioral strategies are often provided along with other therapy options. Your customized treatment plan will reflect your needs. 

If you’re ready to take back control of your life, contact a professional substance abuse and mental health facility today.

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