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The Dangers of Cocaine Withdrawal

by Landmark Recovery

October 30, 2019

Updated: August 3, 2023, at 10:08 a.m.

You might have heard that cocaine withdrawal is nowhere near as intense as withdrawal from other drugs, but is that true? We’ll be exploring the specific dangers of cocaine withdrawal today. If you feel you or a loved one might be using cocaine to the point of abuse, it pays to be aware of what lies ahead down that road to recovery.

Discontinuing use is the first step in an ongoing journey, but we’re getting ahead of ourselves here. What is cocaine, and what effects can you expect when you take the drug?

What Is Cocaine and What Happens When You Take It?

Cocaine is a potent central nervous system stimulant extracted from the leaves of the coca plant which grows throughout South America. When cocaine reaches the brain, it interferes with your brain’s ability to process chemicals associated with mood and energy levels. With this chemical imbalance forced, the pleasure center in the brain is stimulated to create feelings of euphoria and energy.

Cocaine also impacts the proper response to dopamine receptors. This is what makes the drug so addictive. It’s very easy for tolerance to build and for use to slide into abuse. Dependence sets in then withdrawal is almost inevitable.

The drug is normally snorted but can also be ingested orally. This is especially damaging and can cause serious bowel complications. Less frequently, cocaine is injected intravenously. Cocaine in the form of crack is smoked. For the purposes of today’s glimpse at cocaine withdrawal, we’ll be assuming the regular intra-nasal delivery method.

While snorting cocaine might not have the immediacy of injecting or freebasing, the onset of effects is nevertheless swift. The drug hits your brain within minutes and you’ll experience an exhilarating rush accompanied by a surge of energy. With crack, those effects are apparent in 10 seconds flat.

The stimulating effects will make you feel highly excitable and fidgety while you might notice a feeling of calm and invulnerability. This rash confidence can lead to reckless behavior like drink or drug driving and even criminal activity.

Although the effects of cocaine come on quickly, the high is fleeting. The euphoria induced by powdered cocaine wear off in a couple of hours at most. With crack cocaine, the effects are gone within as little as 20 minutes. As this high subsides, you’ll feel a strong urge to recapture that initial soaring feeling. This is in large part what leads to abuse and, ultimately, dependence.

There are around 5 million cocaine users in the US so it’s not surprising that so many people end up becoming addicted to this alluring but intensely damaging substance.

Whether it’s the crash after the effects of the drug have worn off or cocaine levels in the body of a heavy user dropping after a binge, the backlash can be severe. As the brain struggles badly to adapt to the absence of cocaine, fatigue, and irritability set in. Sleep disturbance is standard and there will likely be strong cravings for the drug.

We’ll look now at the short-term and long-term effects of taking cocaine before we push on to examine the complications involved with withdrawal.

Short-Term Effects of Cocaine

As a stimulant, cocaine speeds up thinking, speech and movement. Even if you think you’re concealing this, others will often notice this heightened state of overall arousal.

Other signs of cocaine use include:

  • Changes in sleeping patterns
  • Decreased appetite
  • Elevated confidence
  • Enlarged or dilated pupils
  • Excessive enthusiasm
  • Grandiosity
  • Hypersensitivity to sight, sound, and touch
  • Irritability
  • Impotence in males
  • Lowered inhibitions
  • Mood swings
  • Nausea
  • Nosebleeds
  • Paranoia
  • Risky behaviors
  • Runny nose
  • Talkativeness
  • Tics

What happens when casual use becomes less recreational and more habitual? Well, unfortunately, cocaine is a remarkably damaging drug with a range of unpleasant long-term effects. We’ll touch on those right now before addressing the issue of cocaine withdrawal.

Long-Term Effects of Cocaine

Cocaine impacts practically every part of the body.

Using the drug regularly means you’re at heightened risk of a range of serious health issues.

Long-term effects of using cocaine can include:

  • Headaches
  • Movement disorders mirroring the effects of Parkinson’s disease
  • Reproductive problems and infertility
  • Severe weight loss leading to malnourishment
  • Sexual dysfunction

Sadly, most of the havoc wreaked by cocaine remains invisible. Heavy cocaine use can cause irregular heartbeats and a general thickening of the heart muscle. Using the drug to excess increases your chance of heart attack.

Cocaine can also trigger spikes in blood pressure to the extent that blood vessels in the brain are ruptured. This is known as hemorrhagic stroke. It can also lead to aortic dissection where the aorta itself is torn. Either of these conditions can be fatal.

The lining of the nose becomes inflamed and damaged. This can lead to a perforated septum requiring reconstructive surgery.

With chronic cocaine use, the gastrointestinal tract suffers. Cocaine constricts the blood vessels and, with blood supply to the intestines impaired, the bowel can rupture or even die. Again, this can be deadly.

How, then, can you determine when cocaine use spirals into abuse, dependence, and addiction?

Signs of Cocaine Abuse and Addiction

One of the most blatant red flags for anyone with a substance abuse problem is secretive behavior. Many people struggling under the burden of a cocaine habit attempt to hide their usage from others.

When use becomes more habitual to the point of dependence, it’s easy for your whole life to revolve around getting, using, and coming down from cocaine. It’s commonplace by this stage to neglect friends and to lose interest in normal activities. The drug becomes all-consuming.

Other signs of cocaine abuse and dependence include:

  • Financial problems
  • Inability to stop using the drug
  • Obsessive thoughts about the drug
  • Ravaged physical appearance
  • Relationship problems
  • Risk-taking behavior
  • Unsuccessful attempts to stop using the drug

Using cocaine to the extent that physical tolerance builds means that more and more of the drug is required to achieve the desired effect.

