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Cocaine Withdrawal and Detoxification

Written by Thomas Christiansen

& Medically Reviewed by Dr. Annie Tye, PhD

Medically Reviewed

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Last Updated - 08/09/2021

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Updated 08/09/2021

Key Takeaways

  • Cocaine withdrawal symptoms can vary, depending on the degree of dependency or addiction.
  • Chronic users may face post-acute withdrawal syndrome (PAWS) or protracted withdrawal, which are characterized by intermittent periods of withdrawal months or even years after the last use.
  • Medically assisted cocaine detox is done under 24/7 care from medical professionals who may prescribe pharmaceutical agents that will reduce withdrawal symptoms.
  • Detoxing at home may be possible but poses challenges that may be difficult to overcome.

Cocaine withdrawal can cause physical and psychological discomfort. Learn how medically assisted detoxification can ease the discomfort of withdrawal symptoms.

What are the Symptoms of Cocaine Withdrawal?

Acute cocaine withdrawal symptoms begin within hours after cessation and are characterized by powerful cravings for more cocaine that occur in conjunction with feelings of dysphoria, irritability, anxiety, restlessness and fatigue.

Cocaine Withdrawal Timeline

The cocaine withdrawal timeline depends on several factors, most notably the degree of dependence. People who regularly use cocaine are far more likely to experience symptoms beyond the initial “crash” phase. Withdrawal symptoms can be broken into three overlapping categories that fall on a relatively predictable timeline:

The Crash

Within hours after the last use, early withdrawal symptoms including cravings, restlessness, and insomnia become apparent and may persist for several hours or days.

Acute Withdrawal

Immediately following the crash, a period of withdrawal sets in. Characteristics include exhaustion, lethargy, dysphoria, anhedonia, anxiety, and hypersomnia (periods of excessive sleep). Acute withdrawal can last anywhere from several days to up to four weeks. Acute withdrawal is associated with susceptibility to triggers and a high risk of relapse in an unstructured environment.

Extinction

Once the acute withdrawal has been overcome, a period of learning how to master cravings and resist triggers sets in. This phase can last for months or even years while someone who has successfully achieved early recovery reorients to a lifestyle without cocaine.

People who overcome serious cocaine dependence may experience protracted withdrawal symptoms that persist for weeks or months beyond the expected withdrawal timeline. This frustrating “post-acute withdrawal syndrome” is characterized by fluctuating symptoms that will gradually abate.

What Causes Cocaine Withdrawal?

Cocaine use is associated with increased dopamine in the brain, which results in the characteristic euphoria experienced immediately after use. Shortly after use, as dopamine levels fall, the person begins to feel dysphoric and may experience a profound craving for more cocaine. Heavy cocaine use can cause structural changes in the brain as functional connections are rewired, the result of which is a self-reinforcing pathway of addiction. Chemical and structural changes in the brain take time to develop. It is important for people struggling with cocaine use disorder to remember that addiction takes time to develop and recovery takes time and energy to sustain.

Factors Affecting Withdrawal Duration

The most significant factor affecting cocaine withdrawal duration is the amount and duration of use. Long-time users, particularly those who used large amounts of cocaine regularly, face the biggest hurdle in successfully managing withdrawal. Other factors that affect withdrawal include mental health status, the amount of physical activity the person gets, polysubstance abuse, social support (or a lack of social support) and proximity to triggers. Thus, how long cocaine withdrawal lasts can be broadly estimated to be weeks to months or even years, but a precise answer is difficult to provide. For those who used small or moderate amounts of cocaine, the duration of withdrawal can be expected to be relatively short. Heavy, chronic users are more likely to face an extended cocaine withdrawal symptoms length or even PAWS, which can last for months or years after quitting.

Professional vs At Home Detox

Cocaine withdrawal treatment begins with a period of detoxification, where accumulated chemicals leave the body. This period can be profoundly uncomfortable because of the chemical and structural changes in the brain. Prolonged cocaine use can cause the brain to perceive a need for cocaine in the same way that it needs food or water.

Medical Detox

Medically assisted detoxification can be the first step toward recovery. The physiological changes that are associated with cocaine addiction can cause overwhelming cravings for the drug and, in its absence, profoundly uncomfortable or debilitating withdrawal symptoms may create an atmosphere where relapse is likely. Medical detox is carried out under 24/7 care from a physician and staff, who can offer behavioral tools to attenuate cravings and physical symptoms, and who may prescribe pharmacological agents that have been shown to reduce the symptoms of acute withdrawal.

