Cocaine Withdrawal Treatment

depressed man in counseling

Cocaine is a highly addictive stimulant drug ¹. Withdrawal symptoms can occur when an individual who has a cocaine addiction drastically reduces or abruptly stops taking the drug. While cocaine withdrawal isn’t as physically taxing as withdrawal from other drugs, the experience can still be problematic and the unpleasant symptoms may contribute to relapse. A cocaine detox program can help you to obtain sobriety and prepare you for a transition into an ongoing treatment program. This article covers the following information about cocaine withdrawal and treatment:

Cocaine withdrawal syndrome.
Timeline for withdrawal.
Protracted withdrawal symptoms.
Cocaine withdrawal treatment.
Medication for cocaine withdrawal.
Relapse prevention.
Finding substance abuse treatment.

Cocaine Withdrawal Syndrome

When someone who is addicted to cocaine suddenly quits using the stimulant, they may experience unpleasant withdrawal symptoms, many of which are quite opposite in character to cocaine’s short-term effects. Not all individuals experience withdrawal the same way, and the type of symptoms, severity, and length of withdrawal can vary based on numerous factors. The amount of time an individual has been addicted to cocaine, the average amount used, any concurrent use of other substances, and the physiological makeup of each person can influence how withdrawal symptoms manifest. Cocaine withdrawal symptoms can include ^1,2,3,4,5:

Severe cravings for cocaine.
Depression.
Suicidal ideation.
Anhedonia, or the inability to feel pleasure.
Restlessness.
Agitation.
Anxiety.
Paranoia.
Severe fatigue.
Increased appetite.
Nightmares.
Insomnia or hypersomnia.
Slowed movements and thought.
Slowed heart rate.

If you or a loved one is addicted to cocaine, please call our confidential helpline at 11111 . Addiction support specialists are available to help you learn about detox and treatment options.

Timeline for Withdrawal

Cocaine has a short half-life, which means that it is metabolized from its active form relatively quickly. As such, withdrawal symptoms can appear within a few hours of the last use ^1,4,5. As the individual comes down from being high on cocaine, the first phase of withdrawal is known as the crash ¹. A crash typically occurs after cocaine binges in which the individual repeatedly uses high doses of cocaine to maintain the high ⁴. This crash may include severe cravings accompanied by feelings of exhaustion, irritability, anxiety, depression, or agitation ^1,4. Some people may require numerous days of rest after coming down from a cocaine binge ⁴. Acute withdrawal symptoms usually subside within 1-2 weeks after the last dose of cocaine ⁶. However, cravings for cocaine may linger beyond the acute withdrawal period.

Protracted Withdrawal Symptoms

depressed woman cocaine withdrawal

In some cases of drug addiction, individuals may experience protracted withdrawal symptoms that last longer than the acute withdrawal syndrome. Acute withdrawal syndrome consists of the immediate and predictable symptoms that occur with abrupt cessation of or reduction in cocaine use ⁶. Once acute cocaine withdrawal has subsided, protracted withdrawal symptoms may persist for weeks, months, or possibly years ^6,7. Protracted withdrawal is also known as post-acute withdrawal syndrome (PAWS), and may include long-lasting symptoms, such as ^6,7:

Cravings for cocaine.
Cognitive difficulties.
Depression.
Anxiety.
Irritability.
Insomnia or sleep disturbances.
Inability to feel pleasure.
Apathy.
Obsessive behaviors.

During protracted withdrawal, an individual may experience impairment in the ability to manage emotions and control impulses ⁶. These areas tend to improve over time, with emotional regulation improving significantly after about a month of sobriety. However, improvements in impulse control may take much longer to develop ⁶. PAWS is thought to be associated with changes in the brain resulting from chronic cocaine abuse. Long-term cocaine use causes the brain to adapt to the presence of the stimulant and the changes in neurotransmitter levels, which then leads to withdrawal symptoms when cocaine use is stopped or decreased ⁷. The resulting protracted withdrawal symptoms resemble those of anxiety and mood disorders and can cause significant impairment and distress in a recovering user’s life ⁷.

