Cocaine withdrawal: symptoms, timeline and treatment

Understanding cocaine withdrawal and what you should do if you’re experiencing symptoms.

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Page clinically reviewed by Dee Johnson (Mbacp, MNCS), Addiction Therapist at Priory Hospital Chelmsford in August 2023.

Cocaine is a potent stimulant drug that’s typically snorted as a white powder. Its potency means that cocaine withdrawal can be unpleasant and sometimes dangerous. Withdrawal can lead to intense cravings and various physical and psychological symptoms that need to be carefully managed in a medical setting.

This article will explore cocaine withdrawal in more detail, ranging from what causes cocaine withdrawal, the symptoms you might experience, and what treatments are available for those experiencing cocaine withdrawal.

Cocaine withdrawal symptoms

The symptoms of cocaine withdrawal can overlap with many signs of cocaine addiction, ranging from subtle mood shifts to severe physical discomfort:

  • Fatigue: you might feel drained and exhausted when coming off cocaine, contrasting with the heightened energy you will have experienced when the drug was in your system
  • Sleep disturbances: insomnia (an inability to achieve good quality sleep) or hypersomnia (excessive sleepiness during waking hours) can be common, affecting your body's natural circadian rhythm
  • Increased appetite: after periods of suppressed appetite while on cocaine, you might experience intense hunger during withdrawal
  • Motor-related symptoms: this can include tremors or slowed movements
  • Depression: without the dopamine highs of cocaine, you might feel a profound sense of sadness or hopelessness
  • Anxiety: intense worry or panic attacks can occur during withdrawal
  • Vivid and unpleasant dreams: these can disrupt sleep and increase feelings of anxiety
  • Difficulty concentrating: tasks that were once easy may now seem challenging
  • Impaired decision-making: withdrawal symptoms can be unpleasant and uncomfortable, which might mean that you make poor choices and end up exacerbating the addiction cycle
  • Suicidal thoughts: in severe cases, the emotional and physical toll of cocaine withdrawal can lead to suicidal ideation. In these instances, it’s crucial that you seek immediate medical attention

What causes cocaine withdrawal?

Cocaine withdrawal, or withdrawal from any powerful drug, happens because of the way the drug interacts with the brain. Cocaine causes you to experience intense euphoria, due to the neurotransmitter, dopamine, (which is also known as the ‘happy chemical’) being sent to your brain. This initial high will usually last around 1-2 hours (although this will be shorter if you’ve taken crack cocaine). The high will then be followed by a ‘crash’ as the effects of the cocaine begin to wear off.

With continued use, your brain will start to rely on cocaine to produce these elevated dopamine levels. Your brain will produce less dopamine naturally, therefore increasing your reliance on the drug. When you stop using cocaine, the reduced dopamine levels result in what’s known as a ‘deficiency state’. This causes your brain and body to crave the lost stimulus (in this case, cocaine and the resulting dopamine hit), thus leading to withdrawal symptoms.

This is what causes a cycle of dependency, leading to cocaine addiction. The more you use cocaine, the more your brain will become accustomed to its effects. And when it's suddenly taken away, your body will respond with a range of physical and psychological symptoms.

How long does cocaine withdrawal last?

The timeline of cocaine withdrawal is often broken down into phases. The initial 'crash' can last for several days following the last use. This phase usually causes  feelings of depression, agitation and intense cravings.

Following this, you may enter an extended withdrawal phase, which can last for days or even weeks as cocaine remains in your system. Symptoms during this period might be less intense, but can come and go. For some individuals, certain symptoms, especially cravings or mood disturbances, can persist for a significant amount of time.

It's worth noting that everyone is different. Some people might have withdrawal symptoms for a shorter amount of time, while others might feel them more intensely and for longer. The severity and duration of withdrawal can also be influenced by various factors, such as the amount and frequency of your cocaine use, how long you have been addicted to cocaine, the method you’ve been using to take cocaine, and individual physiological factors.

Cocaine withdrawal treatment

Treating cocaine withdrawal is initially about managing uncomfortable and potentially dangerous withdrawal symptoms, before then looking to address any underlying causes of addiction and ensuring long-term recovery. Effective treatments include:

Detoxification

This first step, supervised by medical professionals, ensures that cocaine is safely removed from your body. It can last for several days to weeks, depending on the severity of your addiction. In most cases, the medically assisted detox process lasts between 7 to 10 days.

A drug detox should only take place under medical supervision, in a safe environment. Withdrawal symptoms are potentially dangerous to your long-term health, which is why you shouldn’t attempt this alone. A detox aims to remove all traces of cocaine from your system while managing your physical and mental health. This sometimes involves using carefully controlled medication to ease your symptoms and allow you to get plenty of sleep – aiding in your recovery.

Therapy

You’ll usually be able to commence with addiction therapy as soon as you are physically able to do so, following detox.

Therapies, such as cognitive behavioural therapy (CBT), are effective at treating the underlying causes of cocaine addiction. Therapy helps individuals identify triggers and learn coping mechanisms so they can maintain sobriety in the long-term.

Therapy can take place on a one-to-one basis or as part of a group. Group therapy allows for those in recovery to meet peers to discuss their experiences and support one another. Many therapies are informed by the 12-Step programme for addiction recovery, where you are encouraged to share your progress with peers, receive constructive feedback and develop insight and awareness.

Medications

Medication might also be prescribed to someone in recovery for cocaine addiction. The aim of medication in the treatment of drug addiction is to reduce potentially harmful withdrawal symptoms, allowing you to fully focus on your long-term recovery without the urge to take cocaine again. 
For example, antidepressants can help manage depressive symptoms that may have been caused by withdrawal or a co-existing mental health problem.

Aftercare

Recovery from addiction is a lifelong endeavour. Aftercare programmes, or secondary care, continue to support people after their initial treatment, keeping in place that valuable support network of peers and clinicians that can help reinforce abstinence in the long-term.

Treatment for cocaine withdrawal and addiction with Priory

Led by a world class team of consultant psychiatrists, psychologists, therapists and other medical professionals, Priory offers world-class treatment for cocaine addiction at a network of UK hospitals and wellbeing centres. Use the information below to contact us and begin your recovery journey.

Contact us to make an enquiry or for more information

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