How To Quit Cocaine

What is cocaine abuse?

Cocaine abuse refers to the use of cocaine powder or crack cocaine. Cocaine is usually inhaled nasally (snorted), smoked, or dissolved and injected. Crack cocaine is typically smoked, either alone or combined with tobacco or marijuana.^[1] Some people use cocaine alongside other substances, such as alcohol or heroin (speedballing).^[2]

Cocaine abuse can include anything from sporadic use at parties or clubs to regular binges or everyday use. Regardless of the frequency, cocaine abuse can have harmful effects on physical and mental health, social and professional functioning, and general well-being. Prolonged and heavy use is more likely to result in the development of dependence and addiction, which may lead to a diagnosis of cocaine use disorder (CUD).^[2][3]

Why is cocaine addiction-forming?

Cocaine is addiction-forming as it can cause long-term changes in the brain, contributing to the physical and psychological aspects of addiction.^[4]

Cocaine affects the neurotransmitter dopamine, which is involved in the brain’s reward circuit. Cocaine alters dopamine activity, causing a buildup that floods the reward circuit with up to ten times more dopamine than other pleasurable or rewarding activities. This contributes to a feeling of euphoria or ‘high’ and reinforces cocaine use.^[1]

With continued use, the brain adapts to the increased dopamine, causing a gradual reduction in the effects of cocaine. This is known as tolerance and can lead to the use of larger or more frequent doses in an attempt to achieve the same ‘high’.^[2]

If cocaine use continues, long-term changes occur in the brain. These brain changes can cause a reduced ability to feel pleasure from anything but cocaine use, regular cravings and triggers, and increased tolerance and dependence. These effects all contribute to the formation and continuation of cocaine addiction.^[1][4]

How hard is it to quit cocaine?

Quitting cocaine could be very difficult for some people and easier for others. Many factors can impact how hard it is to stop using cocaine, including:^[1][4][5][6]

• Amount and duration of use: Long-term and heavy cocaine use can contribute to the development of physical dependence, causing withdrawal symptoms when stopping. These symptoms can be very unpleasant and distressing, including extreme mood changes such as depression and suicidal thoughts, insomnia, pain, and fatigue. This can make quitting more difficult and may result in a relapse if appropriate support is not provided.

• Environment: Quitting cocaine use can be more difficult when spending time with others who are using it regularly. Certain environments and people can trigger a craving, making abstinence feel more challenging.

• Underlying mental health conditions: Some people begin using cocaine due to underlying mental health conditions or develop psychological issues because of their drug use. In these instances, quitting cocaine use without psychological support can be very difficult.

• Support network: Individuals with supportive friends and family are found to be more successful at quitting drug use than those without a support network.

• Access to treatment and professional support: Finances, time, motivation, and education can be barriers to accessing treatment that can help make quitting easier.

How do I know if I have a cocaine addiction?

Cocaine addiction is considered to be a severe form of substance use disorder (SUD), a condition that is outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).^[7] Criteria for a substance use disorder in the DSM-5, include:^[7]

• Using cocaine in dangerous environments, or jeopardizing personal safety or the safety of others because of drug use.
• Experiencing issues within interpersonal relationships due to cocaine use.
• Neglecting professional or personal roles and responsibilities because of cocaine use.
• Experiencing withdrawal symptoms when reducing or stopping cocaine use.
• Developing an increased tolerance to cocaine, requiring larger doses to achieve the same effects.
• Using increasing cocaine in increasing amounts or frequency or taking more than intended in one sitting.
• Making regular attempts at quitting or reducing cocaine use but having little or no success.
• Spending long periods using cocaine.
• Experiencing new or worsening physical and/or mental health issues because of cocaine use.
• Spending less time engaging with others or in activities or hobbies that were previously enjoyable, to instead use cocaine.
• Experiencing strong cravings, desires, and triggers to seek and use cocaine.

Mild

A cocaine use disorder is considered mild if the individual meets two or three of these criteria. An example of this might be someone who is using larger or more frequent doses and experiencing increasing desires to use but not experiencing harmful effects on their physical and mental health or daily and professional functioning.

Moderate

A cocaine use disorder is considered moderate if the individual meets four or five of these criteria. This might include some detrimental effects on health or functioning, experiencing some withdrawal symptoms and increased tolerance, while still managing most personal, social, and professional responsibilities.

Severe

A cocaine use disorder is considered severe if the individual meets six or more of these criteria. They may be experiencing harmful effects of their drug use in several aspects of their life and functioning, using frequent and heavy doses, and being unable to stop using despite issues.

How to quit cocaine if your use is mild to moderate

For some people, quitting cocaine can be very challenging, even if use is mild. The following advice may be beneficial for individuals with mild to moderate cocaine use who wish to quit:^{[1][4][5][6][8]}

• Talk to a professional: Contacting a doctor might be a useful step to take in quitting mild to moderate cocaine use. Some individuals may be able to stop without experiencing withdrawal symptoms, while others may need support in managing these effects. Additionally, a doctor can provide a referral to a specialist service if required, advise on changing behaviors and attitudes relating to drug use, and treat any drug-related physical or mental health concerns.

• Tell friends and family: Informing loved ones about quitting cocaine use can be helpful so that they know not to make suggestions that may be triggering and allow them to provide support in maintaining abstinence.

• Recognize triggers: Certain people or places may trigger a craving or desire to use cocaine. Recognizing these triggers can help avoid or manage these situations, improving the chances of quitting successfully.

• Attend support groups: Various types of support groups can be useful when quitting cocaine use. This might include a drug-related support group such as Narcotics Anonymous or a group focused on providing mental health support.

