Medication for Cocaine Addiction and Withdrawal
If you are struggling with cocaine addiction, you are not alone. In 2020, approximately 1.3 million people in the United States had a past-year cocaine use disorder.1 Cocaine is highly addictive and relapse is common, with almost 25% of people relapsing within a year of treatment.2 Fortunately, medication therapy for cocaine addiction allows patients to get through the most challenging aspects of withdrawal more easily to begin rebuilding their life.
How Cocaine Affects the Brain
The reason that cocaine addiction is so difficult to overcome lies in how cocaine interacts with the neurons in the brain. Inside the brain is a pathway called the mesolimbic dopamine system. This pathway is stimulated by rewarding stimuli, such as drugs, that interact with dopamine. The pathway starts in the midbrain section and helps regulate emotions and motivation. When dopamine is released after something pleasurable (such as eating food), it binds to specialized proteins called dopamine receptors. This makes dopamine into a sort of chemical messenger.3
Using cocaine interferes with the normal communication of dopamine in the brain. Cocaine binds to dopamine transporters and blocks the removal of dopamine from the synapse. The result is that dopamine accumulates at the synapse site and produces an amplified signal to the surrounding neurons. That’s why most users experience a feeling of euphoria and pleasure after using cocaine.3
The release of dopamine acts as a reward for the brain, sending signals for both upbeat energy and feelings of intense pleasure. With continued use, the brain’s reward system cannot function with cocaine as its stimulus. People need to take more of the drug to feel the sensations first experienced. The loss of pleasure is a condition called anhedonia and it is one of the most challenging aspects of cocaine withdrawal for many. Most research suggests that anhedonia is the driving force for relapse, as those in recovery may feel there is little joy in life.4
Side Effects of Cocaine Withdrawal
The National Institutes of Health reports that people almost immediately experience an emotional crash after a cocaine binge.5 Cravings can last for months after giving up the drug. There are some side effects that make it hard to tackle a cocaine addiction. These may include:
- Inability to handle stressful situations.
- Increased appetite.
- Lack of energy (both mental and physical).
- Muscle tremors.
- Nervousness and agitation.
Hope on the Horizon
The goal of medication therapy to treat cocaine addiction isn’t what people might think. Medication isn’t used to make cravings go away or eliminate withdrawal symptoms. Instead, medication will help patients get through the most challenging aspects of withdrawal to begin rebuilding their life.
When trying to overcome cocaine addiction, a multi-tiered approach increases the chances of success. There’s no one approach that will help successfully overcome an addiction. Because cocaine withdrawal can cause intense emotional and physical discomfort, detoxing under the care and supervision of trained medical staff is usually the least painful approach.
Currently, there are no FDA-approved medications to treat cocaine addiction, but there are some medications that are useful in offsetting the symptoms of cocaine withdrawal. Of course, these medications come with some side effects, and should always be used in combination with therapy.
Types of Medication Prescribed
Medically supervised recovery programs consider the patient’s health history, age, and physical condition. Additionally, an intake specialist will consider any life stressors that might make it difficult to overcome cocaine addiction.
Many of the medications used in top cocaine inpatient addiction treatment rehabs help to calm the central nervous system. Using cocaine over a long period of time can affect the brain’s natural production of neurotransmitters—the chemical messengers that generate certain feelings or responses. If you’re having trouble with anxiety and agitation, a doctor may prescribe medication that triggers the release of neurotransmitters that make you feel relaxed, like GABA and dopamine.
Some medications may be prescribed only during the detoxification period when the body is adjusting to the absence of cocaine. Other medications may be recommended on a long-term basis to help avoid a relapse in the months ahead. Many of the medications that are currently prescribed for cocaine addiction are also used to treat other conditions. These include the following:
- Modafinil: May prevent the fatigue and drowsiness associated with cocaine withdrawal by promoting healthy nighttime sleep and encouraging dopamine production.
- Topiramate: An anticonvulsant drug that may ease agitation during recovery by reducing activity in the central nervous system
- Vigabatrin: An anti-epileptic medication that may reduce cocaine cravings by increasing the production of GABA.
- Gabapentin: This drug helps to restore feelings of wellbeing by promoting the release of the neurotransmitter GABA.
- Baclofen: In cocaine recovery, Baclofen may be used to increase the release of GABA.
One of the most promising medications available is disulfiram. This medication has been used for years to treat alcohol addiction. Emerging research suggests it might help prevent cocaine relapse in the same way it prevents alcohol relapse through the processing of dopamine in the brain.6
What Are the Drawbacks of Medication Therapy for Cocaine?
Because there isn’t one specific medication that can be used to treat cocaine addiction, some medications come with side effects. Generally, these side effects are mildly unpleasant but, in some instances, can be life-threatening.
Some medications can cause dizziness, nausea, and drowsiness. However, everyone responds to medications differently. One of the reasons it’s so important to have an assisted detox from cocaine is so your situation can be monitored and evaluated.
One of the most important things to do is to follow the orders of the treatment team. For many who enter addiction recovery, life is chaotic and unorganized. Beginning on a medication regimen is taking the first step toward restructuring a person’s life. Medication can make recovery easier to tolerate, but don’t confuse that with a false sense of security.
It’s important not to assume that pharmacological treatment is the only therapy needed to beat cocaine addiction. While pharmacotherapy may make it easier for to deal with detox, medication is only one aspect of a comprehensive recovery plan.
The Future of Cocaine Treatment
Research into the field of cocaine treatment is progressive and ongoing. There are many areas of research that the scientific community is exploring. Some of that research includes:7,8
Medications that reduce cocaine cravings and lower relapse risk by modifying the brain’s production and utilization of neurotransmitters.
- New emergency medical interventions for cocaine overdose.
- Pharmaceutical therapies to help people in cocaine recovery respond to stress and other emotional factors that can trigger a relapse.
- Vaccines that block the passage of cocaine from the bloodstream to the brain.
- Through careful research, it’s possible that the scientific community might eventually discover a medication that will help offset the many challenges of cocaine addiction.
What Else Can Be Done to Succeed at Recovery?
A patient is at a greater risk for relapse if they are not receiving a combination of medication with intensive counseling. Along with that, treatment should include behavior modification to help address the causes of cocaine use. Understanding personal triggers will make success more likely.
The reality is that an individual who is addicted to cocaine is going to have to face some hard truths—namely, the state of relationships not just with family and friends but colleagues as well. That means a lot of support will be needed from many different sources to help aid and assist in recovery.
Medication to help treat addiction is just one part of the puzzle. Addiction is a multi-pronged issue, so it’s important to develop a network of trusted professions and peers. Medication might help curb cravings, but until root behavior patterns are dealt with, treatment might not be successful. However, recovery can be an amazingly rewarding experience if all the necessary components of treatment are in place.
If you are considering treatment for cocaine addiction, most insurance plans cover at least part of, if not all, addiction treatment. You can call the number on the back of your insurance card or check your insurance coverage online by filling out the form below.
Getting Help for Cocaine Addiction
American Addiction Centers (AAC) is a leading provider of inpatient and outpatient rehab treatment services. We know that addiction and the road to recovery look different for each person. We are committed to supporting those struggling with addiction on their journey to recovery. If you are looking for information on cocaine addiction treatment, you can contact us 24/7 at to learn more.