Understanding Cocaine Withdrawal: Symptoms and Timeline

Cocaine withdrawal can be a tough hurdle for many, with unpleasant psychological symptoms. In this article, we’ll take a look at the basics of this condition so you know what to expect if you choose to attend drug addiction treatment. Addiction therapy in drug rehab can help anyone turn things around.

What Is Cocaine Withdrawal?

Cocaine affects the brain by increasing levels of dopamine, a neurotransmitter associated with pleasure and reward. Normally, dopamine is released in response to potential rewards and then recycled back into the cell that released it, shutting off the signal between nerve cells. Cocaine prevents the reuptake of dopamine, leading to excessive amounts in the brain. This disrupts normal brain communication and causes cocaine’s high.

Over time, the brain adjusts to these high levels of dopamine, leading to dependence and, eventually, the need for more of the drug to achieve the same effect (tolerance). When cocaine use is stopped, the brain experiences a significant drop in dopamine levels, leading to cocaine withdrawal symptoms such as depression and irritability.

What Are the Signs of Cocaine Withdrawal?

Unlike some other drugs, symptoms of cocaine withdrawal aren’t primarily physical but rather a rollercoaster of emotional and mental effects.

However, there are still some physical effects, such as:

• Fatigue – The body may feel extremely tired as it adjusts to the absence of cocaine’s stimulant effects.
• Increased Appetite – Cocaine suppresses appetite, so withdrawal often causes a rebound increase in hunger.
• Sleep Disturbances – Insomnia or hypersomnia can occur as the body’s rhythm adjusts.
• Physical Sluggishness – Reduced physical energy and slow movements are common as the stimulant is no longer present to boost activity levels.

Behavioral signs of cocaine withdrawal include agitation or irritability, as well as a general lack of motivation due to the person’s crashing dopamine levels.

The primary mental signs of cocaine addiction are:

• Depression – The sudden drop in dopamine levels can lead to feelings of sadness or depression, sometimes severe.
• Anxiety – Anxiety is a common symptom, partly due to uncertainty about coping without the drug and the physiological changes occurring in the brain.
• Difficulty Concentrating – Withdrawal can impact cognitive functions, making it hard to focus or think clearly.

These symptoms, while challenging, are a normal part of the detox process as the body works to regain balance and function without cocaine.

What Is the Timeline for Cocaine Withdrawal?

The effects of cocaine withdrawal can begin as soon as a few hours after the last dose.

Here’s what to expect:

• First 24 Hours (The Crash) – This initial phase begins within hours of the last dose. Users often experience a “crash” characterized by intense cravings for more cocaine, anxiety, fatigue, sleepiness, and sometimes depression. Physical symptoms are generally less pronounced compared to other substances like opioids or alcohol.
• Days 1-3 – During these first few days, the acute symptoms of fatigue, irritability, and anxiety continue. Sleep disturbances are common, with individuals experiencing either insomnia or hypersomnia (excessive sleep). Mood swings and cravings can be intense.
• Days 4-7 – Many of the physical symptoms start to decrease in intensity during this period, but psychological symptoms can remain strong. Cravings may persist, and users might experience emotional fluctuations, including feelings of depression or lack of motivation. Increased appetite and disturbed sleep patterns may continue.
• Weeks 1-4 – The first month can bring a continuation of cravings and mood disturbances. Users might experience what is known as “anhedonia,” which is the inability to feel pleasure from activities that were previously enjoyable. Cognitive impairments, such as difficulties with concentration and memory, can also be noticeable.
• First Month and Beyond (Protracted Withdrawal) – Some individuals may experience prolonged withdrawal symptoms, known as Post-Acute Withdrawal Syndrome (PAWS). These can include ongoing depression, anxiety, mood swings, and cravings. These symptoms can wax and wane over a period of several months. It should be noted this does not happen to everyone.

If you or someone you know is going through cocaine withdrawal, it’s important to seek professional help to effectively manage the symptoms and prevent relapse.

What Factors Influence the Cocaine Withdrawal Timeline?

The severity or duration of cocaine withdrawal will depend on several factors:

• Duration and Intensity of Use – Those who have used cocaine for a longer period or at higher doses tend to experience more severe and prolonged withdrawal symptoms.
• Method of Use – The way cocaine is consumed (snorting, smoking, injecting) can affect how quickly it enters the bloodstream and how fast the body becomes accustomed to its presence, impacting the onset and duration of cocaine withdrawal.
• Support Available – Access to a supportive environment and professional help can significantly affect the course of withdrawal. Those who engage in a structured detox program may have a more managed and potentially shorter withdrawal process.
• Polysubstance Abuse – Use of other drugs in combination with cocaine can complicate the cocaine withdrawal process, leading to more complex and extended symptoms.

Overall, cocaine withdrawal will take roughly a month but can be longer depending on factors such as these. Understanding the factors involved in cocaine withdrawal can help individuals and healthcare providers better prepare for and manage the withdrawal process.

What Happens After Cocaine Detox?

After treatment is complete, the most important priority is relapse prevention. There are five evidence-based strategies for that:

1. Education – Education is an important aspect of preventing relapse. Individuals learn to understand and anticipate the subtle cues that can prime them for relapse and drug abuse. The various causes that drive their cocaine use and the necessity for full abstinence from all mood-altering drugs, including alcohol and marijuana.
2. Twelve-Step Programs – As mentioned earlier, a supportive environment is a key element not just during cocaine withdrawal but the recovery phase as well. Cocaine Anonymous is one such 12-step group that can provide much-needed moral support to those on the same recovery journey.
3. Coping Skills – Life is full of stressors and temptations, which can lead people to abuse drugs like cocaine. Coping skills can help address this. These include things like positive visualization, meditation, exercise, better sleep, and more.
4. Ongoing Counseling – Drug abuse often stems from psychological causes. Counseling will help those in recovery understand and tackle the causes underlying their cocaine abuse.
5. Cocaine Relapse Prevention Medications – Cocaine withdrawal’s unpleasant effects can spur some to relapse. There are a variety of medications out there to prevent this. These include medications that increase GABA, such as baclofen, tiagabine, and topiramate, as well as the anti-narcolepsy drug modafinil. Disulfiram, a relapse prevention medication originally prescribed for alcoholism, has also shown promise.

Cocaine is a very addictive substance, and urges may never completely go away. Long-term rehabilitation with a counseling program, whether inpatient, outpatient, or sober living, can be extremely beneficial to people’s recovery.