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Article Summary

Cocaine Withdrawal

The DEA (Drug Enforcement Administration) reports that close to 5 million people aged above 12 abused cocaine at some point in 2011. Today, the drug is commonly associated with many risks, including but not limited to:

  • Death
  • High blood pressure
  • Increased anxiety
  • Irritability
  • Paranoia
  • Restlessness
  • Severe cardiac issues

Cocaine also causes severe damage and other effects that are clear in the rising number of visits to emergency rooms in hospitals, as well as calls made to poison control. According to the same report by the DEA, over half a million people paid a visit to an emergency department in 2011 for emergencies related to the drug.

As a result of the many dangers typically associated with increasing and continued cocaine use, it is clear that the only way to reduce your risk of being affected is to stop using this drug.

However, some people are unable to stop because of the onset of withdrawal symptoms. Usually termed as withdrawal syndrome, this condition tends to trigger a number of unwanted symptoms that might make it difficult for you to stop using cocaine. These symptoms will make it more difficult and uncomfortable for you to establish full recovery.

Luckily, there are programs you can sign up for that help you manage the symptoms and alleviate the discomfort commonly associated with withdrawal. These programs may also help you recover and kick start your journey to full sobriety.

Even though withdrawing from cocaine might not be as intense as it is to withdraw from other addictive substances, it comes with an unique set of hardships and challenges. When you withdraw from other substances like benzodiazepines and alcohol, you are likely to experience severe physical symptoms. Cocaine, on the other hand, mostly brings about psychological symptoms.

That said, withdrawal will happen when you have used cocaine for an extended period and you decide to stop taking the drug or to cut down on your usage. The withdrawal symptoms can also occur even if you are not completely off the drug but reduce your intake dramatically.

In this guide, you will learn more about cocaine withdrawal, what causes it, its typical symptoms, and how to manage it:

Causes Of Cocaine Withdrawal

The withdrawal symptoms for cocaine occur when you decide to stop using the substance after a period of extended use. Abusing cocaine constantly and consistently may cause physical dependence on the substance. When your body gets used to cocaine, it will rebound when you do not take it. However, even a single episode of use can cause withdrawal.

In effect, using cocaine will typically cause excitability, and euphoria. It does this by causing the brain to release dopamine - a biochemical occurring naturally in the brain - in excess amounts.

Symptoms will, therefore, occur after you use the drug and start withdrawing from it. This is because your body will start coming down from the extreme high and going through homeostasis.

As a direct result, you are likely to feel a deep sense of dissatisfaction with your life after you take the drug. It is also common for users to experience extreme cravings for cocaine after a binge because of the high their bodies are coming down from.

Although cocaine will produce euphoria and extreme mood elevation after causing your brain to release dopamine in higher than the usual amounts, its effects on the other parts of your body might prove to be serious or even deadly.

This is because after your binge ends or when you stop using the drug, you will experience a crash almost immediately. As an user, you may also have strong cravings for more of the drug during your crash. The other symptoms you may experience include paranoia, extreme suspicion, agitation, sleepiness, irritability, anxiety, lack of pressure, and fatigue, among others.

In most cases, therefore, withdrawing from cocaine will not bring about any visible physical symptoms like shaking and vomiting as is typical of withdrawing from alcohol and heroin. Instead, as you might already have guessed, it causes psychological and emotional symptoms.

Severity Of Cocaine Withdrawal

Several factors will influence the severity of your cocaine withdrawal. These factors include, but are not limited to:

  • The duration of use, in total
  • The frequency of cocaine abuse
  • The purity or potency of the batch you abused
  • The duration of the action as influenced by the mode of use, such as smoking, injecting, or snorting
  • The existence of any other physical or mental health conditions

Generally speaking, therefore, withdrawal is the condition that will begin when you are dependent on cocaine and you decide to either reduce your use drastically or stop using altogether.

As your body becomes accustomed to having cocaine in the system and adapting to it, you may also develop physical dependence. Through this adaptation, therefore, your brain will start needing cocaine to function normally and feel good.

Therefore, if you do not take cocaine at the same levels that your body and brain have become used to, you will experience withdrawal.

NOTE: Cocaine is quite addictive. However, you need to understand the distinction between dependence and addiction. Addiction is the inability to stop abusing cocaine even when you experience distress when you do not use it. Dependence, on the other hand, is the physiological adaptation of your brain and body to the drug. When dependence develops, you will start suffering an onset of withdrawal symptoms any time you do not use cocaine.

The Dangers Of Cocaine Withdrawal

As mentioned above, withdrawing from cocaine does not carry the same risks typically associated with withdrawing from other substances like benzodiazepines and alcohol - which may lead to lethal complications.

As such, cocaine withdrawal is similar to withdrawing from other stimulants in the sense that it is not typically life-threatening. Still, there are other dangers that might arise in several situations. These include:

a) Physical Health Complications

If you abuse alcohol and cocaine concurrently, you run a risk of experiencing problems with your heart during withdrawal. You may, for instance, increase your risk of developing an infarction (heart attack) or arrhythmia (abnormal heart rhythm).

Using cocaine concurrently may also increase your risk of developing seizures, a condition that is also likely to happen when you start withdrawing from abusing this substance.

b) Mental Health Concerns

Cocaine withdrawal also produces depression among users. The symptoms of depression can be experienced through low motivation, low energy, and low mood. You may also report suicidal intentions and thoughts during your withdrawal.

As a direct result, it is essential that you get monitored closely during your detoxification to ensure that you are safe. In particular, suicidal intentions and thoughts are most common among those who abuse multiple substances.

