Cocaine (coke) is a powerful, mostly illicit stimulant drug that when abused, can cause widespread devastation in the life of the user. While coke withdrawal may not be as intense as withdrawal from other drugs, such as heroin, it can come with its own set of unique challenges.
Moreover, withdrawal from some substances, such as alcohol and benzodiazepines, can induce severe physical symptoms. Coke withdrawal, however, result in mostly psychological symptoms.
include the following:
- Poor concentration and foggy thinking
- Slowed activity and physical fatigue
- Exhaustion
- Restlessness
- Inability to experience sexual arousal (reduced libido)
- Anhedonia, or the inability to experience pleasure
- Depression, anxiety, suicidal ideations
- Unpleasant and vivid dreams
- Physical symptoms including chills, tremors, muscle aches, and nerve pain
- Drug cravings
When is Medical Detox Beneficial?
While a detox from cocaine may be undertaken as an outpatient, inpatient medical detox is recommended in some circumstances. For example, if there have been multiple attempts to detox and the person subsequently relapsed, the around-the-clock supervision provided by an inpatient medical detox can be invaluable.
Also, if a person suffers from a co-existing mental health condition, such as depression or anxiety, a medical detox followed by integrated inpatient addiction treatment can address both withdrawal management and mental health needs.
One of the more severe withdrawal effects that can result from acute coke withdrawal is an increased risk of suicidal thoughts and behaviors. People who try to stop using cocaine after long-term abuse or addiction has developed can experience severe depression and wild mood swings, including thoughts of suicide.
With chronic, routine cocaine use, the brain grows accustomed to an abnormal amount of dopamine. Over time, the reward circuit is interrupted and becomes less sensitive to dopamine – this is called tolerance. At this point, the person needs increasing amounts of cocaine to feel the desired effects – without it, they may feel deeply depressed and discontented with life.
If a person has a history of depression or suicidal ideations, medical detox is often recommended to ensure the patient is safe and protected during the withdrawal process.
Withdrawal Timeline
Most of the symptoms of acute coke withdrawal should resolve after about 7-10 days. However, like with many psychoactive substances, cravings for cocaine may continue for much longer and could spontaneously reemerge, months or years after the person achieves abstinence.
Cocaine has a fairly short half-life, and among people with a severe dependence, withdrawal symptoms can onset as soon as 90 minutes after the last use.
The timeline for withdrawal symptoms will vary somewhat depending on the individual and factors such as the following:
Duration of Use and Average Dose
People who have abused cocaine for a relatively short period are less likely to have prolonged, intense withdrawal symptoms. People who have used cocaine for many years, however, may suffer from lingering withdrawal symptoms that persist for weeks.
Also, those who have used very large doses may suffer more intense withdrawal symptoms than someone who typically used lower amounts.
Polysubstance Dependence and Co-occurring Mental Health Conditions
A person who has developed a dependence to more than one substance may encounter withdrawal symptoms associated with both, potentially complicating the progression of withdrawal symptoms and adversely intensifying the experience of the person undergoing detox.
Also, people who abuse substances commonly suffer from one or more co-occurring mental or physical health conditions such as depression, anxiety, an eating disorder, or cardiovascular disease. Similar to polydrug abuse, these additional conditions may also complicate the coke withdrawal process.
Environment
If coke was used to escape from a stressful or traumatic environment, stress might trigger the desire to use again. Therefore, environmental factors that cause stress, such as relationship issues, work challenges, or other factors may intensify cravings for cocaine, and complicate the withdrawal process.
Treatment for Coke Withdrawal
Unlike some substances, such as opioids and alcohol, there are currently no medications approved by the FDA for the treatment of coke withdrawal. However, some medications may help people lessen both acute and long-term withdrawal symptoms.
For example, pharmaceuticals used to treat depression and anxiety could be beneficial to those undergoing cocaine withdrawal, as they work well to stabilize moods and prevent worse outcomes. These could be especially helpful for people whose withdrawal symptoms persist longer than a week.
After detox, patients are highly encouraged to undergo intensive addiction treatment in either a partial hospitalization or outpatient program and take advantage of comprehensive, evidence-based treatments such as behavioral therapy, counseling, group support, and education. Research has shown that programs that meet these conditions result in the best outcomes for those seeking to overcome addiction.
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