Cocaine Withdrawal and Detoxification

A 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.

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.

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

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.

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.”