• Focus on building healthy habits: When quitting cocaine use, it can be helpful to replace drug-using behaviors with more positive habits, to distract from triggers or cravings, improve well-being, and reinforce abstinence.

• Make a list: Some people find it helpful to have a list of reasons why they are quitting cocaine use, as this can be motivating and serve as a reminder when facing temptations.

How to quit cocaine if you have an addiction

The first step to recovering from a cocaine addiction is to recognize and accept that there is a problem. Only when individuals can admit that their use is causing harm to themselves or others can they start to make positive changes.^[6]

Steps to overcoming a cocaine addiction might include:^{[5][6][8][9][10]}

• Seek professional support: Severe cocaine use, dependence, and addiction often require professional intervention during both the detox and rehabilitation processes. This can include inpatient or outpatient treatment, psychotherapy, psychosocial interventions, and medication.

• Utilize detox treatment: Stopping heavy cocaine use is likely to result in physical and emotional withdrawal symptoms which can be unpleasant or distressing without professional treatment. Detox services can provide professional monitoring and management of withdrawal symptoms, helping with the detox and withdrawal process.

• Engage in therapies: Behavioral therapies, family therapies, and group therapies can provide significant benefits when attempting to quit heavy cocaine use. They can provide support and incentives to improve the success of reducing and stopping use.

• Involve family and friends: People who utilize a support system are more likely to reduce or stop cocaine use and have better outcomes in addiction recovery.

Different methods for treating cocaine addiction

Appropriate and effective treatment for cocaine addiction can vary depending on the person, the severity of their cocaine use, and their personal needs. Many options are available, including psychological and psychosocial therapies, inpatient and outpatient treatments, medications, and holistic therapies.

Outpatient treatment

Outpatient treatment programs allow the individual to remain living at home while receiving treatment. Outpatient treatment will involve attending appointments for medicinal and therapeutic interventions while reducing and stopping use or during long-term recovery.^[6][10]

Some outpatient treatments require just a few hours per week, while others involve more extensive treatments. For example, intensive outpatient treatment (IOT) involves several hours per week, usually nine or more, during which individuals attend individual, group, and family therapies.^[11]

Inpatient treatment

Inpatient treatment involves staying in a hospital or facility for several days or weeks and can be a beneficial option for individuals with heavy or long-term cocaine use and dependence.^[6]

Inpatient facilities can provide medically assisted detox services, in which professionals monitor and treat withdrawal symptoms, helping to prevent relapse during this time. Additionally, they can offer more long-term treatments, helping individuals learn skills to prepare for continued abstinence and recovery following detox.^[12]

Typically, inpatient or rehab centers provide a range of treatments, including medications, individual and group therapies, mental and physical health treatment, and holistic therapies.

Therapeutic communities

Therapeutic communities or ‘sober houses’ allow individuals to reside in a controlled and drug-free environment for 6-12 months, helping to prevent relapse and triggers. Many of these residencies provide rehabilitation services and psychosocial interventions and promote group support throughout the recovery process.^[9]

Psychological therapies

Various therapies have shown effectiveness in treating cocaine and other substance use disorders. Typically, behavioral therapies, such as cognitive behavioral therapy (CBT) and contingency management (CM) have demonstrated the most successful outcomes.^[1][9]

CBT is an effective treatment that can help people recognize and adjust addictive behaviors, learn how to understand and cope with cravings and triggers, and manage emotional distress. Many people continue to make improvements following CBT treatment and are less likely to relapse.^[8][11]

CM, also known as motivational incentives or voucher-based reinforcement therapy, helps to build and reinforce new and positive behaviors when used alongside other therapeutic treatments. It offers individuals rewards for abstinence, such as vouchers or prizes, which promotes and reinforces sobriety.^[9][11]

Group therapies

Many people recovering from cocaine and other substance use disorders benefit from group support and therapy. This can be utilized through inpatient and outpatient treatment programs and within the community. Many of these groups, such as Narcotics Anonymous, involve the 12-step principles, which help to promote and maintain abstinence through advice and shared experiences within the group.^[5][11]

Family or couples therapy

Family and couples therapies can help individuals who are overcoming cocaine addiction while also providing support to their loved ones. This can improve interpersonal relationships within the home, provide skills to improve communication and understanding, manage any issues that occur due to drug use, and teach families how to provide support during the recovery process.^[9]

Psychosocial interventions

Often, cocaine addiction harms various aspects of an individual’s life and functioning. Psychosocial interventions can be provided that are tailored to each person’s needs and can help make improvements in these areas. This might include support with housing, employment, finances, returning to previous roles and responsibilities, and improving social and professional relationships.^[6][9]

Medications

Although there are no approved medications to treat cocaine addiction, some medications can be prescribed to help in the withdrawal or recovery process.^[5][11]

• Disulfiram: Disulfiram is a medication used to treat alcohol addiction but has also shown some effectiveness for individuals with cocaine addiction.
• Antidepressants, antipsychotics, anticonvulsants, benzodiazepines: These medications can be used short-term during the withdrawal process to reduce the severity of withdrawal symptoms such as depression, anxiety, agitation, and insomnia.

Currently, scientists are researching new medications to be used in treating cocaine addiction, including other stimulants, such as long-acting amphetamine and modafinil, and a cocaine vaccine.^[9][11]

Holistic therapies

Cocaine addiction can have a detrimental impact on physical and mental health and general well-being. Holistic therapies can provide positive changes in several areas, treating the individual as a whole rather than just their addictive behaviors. This can have a significant effect on the general well-being of the individual and improve their recovery process.^[12]

Holistic therapies include equine therapy, mindfulness, meditation, yoga, massage, acupuncture, nutritional counseling, and exercise.