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What Is the Process of Cocaine Withdrawal?

While the National Institute on Drug Abuse (NIDA) states that cocaine use has generally decreased since the 1990s, the past few years have seen a renewed increase in cocaine-related overdose deaths. Nearly 2 million people in the US use cocaine in a given month, according to the National Survey on Drug Use and Health from 2015, with nearly 900,000 people 12 and older exhibiting symptoms of a substance use disorder involving cocaine.

While these statistics may be frightening to some people, there is still a great deal of hesitation to quit using the drug, mostly due to fears regarding the discomforts and risks of the withdrawal process. It is important to note that, while the withdrawal process from cocaine can be extremely uncomfortable and cravings can create a high risk of relapse to cocaine use, it is highly unlikely that an individual will die due to the withdrawal process. In general, cocaine withdrawal is not considered dangerous. In fact, it is more likely that continued use will lead to an overdose, or to cardiac or other physical issues that may lead to death. Given these facts, quitting cocaine use is certainly the safer option.

Cocaine Withdrawal Process

Still, concerns about the withdrawal process may remain. However, by learning more about the process, being prepared, and getting professional substance abuse treatment, the withdrawal process can be eased and the individual can move forward in recovery.

1. Deciding to quit cocaine

The first major step in the process of cocaine withdrawal is really making the decision to quit. This can be challenging due to the highly addictive nature of this drug. In many cases, the decision is made based on the effect that the drug use has on the individual and loved ones. However, the simple fact of the pleasure derived from cocaine use can derail the best intentions because of the drug’s effects on the body and brain.

A report from NIDA, based on a variety of research, demonstrates that addiction to the drug is reinforced by the ways in which the drug changes the brain. These changes, which involve the pleasure centers of the brain and the body’s stress hormones, can drive the body to strongly crave continued use of the drug. In addition, the changes can affect the person’s decision-making abilities. These issues add up to a lack of control over the ability to stop using.

When this is the case, it is important to get help. Professional substance abuse treatment programs have the expertise needed to help the individual gain control over the use of cocaine. With professional help, it is possible to take the first step and stop using the drug.

2. The Crash Stage

Just about everyone who has used cocaine has experienced the symptoms of the crash stage. The same basic symptoms can begin to occur between highs if the individual isn’t continually using. When a person stops using cocaine, this stage begins fairly immediately after the high ends. According to Medline Plus, the symptoms include:

  • Extreme cravings for the drug
  • Sleepiness and fatigue
  • Anhedonia (an inability to feel pleasure)
  • Anxiety and irritability
  • Paranoia and edginess

According to Mental Health Daily, while cocaine itself only takes a few hours to be eliminated from the body, its active metabolite – that is, a product of cocaine use that continues to have an effect on the person – stays in the body for a couple days. These early symptoms generally last that long.


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3. The Withdrawal Stage

Continued abstinence from cocaine following the crash will lead to an increase in withdrawal symptoms, which include:

  • Continued cravings
  • Anhedonia and depression
  • Changes in appetite
  • General feelings of unease
  • Altered sleep patterns and bad dreams
  • Lethargy

According to the Australian Department of Health, this main withdrawal stage can take as long as 10 weeks, with a steady increase and peak in symptoms occurring within that time. While the highest risk of relapse occurs during the crash stage, the risk is still extremely high during this withdrawal phase.

Having treatment support for withdrawal can help in a few ways. First, medically supported detox can ease some of the symptoms, with oversight from a professional. In addition, formal treatment can make sure that the person doesn’t give in to cravings and relapse, which can be a bigger danger at this point. During withdrawal, the body begins to lose the tolerance that it may have developed for high doses of cocaine. If the person begins using at those previous doses, the risk of overdose is higher due to that loss of tolerance.

4. The Extinction Stage

The extinction stage is almost exactly what it sounds like: Once withdrawal is complete, cravings to use the drug begin to diminish until, hopefully, they disappear entirely. It can take up to a full six months after stopping use of cocaine for extinction to occur. For this reason, it’s important to keep up with substance abuse treatment during this time.

As described by Mental Health Daily, cravings during the extinction stage are less severe than during the earlier stages. When they arise, it is mostly in response to triggers, such as being around people whom the individual used to use with, or experiencing other environmental cues, such as stress, that used to result in the person bingeing on cocaine. Treatment, particularly Cognitive Behavioral Therapy, can help the person learn to manage those triggers, making it less likely that the person will relapse in response to resulting cravings.

Getting involved in activities that have nothing to do with triggers can help during this stage. Potential activities include:

  • Spending time with people who are not using drugs
  • Taking up a sport or engaging in regular exercise
  • Acquiring and enjoying a hobby
  • Eating well, drinking lots of water, and taking care of the body

Being healthy and participating in enjoyable events can distract from occasional cravings or even prevent them from happening.

5. Treatment and Recovery

Continued treatment or involvement in addiction support groups can make a real difference once withdrawal from cocaine is completed. Sometimes, people will continue to get cravings even years after the extinction phase, depending on the extent of cocaine use and other personal factors. Some people never really experience a complete extinction of cravings. Because of this, continuing to work with treatment professionals and peer support groups can make the difference between staying productive and sober, and returning to dangerous cocaine use.

Finding the right treatment center can help immensely. Organizations and professionals who use research-based treatments, including peer support and cognitive therapy, are more likely to be successful in helping the person stop using and move forward in recovery. Because they can also provide support throughout the withdrawal process, decreasing both discomfort and risk, professional treatment programs show the most promise for stopping cocaine use and living a productive life free of the drug.