What about those withdrawal effects, though? What can you expect if you attempt to stop using cocaine?

Symptoms of Cocaine Withdrawal

To kick off, this is a snapshot of just some of the symptoms associated with cocaine withdrawal:

  • Agitation
  • Chills and tremors
  • Cravings for cocaine
  • Depression
  • Diminished sexual desire
  • Extreme sleepiness
  • Generalized discomfort
  • Headaches
  • Hostility
  • Impaired concentration
  • Inability to feel pleasure or joy
  • Increased appetite
  • Irritability
  • Lack of motivation
  • Mental and physical exhaustion
  • Muscle ache
  • Paranoia
  • Slowed activity
  • Suicidal thoughts
  • Vivid, troubling dreams

With that troubling list of symptoms in place, how does withdrawal occur?

The 3 Phases of Cocaine Withdrawal

While many variables impact the severity of withdrawal symptoms, discontinuing use of the drug can be categorized by 3 distinct phases:

  1. The Crash
  2. Continued Withdrawal
  3. Extinction

1) The Crash

Anywhere from a few hours to a few days after last using cocaine, the crash phase begins.

Characterized by crushing depression, crippling exhaustion and debilitating fatigue, it’s not uncommon to experience suicidal thoughts at this stage.

2) Continued Withdrawal

Following the initial slump, mood and overall functioning start to improve. At this point, anhedonia often kicks in. This is a condition where you’ll be unable to feel pleasure or joy.

Boredom, irritation, and intense cravings for cocaine dominate.

This extended phase lasts anything from 1 to 10 weeks and it’s here the chance of relapse is highest.

Making it out of this knotty phase of continued withdrawal is the start of recovery proper.

3) Extinction

Aside from persistent and acute mood swings and intermittent cravings over the following 6 months, the worst is behind you at this point.

We’ll double down now on what to expect over those few months it takes to withdraw completely from cocaine.

Cocaine Withdrawal: Timeline

For most users, the most severe withdrawal symptoms last no more than a couple of weeks. This depends, though, on how long and how heavily you’ve used cocaine for along with other variables.

If you’ve only developed a mild to moderate pattern of using the drug, withdrawal symptoms can be gone in as little as 18 hours. For heavier uses, this period extends from 2 to 4 days.

Most of the symptoms of acute withdrawal will be resolved in 10 days or so. It’s the cravings and depression that tend to linger over a period of months.

Withdrawal symptoms will be worse if:

  • You’ve used the drug over a lengthy period
  • You have been taking large quantities of cocaine
  • You are or have been using other drugs along with cocaine
  • You remain in a stressful environment. This might trigger cravings leading to relapse
  • You are suffering from a co-occurring disorder, whether related to a medical or mental health condition

Now you now what to expect from withdrawal, what treatment is available to ease your early road to recovery?

Treatment for Cocaine Withdrawal

Cocaine withdrawal is not normally life-threatening and there’s usually no need for medical treatment. There are many variables at play here, though. It’s entirely possible medically supervised detox will be required if you’ve developed a heavy dependence on the drug. Medical detox is also recommended if you’ve relapsed during a previous withdrawal attempt.

With 24% of all ER visits by those seeking either detox or treatment for substance abuse in 2011 involving cocaine use according to SAMHSA (the Substance Abuse and Mental Health Services Administration, many people do seek out professional assistance when it’s time to put the coke spoon away.

Specialized cocaine addiction treatment will not only help you through detox and withdrawal but will provide you with the coping strategies and behavioral tools you need to leave the cycle of addiction in your wake.

Unlike other drugs like opioids, there are not any FDA-approved medications specifically designed to counter cocaine withdrawal.

Some animal studies have shown that naltrexone and buprenorphine might offer some relief for cocaine withdrawal. Findings are still at the preliminary stages, though.

Studies at the University of Wisconsin-Milwaukee have shown propranolol, a blood pressure medication, might help to reduce cravings.

Amantadine, an antiviral medication, might be “an effective treatment” if you’re suffering from “severe cocaine withdrawal symptoms” according to a study recently published in the American Journal of Psychiatry.

Beyond these promising options, medication typically used to treat anxiety and depression could come in useful for stabilizing mood and lowering depression when cocaine withdrawal symptoms extend beyond a week.

Assuming you manage to stop using cocaine and negotiate these withdrawal symptoms without relapsing, what’s next?

After Withdrawal: What Happens Next?

Although you could feasibly stop using cocaine and then never find yourself tempted to use the drug again, this is unlikely.

At minimum, a few weeks of therapy should be considered to help you learn to cope with cravings.

Depending on the extent of your problem, you might very well find that a residential rehab program would pay dividends. How can you make that happen?

What To Do Next

What should do if you or one of your loved ones is using cocaine to the extent it’s damaging your life and you’d like to clean up?

Don’t hesitate to get in touch with us here at Landmark Recovery so you can determine whether you need detox and residential rehab in order to kickstart recovery safely. If so, we’ll be delighted to discuss your options with you and how you can join one of our drug and alcohol rehab programs.

Even if you feel you could stop using the drug without outside assistance, don’t underestimate cocaine withdrawal symptoms and don’t hesitate to reach out if you’d like any guidance.

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About the Author

Landmark Recovery

Landmark Recovery

Landmark Recovery was founded with a determination to make addiction treatment accessible for all. Through our integrated treatment programs, we've helped thousands of people choose recovery over addiction and get back to life on their own terms. We're on a mission to save one million lives over the next century. We encourage all those struggling with substance use to seek professional help.