It can be extremely difficult to quit using cocaine without assistance. Unpleasant withdrawal symptoms and strong urges to use cocaine can often lead to relapse. Fortunately, there are a wide variety of detox and treatment options available to assist you throughout the withdrawal process, ensuring your comfort and safety. Short-term detox is often the first step towards long-term recovery but isn’t a replacement for formal substance abuse treatment. Detox often occurs in a residential facility where the person stays for the duration of the withdrawal period and receives 24-hour medical and psychiatric supervision. A short-term detox program provides a safe place with limited relapse triggers while the person’s system is cleared of cocaine, but detox doesn’t treat the underlying issues associated with addiction ⁸. Improved outcomes can be seen with continued treatment, such as attending a formal inpatient or outpatient rehab program, following successful completion of a detox program ⁹. Treatment is carried out as a combination of therapeutic techniques, such as individual counseling, group therapy sessions, education about addiction, development of relapse prevention skills, medical care, and psychiatric care ⁸. Treatment options include:

Inpatient treatment: An individual lives at the residential facility from 28 days up to 90 days, depending on their needs. Intensive individual and group counseling sessions, medical care, and psychiatric support are provided in a structured format to prepare each patient to re-enter daily life while maintaining sobriety.
Outpatient treatment: Someone who wants to continue working or attending school while recovering from a cocaine addiction can attend treatment at an outpatient facility. These programs can range in intensiveness; partial hospitalization programs (PHP) and intensive outpatient programs (IOP) require a high level of commitment, meeting several times a week for multiple hours each session, while other outpatient programs may meet 1-2 times per week.
12-step programs: Fellowship programs, such as Cocaine Anonymous (CA) and Narcotics Anonymous (NA), allow individuals in recovery to build a sober support group of peers. Attending meetings can promote sobriety through healthy socialization, support, and the development of skills to prevent relapse.
Non-12-step programs: Programs, such as SMART Recovery and Secular Organizations for Sobriety (SOS), provide an alternative to the 12-step model. These programs will frequently utilize research-backed methods to promote recovery.
Luxury treatment: These inpatient programs provide resort-like settings, additional privacy, and cutting-edge treatments that may not be available in traditional rehab centers. Some luxury amenities and services may include swimming pools, golf courses, spa treatment, gourmet meals, massage therapy, and exercise facilities.
Executive treatment: These inpatient programs cater to business personnel who require access to phones and computers to continue working while still receiving high quality treatment for cocaine addiction. This type of facility may offer additional amenities such as private rooms and alternative therapies.
Holistic treatment: This type of treatment focuses on the mind-body-spirit connection and treats patients in all areas. These treatment modalities can include yoga, exercise therapy, nutrition counseling, meditation and mindfulness, music and art therapy, and equine therapy.
Population-specific treatment: Some treatment facilities may specialize in addressing the specific needs of various populations, such as men-only, women-only, LGBT, veterans, and teens.

Please call our helpline today at 11111 for more information about the types of cocaine addiction treatment that are available.

Medication for Cocaine Withdrawal

There are currently no FDA-approved medications to specifically treat cocaine withdrawal ^3,9. In some circumstances, antidepressants may be used to treat depressive symptoms ³. Currently, research is being conducted on other medications, such as Modafinil, that could someday be used to treat cocaine withdrawal ^1,3. Modafinil has stimulant-like properties that could aid in cocaine detoxification ³.

Relapse Prevention

woman in counseling cocaine withdrawal treatment

Aftercare is a plan that is developed through the treatment process and outlines the steps an individual will take to maintain sobriety once an initial treatment program has been completed. Relapse rates for addiction are similar to those of medical conditions, such as hypertension or diabetes; about 40-60% of those in recovery relapse at some point. This is why developing and following an aftercare plan is an important component of recovery ¹⁰. Aftercare options can include:

Sober living homes: Halfway houses provide a supportive, sober environment where residents are free to come and go as they please but may be subject to following rules, such as abiding by curfew or completing chores. Residents receive regular drug tests to ensure sobriety.
12-step programs: Many people attend 12-step meetings for life due to the sober and supportive environment of NA and CA.
Non-12-step programs: Likewise, those who find alternative support groups to be beneficial while recovering from cocaine addiction may attend these meetings long-term to prevent relapse and promote empowerment.
Individual and group counseling: Therapy can be helpful for those who need a little boost in maintaining sobriety, preventing relapse, or working through underlying issues, such as trauma or mental illness.

Find a Treatment Program Today

If you or a loved one is addicted to cocaine, don’t hesitate to call our confidential helpline at 11111 for help finding a detox or treatment program that meets your needs.

Sources

U.S. National Library of Medicine. (2015). Cocaine withdrawal.
Substance Abuse and Mental Health Services Administration. (2016). Stimulants.
U.S Department of Health and Human Services. (2006). KAP KEYS based on TIP 45: Detoxification and substance abuse treatment.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
The University of Arizona. (2006). Medical complications.
Center for Substance Abuse Treatment. (2010). Protracted withdrawal. Substance Abuse Treatment Advisory, 9(1).
UCLA Dual Diagnosis Program. (2016). Post-acute withdrawal syndrome (PAWS).
National Institute on Drug Abuse (2012). Types of treatment programs.
National Institute on Drug Abuse. (2016). How is cocaine addiction treated?
National Institute on Drug Abuse. (2014). Drugs, Brains, and Behavior: The Science of Addiction.

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