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Cocaine Withdrawal

Cocaine is a powerful, highly addictive illegal stimulant drug that can cause a range of adverse health effects.1 When used repeatedly, cocaine can cause long-term changes in the brain that can contribute to the development of cocaine addiction.1 A person can also be at risk of developing cocaine dependence which can cause withdrawal if the drug is abruptly reduced or stopped.

Stimulant withdrawal typically results in less severe symptoms than those associated with alcohol, opioid, and sedative dependence.2 However, due to potential complications and risks, a person may still benefit from or require closer medical attention as they undergo cocaine withdrawal.2

This article will help you understand:

  • What causes cocaine withdrawal.
  • The symptoms of cocaine withdrawal.
  • How long cocaine withdrawal lasts.
  • Cocaine withdrawal treatment options.

What Causes Cocaine Withdrawal?

A person who regularly uses cocaine and abruptly stops or cuts back their use of the drug may experience cocaine withdrawal.3 This typically happens when a person is dependent on cocaine, which occurs due to chronic, and typically high dose, cocaine use.

Dependence is a physiological adaptation of the body to a substance, wherein the body becomes so used to the drug being present in the system that when the individual cuts back on their use or quits, withdrawal symptoms emerge. With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms.

Chronic cocaine use can result in adaptations in the reward circuit and other areas of the brain, including areas associated with stress.1 Cocaine causes a buildup of the neurotransmitter dopamine, which is associated with feelings of euphoria, pleasure, and reward.1 This buildup of dopamine is what makes a person experience the “high,” or intense pleasurable effects associated with cocaine use.1, 6

Cocaine’s effects do not last long and typically subside after a few minutes to 1 hour depending on the method of use (e.g., smoking, snorting).7 This is one reason why people sometimes use cocaine in binges. When the high subsides, a person may use more cocaine to continue feeling the pleasurable effects and to avoid withdrawal symptoms.3, 7 With repeated use, the brain adapts to the presence of increased levels of dopamine. As a result, a person needs to take increasing doses to experience previous effects (known as tolerance), and to prevent withdrawal. This reinforces cocaine use and can fuel the cycle of addiction.5, 7

Symptoms of Cocaine Withdrawal

Signs of cocaine withdrawal can include:2, 3

  • Depression.
  • Hypersomnia (excessive sleepiness) or insomnia.
  • Fatigue.
  • Agitation.
  • Paranoia.
  • Poor concentration.
  • Psychomotor retardation (slowed mental or physical activities).
  • Increased appetite.
  • Drug cravings.
  • Vivid or unpleasant dreams.

Withdrawal from cocaine isn’t typically considered to be life-threatening or medically dangerous, however, there are potential complications a person should be aware of, including cardiovascular issues (e.g., irregular heartbeat, heart attack) and seizures.2

Mental health concerns are another potential complication but are often overlooked. Withdrawal from cocaine can be very distressing, and, in certain cases, lead to severe psychiatric concerns, such as profound depression or suicidal ideation.2

The severity of withdrawal can vary from person to person and is based on multiple factors, including the amount of cocaine a person normally uses and how often they use it.8 Generally, cocaine withdrawal symptoms are less severe than those associated with other substances such as alcohol and opioids, but withdrawal experiences can vary, and may in some cases require close medical attention.2

How Long Does Cocaine Withdrawal Last?

The cocaine withdrawal timeline can vary. Acute withdrawal symptoms typically appear within a few hours of a person’s last use and tend to subside after several days of abstinence, but symptoms can persist for 3 to 4 weeks.2, 3

However, people who struggle with stimulant abuse or addiction often have difficulty maintaining abstinence, so persistent withdrawal symptoms can be a feature of active addiction, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).2

Postacute withdrawal involves symptoms that may last 2 or more weeks after a person’s last use.8 It can be accompanied by increased appetite, fatigue, mood changes, and strong cravings that may cause a person to binge or return to their previous level of use.8

Some people may also experience protracted withdrawal. This can involve ongoing withdrawal symptoms, such as fatigue, anxiety, severe depression, and cravings—which can reemerge or be stronger in some cases—that may persist for months.8 The duration and severity of protracted withdrawal are usually correlated with the duration and severity of a person’s previous cocaine use.8

Additionally, after 3 to 6 months of abstinence, some people may experience depression, which can be associated with a high likelihood of resuming cocaine use.8

Cocaine Withdrawal Treatment

Unlike withdrawal from other substances like alcohol and opioids, symptoms of stimulant withdrawal aren’t typically treated aggressively with medications as there are no FDA medications approved for cocaine withdrawal.2

However, because cocaine withdrawal symptoms can be distressing or lead to certain complications, symptoms can often be managed through detox interventions.2 SAMHSA indicates that acute treatment programs (detox) may treat patients for 3 to 10 days for observation during the initial withdrawal period as the body returns to a state of homeostasis, the body’s natural ability to maintain critical functions (e.g., blood glucose levels and temperature).8

Detox involves a set of interventions designed to alleviate withdrawal symptoms, help a person achieve a medically stable and substance-free state, clear the body of toxins caused by the substance, and allow for the transition into ongoing treatment.2

Although no medications have been developed for stimulant withdrawal, people may receive medications for symptomatic relief of specific complaints, such as headache and insomnia, as a part of a withdrawal management program.2

Promising research has been conducted on the potential benefits of some medications to reduce certain symptoms of cocaine withdrawal, but many of these studies have been small or have only been conducted on animal models.9

Detox can be an important part of treatment for many people, but it is not intended as a substitute for more comprehensive addiction rehabilitation.2 It is often the first step in the recovery process that can help prepare a person for ongoing treatment, such as inpatient or outpatient rehab.2 Rehab can help a person address the behavioral, psychological, and social factors related to addiction.2

Getting Help

If you or a loved one are struggling with cocaine use or addiction, you should know that professional detox and cocaine addiction treatment is available and can help you take back control of your life.

If you are ready to learn more about addiction treatment, American Addiction Centers (AAC) is ready to help. AAC is a leading provider of evidence-based addiction treatment with facilities across the U.S. You can call our free, confidential helpline at for more information about rehab, and easily verify your insurance by filling out the form below.

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