Outpatient Detox

Outpatient detoxification can be a valuable tool for people who do not face consistent drug use triggers. Outpatient detox is carried out after a consultation with a rehabilitation facility and may include a prescription to help reduce the acute withdrawal symptoms.

Detoxing at Home

Cocaine detox at home is certainly possible for some people who have light to moderate dependency issues. People who struggle with chronic cocaine use disorder or who do not live in an environment that is conducive to sobriety may find it to be extremely challenging or impossible to successfully detox at home. It is worth consulting with a specialist before attempting home detox, as they can offer instruction on how to detox from cocaine at home, including avoiding triggers and finding ways to replace negative behaviors with positive ones.

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FAQs About Cocaine Withdrawal

How is cocaine withdrawal diagnosed?

formal diagnosis of cocaine withdrawal syndrome is based on recommendations made by the American Psychiatric Association and require: – Cessation of cocaine use– Dysphoria with two of the following: fatigue, hyper-insomnia, insomnia, psychomotor abnormalities, increased appetite, and unpleasant dreams– The two symptoms are clinically significant or cause significant impairment in social/occupational settings– The symptoms are not due to a medical condition or another cause. This diagnosis can be made during an initial assessment at a rehabilitation facility.

How long does cocaine stay in your system?

A drug’s half-life determines how long it will stay in your system. One half-life identifies the amount of time it takes your body to metabolize half of the amount of drug that was administered. After five half-lives, more than 95% of the drug will have been broken down into metabolic byproducts. The half-life of cocaine is about one hour, so over the course of about five hours, all of the cocaine that was taken will be broken down, as long as more cocaine is not used. This is why the pleasurable cocaine effects will have mostly subsided within a couple of hours after use. However, metabolic byproducts can be identified if a drug test specifically looks for them, and byproducts can be present for far longer than the cocaine itself.

How common is cocaine withdrawal?

Symptoms of cocaine use and withdrawal are common even after a single dose of cocaine, but heavy use often causes substantially stronger symptoms.

How can I manage cocaine withdrawal symptoms?

The most effective strategy to successfully manage cocaine withdrawal is to undergo medical detox and acute withdrawal in a professional rehab setting. Cocaine withdrawal is rarely dangerous but people who attempt to quit without support are at high risk for relapse. Unfortunately, there are no shortcuts or home-remedy cocaine withdrawal treatments. If you choose to detox at home, it can be very helpful to enlist a trusted friend or family member who can provide support and encouragement throughout early recovery. Make sure you discuss why quitting is important to you and outline goals for short- and long-term recovery. When you are challenged with cravings and triggers, ask them to remind you why you want to quit. In addition, make sure you eat healthy food and drink plenty of water during detox and early withdrawal.

What is Post-Acute Withdrawal Syndrome (PAWS)?

Because people in recovery may be unaware of PAWS, they expect to feel “normal” quickly after their initial detoxification is complete. When they experience cocaine withdrawal symptoms months after quitting, they risk experiencing a setback because of a perceived failure to overcome addiction. It is important to understand that long-term cocaine use causes substantial chemical and structural changes in the brain and reversing these changes can take weeks, months and sometimes years. When patients understand PAWS, they are better able to manage it. The intensity and duration of PAWS episodes typically fluctuate over time. Common characteristics of PAWS episodes include anhedonia, reduced concentration and short-term memory, depression, altered sleep patterns, changes in appetite and irritability or mood instability.

What is Protracted Withdrawal?

Protracted withdrawal is a synonym for PAWS. According to the Substance Abuse and Mental Health Services Administration, protracted withdrawal is defined as, “…the presence of substance-specific signs and symptoms common to acute withdrawal but persisting beyond the generally expected acute withdrawal timeframes.”

Finding a Detox Center

There are several factors to consider when trying to decide on a detox center. These factors can have a large effect on how successful a person’s detox is. Some aspects to consider when looking for a detox center include:

  • Location,  close to home or far away?
  • Cost of detox
  • The effectiveness of the detox program
  • Staff to patient ratio

Our Drug Detox Center

If you or a loved one struggles with cocaine addiction, help is available. Contact The Recovery Village Palm Beach at Baptist Health to speak with a representative about how professional addiction treatment can address a substance use disorder and any co-occurring mental health disorders. Take the first step toward a healthier future by calling today.

View Sources

Substance Abuse and Mental Health Services Administration. “Protracted Withdrawal: Substance Abuse Treatment Advisory.” July 2010. Accessed July 12, 2019.

Australian Government Department of Health. “The Cocaine Withdrawal Syndrome.” April 2004. Accessed July 12, 2019.

DrugBank.ca. “Cocaine.” Updated September 2019. Accessed September 23, 2019.

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