Cocaine Withdrawal & Detox

Edmund Murphy
Hailey Shafir
Written by Edmund Murphy on 12 August 2021
Medically reviewed by Hailey Shafir on 25 November 2024

Cocaine is a highly addictive stimulant drug that is usually either snorted (powder cocaine) or smoked (crack cocaine). While there aren’t many physical withdrawal symptoms from cocaine, the psychological symptoms can have severe effects on mental health.

Key takeaways:
  • While withdrawing from cocaine isn’t medically dangerous, it can be uncomfortable and many users will continue using it to avoid withdrawal symptoms
  • Some cocaine users develop Post-Acute Withdrawal Symptoms (PAWS) which describes withdrawal symptoms that persist after the drug is detoxed from the system
  • During cocaine detox, the drug is cleared from the body while a healthcare professional manages withdrawal symptoms and keeps the patient calm and comfortable
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Causes

Using cocaine increases the levels of dopamine, a biochemical that is associated with the pleasure and reward centers in the brain, creating a sense of euphoria.

After prolonged cocaine abuse, the brain will build up a tolerance to dopamine production, meaning the normal senses of gratification achieved without the drug are reduced and the user will often feel like they require cocaine to feel a sense of normality. This is what leads to withdrawal symptoms when someone with a cocaine use disorder tries to stop using.

While withdrawing from cocaine isn’t medically dangerous, it can be uncomfortable and many users will continue using it to avoid withdrawal symptoms.

Symptoms

The euphoric sensation felt when taking cocaine is fleeting. Depending on whether the user snorts or smokes the drug, the most intense effects last between 5-30 minutes, and the withdrawal process will begin to set in quickly after usage is stopped as cocaine is processed through the system. This often causes cocaine users to binge in order to keep the euphoria going for a long time or to take larger amounts to delay withdrawal. Cocaine binging can lead to permanent health problems or fatal overdose.

Common symptoms of withdrawal from cocaine include:

Duration

Cocaine withdrawal symptoms can start as soon as the drug wears off, usually an hour, and mostly affects people who are regular, frequent, or heavy users. The most intense symptoms of withdrawal wear off in a few days to a week. The intensity and duration of withdrawal symptoms depends on the frequency and volume the cocaine user has taken the drug in, and for how long. Those with intense cocaine addictions will likely experience worse acute withdrawal symptoms.

Related: How is cocaine made?

Some cocaine users develop Post-Acute Withdrawal Syndrome (PAWS) which describes withdrawal symptoms that persist after the drug is detoxed from the system. PAWS can last up to a year or more after a person stops using cocaine and usually include depressed mood, fatigue, brain fog, or weakness. These symptoms may be persistent or they may come and go and can make it hard for people to function normally.

Withdrawal timeline

Below is the expected timeline for people who are withdrawing from cocaine:

The Crash: Symptoms develop within 1-3 hours of last use and involve the user coming down from the drug. Feeling irritable, anxious, exhausted, and having an increased appetite are common during the cocaine crash, and drug cravings tend to be low.

Acute Withdrawals: Symptoms begin after the crash and usually last 3 days to a week. During this period, the cocaine craving becomes intense. Other symptoms include fatigue, trouble concentrating, and feeling irritable, down, or moody.

Post-Acute Withdrawals Syndrome: A small number of users develop prolonged symptoms of withdrawal. The most common symptoms of PAWS for cocaine users are depression, irritability, fatigue, trouble focusing, and weakness. These symptoms persist after the acute withdrawals and can last up to one year.

Related: Warning signs of cocaine abuse

Detox and treatment

Unlike some other stimulant withdrawal, withdrawing from cocaine is relatively safe, but users may still prefer to detox in a structured setting, such as inpatient treatment or detox facilities. Some treatment programs offer medication to ease symptoms, reduce cravings, and help those quitting, though this is not always necessary.

Similarly, some with cocaine use disorders may not need inpatient treatment but may not be able to detox safely alone. For those, there are outpatient cocaine detox programs that offer similar benefits without being overly time-consuming. Treatment improves the likelihood of achieving long-term sobriety and is recommended for people trying to overcome an addiction.

Withdrawal management

The first stages of cocaine addiction treatment begin with an initial detox. During cocaine detox, the drug is cleared from the body while a healthcare professional manages withdrawal symptoms and keeps the patient calm and comfortable.

Treatment will move on to managing cravings and developing coping systems as cocaine leaves the system, through therapies such as cognitive-behavioral therapy (CBT). This can involve therapies and medication as well as creating a plan for continued sobriety.

Get help today

While there aren’t any life-threatening effects of cocaine withdrawal and detox, it may still be preferable to get professional help to quit cocaine. Those who attend cocaine rehab and addiction treatment centers are 20% less likely to relapse (after a year of sobriety) and can begin to live a normal life after addiction.

Though, for most, it will require continuous monitoring and additional support to stay clean, such as from therapy to find the underlying cause of addiction or 12-step programs for group support. If you or someone you care about is suffering from cocaine use disorder, cocaine dependence, or are a cocaine addict, speak to a treatment center today.

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Resources:

  1. National Institute on Drug Abuse (NIDA). 2021, April 8. Cocaine DrugFacts. Retrieved from on 2021, June 2.
  2. Australian Government Department of Health. The Cocaine Withdrawal Symptom. (2004). Retrieved from on 2021, June 2.
  3. Karila, L., Petit, A., Lowenstein, W., & Reynaud, M. (2012). Diagnosis and consequences of cocaine addiction. Current medicinal chemistry, 19(33), 5612–5618. .
  4. Substance Abuse and Mental Health Services Administration (SAMHSA): Treatment of Stimulant Use Disorders. SAMHSA Publication No. PEP20-06-01-001 Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2020.
  5. White, W. L. (2012). Recovery/remission from substance use disorders. An analysis of reported outcomes in, 415, 1868-2011.

Activity History - Last updated: 25 November 2024, Published date:


Reviewer

Hailey Shafir

M.Ed, LCMHCS, LCAS, CCS

Hailey Shafir is a Licensed Clinical Mental Health Counselor, Licensed Clinical Addiction Specialist, and Certified Clinical Supervisor with extensive experience in counseling people with mental health and addictive disorders.

Activity History - Medically Reviewed on 02 June 2021 and last checked on 25 November 2024

Medically reviewed by
Hailey Shafir

Hailey Shafir

M.Ed, LCMHCS, LCAS, CCS

Reviewer

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