Cocaine Withdrawal Symptoms, Dangers, Detox, and Addiction Treatment

Cocaine is a stimulant drug derived from leaves of the coca plant, grown primarily in South America.¹ It is an addictive substance that produces euphoric effects and has a high potential for misuse.¹

Someone who chronically uses cocaine can build a tolerance, meaning that they may need more cocaine to achieve the desired effect or they do not experience the desired effects when using the same amount of cocaine over time.²They may also experience cocaine withdrawal symptoms when they abruptly reduce their use of or stop using cocaine.

Keep reading to learn more about the signs and symptoms of cocaine withdrawal, treatment options for cocaine addiction, and how to find treatment for cocaine use disorder.

What Is Cocaine Withdrawal?

Addiction refers to compulsive substance use behaviors despite experiencing undesirable consequences, such as interference with responsibilities at work, school, or home, or negative impacts on relationships.³

Physical dependence can occur when a person frequently takes any substance–legal, illegal, or prescribed. With the frequent and continued use of a substance, the body adapts to its presence, and when the substance is no longer present, withdrawal symptoms may emerge.⁴

Another related term is tolerance, which refers to needing more frequent or higher doses of a substance to achieve the same effect felt at previous doses or experiencing a diminished effect with continued use at the same dose.⁴

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) provides guidance to medical professionals in diagnosing addictions, which are known as substance use disorders. Cocaine addiction falls under the category of stimulant use disorders.⁵

Symptoms of acute cocaine withdrawal are also provided in the DSM-5 and include changes in mood and appetite and sleep problems. When someone experiences cocaine withdrawal, they may return to cocaine use to relieve the symptoms. Although stimulant withdrawal is not medically dangerous and generally does not involve intense physical discomfort, people may experience severe depressive symptoms, which may require clinical intervention.⁶

What Are the Symptoms of Cocaine Withdrawal?

There are various withdrawal symptoms that someone may experience when undergoing withdrawal from cocaine, ranging from physiological to psychological and behavioral signs and symptoms. Some common cocaine withdrawal signs and symptoms include:^2,4,7

Depressed mood.
Inability to experience pleasure (i.e. anhedonia).
Anxiety.
Irritability.
Fatigue.
Slowed thinking.
Memory problems.
Persistent, strong drug cravings.
Increased appetite.
Dehydration.
Sleep disturbances, such as periods of insomnia or hypersomnia.
Vivid and unpleasant dreams.

Is Cocaine Withdrawal Dangerous?

Stimulant withdrawal typically includes symptoms that are not medically dangerous compared to the moderate-to-severe withdrawal symptoms associated with substances like alcohol, benzodiazepines, and opioids.⁶ While this is generally the case, however, every person experiences withdrawal differently, and various factors can contribute to the withdrawal symptoms a person may experience, as well as their severity. These factors include the person’s usual dose of cocaine, duration of overall cocaine use, other drug use, medical conditions, and overall health.⁷

Some people experience a profound level of what doctors call “dysphoria,” or depressive symptoms accompanied by negative thoughts and feelings, including suicidal ideas.⁶ During this time, a person is at increased risk of suicide.⁶

Because withdrawal symptoms can be uncomfortable and distressing (and, in some cases, dangerous), people at risk of severe symptoms may benefit from experiencing withdrawal under medical supervision. With medically supervised detoxification (or “detox”), medical providers can help manage a person’s withdrawal symptoms. Medical providers can also monitor the individual for any complications associated with withdrawal.

Cocaine Withdrawal Timeline

Stimulant withdrawal can begin within a few hours after a person’s last use of cocaine and typically lasts 1–2 weeks, although this can vary from person to person based on individual factors.⁵ This immediate withdrawal is also known as acute withdrawal.

In some cases, people may experience symptoms of acute withdrawal beyond the 1–2 week expected time frame for acute stimulant withdrawal. This is sometimes known as protracted withdrawal, chronic withdrawal, extended withdrawal, post-acute withdrawal syndrome, protracted abstinence, subacute withdrawal, or long-term withdrawal.⁸ These symptoms wax and wane over time and can last 1–2 months.⁸

Some of the symptoms experienced during protracted withdrawal from stimulants include anxiety, fatigue, difficulty with concentrating and decision-making, inconsistent sleep patterns, and a strong craving for stimulants.⁸

Cocaine Detox

Detox is a set of interventions to help manage symptoms while a substance is eliminated from the body (acute withdrawal).⁶ Medically supervised withdrawal involves being under the supervision of a physician or another appropriate medical provider. These providers may help manage withdrawal symptoms and can also monitor for any changes in health or medical complications that may arise during withdrawal based on individual factors. Detox is the first stage in the process of substance use disorder treatment and is an important component of a comprehensive treatment plan.⁹

Cocaine Addiction Treatment Programs

Stimulant use disorder—the diagnostic term for a cocaine addiction—is a chronic medical condition generally treated using behavioral therapies—such as cognitive behavioral therapy (CBT) and contingency management—and mutual support groups such as Cocaine Anonymous.¹⁰

Behavioral therapies help people change their attitudes, thoughts, feelings, and behaviors around cocaine and substance use and teach effective, healthy coping skills.^9,10 Therapy can be delivered individually (a patient meets 1:1 with a therapist) and in a group format (several different patients attend a group with a therapist at the same time).^{9, 11}

Although pharmacological treatments (medications) may be used in the treatment of some substance use disorders and may be employed when a person has additional co-occurring mental health disorders, there are currently no FDA-approved medications used specifically to treat stimulant use disorder.⁹

Treatment for stimulant and other substance use disorders can occur in various settings, such as inpatient programs, residential programs, and outpatient programs. The available treatments may include behavioral therapies and treating and addressing co-occurring conditions like depression. Certain settings may work better for different people and situations.

Find Help for Cocaine Addiction

If you are concerned about your cocaine use or that of a loved one, or you or someone you know is experiencing cocaine withdrawal, help and treatment are available. American Addiction Centers (AAC) is a leading treatment provider and has trusted rehab facilities across the country. You can use our treatment directory to find a substance use disorder treatment facility near you and/or verify your health insurance coverage on our website if you have medical insurance. Please call American Addiction Centers (AAC) free at at any time, day or night.