On the other hand, recent reports show that close to 50% of those who abuse cocaine experience co-occurring depression. This condition might complicate the withdrawal process.

If you have been using stimulants like cocaine, you may also express violence, paranoia, and aggression towards the end of your use when withdrawal makes it appearance. These problems are quite dangerous both for you and for others around you. This is why it is recommended that you check into a detox and treatment center so that you are in a safe environment until your body gets used to staying without cocaine.

As mentioned above, any time you use cocaine concurrently other addictive substances, your withdrawal will become more dangerous and complicated. Therefore, if you are serious about quitting, it is essential that you are honest with the treatment center and/or health provider. You should also tell them about all the drugs and substances you have been abusing when you were addicted to cocaine.

Cocaine Withdrawal Symptoms

Most people take cocaine in a binge-and-crash pattern. As a direct result, they tend to experience withdrawal even before they make a conscious decision to stop using the drug.

That said, cocaine withdrawal happens in three distinctive stages or phases. These include:

a) The Crash

You will experience a crash within the first 24 hours after your cocaine, or after a sustained period of intense use. During the crash, you may suffer the following withdrawal symptoms:

  • Anxiety
  • Extreme depression
  • Fatigue
  • Increased hunger
  • Irritability
  • Lack of energy
  • Lack of motivation

b) Withdrawal

This is the second phase. It begins within the first 7 days after your last instance of cocaine use and may last for about 10 weeks. The typical symptoms here include, but are not limited to:

  • Anxiety
  • Changing moods
  • Depression
  • Dysphoria (which is defined as a feeling of general dissatisfaction with your life)
  • Intense cravings for cocaine
  • Low energy
  • Paranoia
  • Trouble concentrating

c) Extinction

The final stage of cocaine withdrawal might continue for the first 6 months after you stop using the drug. During this phase, you will experience a decrease in most of the withdrawal symptoms. However, you will still suffer the following:

  • Low mood
  • Some cravings for cocaine

Research also suggests that you might experience persistent deficits with impulse control within 4 weeks of abstinence. As such, lingering impulse control problems might be part of the general constellation of symptoms supporting the protracted withdrawal syndrome after a period of cocaine abuse. This syndrome is also referred to as PAWS (post-acute withdrawal syndrome).

Additional cocaine withdrawal symptoms include:

  • Anhedonia, which refers to the inability to feel happiness or pleasure
  • Anxiety
  • Depression
  • Difficulty concentrating
  • Exhaustion
  • Fatigue
  • Inability to experience full sexual arousal
  • Increased appetite
  • Increased cravings for the drug
  • Intense physical fatigue after any activity
  • Physical symptoms, including nerve pain, muscle aches, tremors, and chills
  • Restlessness
  • Slowed activity
  • Slowed thinking
  • Suicidal actions or thoughts
  • Vivid, often unpleasant nightmares and dreams

Prognosis For Cocaine Withdrawal

It is difficult to heal/treat cocaine addiction, and relapse is highly likely. Therefore, you should start your treatment with the option that seems most comprehensive and effective. For some people, outpatient care might work quite as well as inpatient treatment - although the latter is highly recommended.

As mentioned above, withdrawing from cocaine is intense but not to the same extent as withdrawing from other substances like alcohol. However, it is quite dangerous because of the risk of overdose and suicidal thoughts/actions.

While withdrawing from cocaine, you may start using anti-anxiety medications, hypnotics, sedatives, or even alcohol to treatment your symptoms. However, using any of these drugs over the long term is inadvisable. This is because it might shift your addiction from cocaine to the other substances you are abusing.

The best solution, therefore, is to undergo detoxification at an inpatient treatment facility. This way, you will receive proper supervision to help you quit the drug once and for all. During your detox, you might even be required to use some medications for a time to help with your recovery. Although there are no known medicines that can reduce your cravings for cocaine, the research is underway and something might come up in the future.

Exams And Tests

When you report to the treatment facility, you will be given a physical examination. The medical team will also note your history of cocaine abuse. In most cases, this is all that would be needed to diagnose your cocaine addiction. However, you may also receive routine testing, including:

  • Urinalysis
  • Toxicology (drug and poison) screening
  • ECG (the electrocardiogram would be designed to measure the electrical activity in your heart)
  • Chest x-ray
  • Cardiac enzymes (where the team will look for evidence of heart attack or heart damage)
  • Blood tests


Although you can complete cocaine detoxification in an outpatient setting, it is highly recommended that you undergo detox at an inpatient center. If you have relapsed in the past as a result of withdrawal, you will receive supervision. Additionally, if you have any co-occurring mental health problems, the conditions will be treated concurrently. After that, you may be advised to undergo comprehensive inpatient treatment for cocaine addiction.

In most cases, withdrawing from cocaine may increase your risk of suicide. People who try to stop using this substance after they have become addicted to it can also suffer intense mood swings and depression, accompanied by suicidal ideation. This is because your brain will have become accustomed to the continuous and regular flood of the neurotransmitter dopamine.

Since the drug prevents this neurotransmitter from being reabsorbed, NIDA (the National Institute on Drug Abuse) reports that the dopamine will start flooding your brain and causing the high that is commonly associated with regular episodes of cocaine abuse. If your brain stops experiencing this euphoric high, you may start feeling depressed.

In conclusion, therefore, it is recommended that you undergo detoxification in an inpatient setting. This will ensure that you are safe all through the cocaine withdrawal process until you are finally weaned of the drug and its resultant effects.






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