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Cocaine Withdrawal Timelines

Withdrawal is the often difficult and unpleasant process of the body and brain readjusting to its normal state after changing to accommodate the constant presence of a drug over a significant period of time. This can happen after a person takes a nonaddictive and non-intoxicating substance like a medication for a mental illness, but it’s typically associated with intoxicating drugs, such as alcohol, heroin, or cocaine.

Cocaine is definitely a strongly intoxicating substance that can produce serious withdrawal symptoms. This is particularly true with cocaine due to the fact that it’s highly addictive, both in the physical and psychological sense. Withdrawal from this drug can be so intense that it often serves as a deterrent to people who are thinking about quitting. However, continuing to use cocaine when addicted inevitably produces worse results than the temporary pain of withdrawal, and the process doesn’t have to be a terrible ordeal.

Knowing what to expect from withdrawal can help addicted individuals properly prepare for the experience. It’s also important to note that detoxing at home is not the only option. Many addiction treatment centers have inpatient detox services that can make process much easier than what is described here, and there are over 14,500 facilities dedicated to the treatment of addiction in the US alone. The timeline and symptoms listed in this article are typical of addicted persons who attempt to detox on their own.

What Is Withdrawal?

Withdrawal happens because of changes that happen in the brain during long periods of drug use or abuse. For example, a person who abuses cocaine is frequently flooding the brain with neurotransmitters associated with pleasure. The brain naturally attempts to compensate for this unnatural activity by decreasing the sensitivity of the receptors that cause these neurotransmitters to be released. This produces tolerance, meaning that a drug user will need to take more of the substance to get the same effect.

When it comes to addictive intoxicants like cocaine, users typically take higher and higher doses, and/or start mixing the drug with other substances to increase the effect. The more the drug is used, the more the brain changes itself in an attempt to bring things back to normal. Eventually, an addicted person is likely to overdose or reach a point where they don’t experience much pleasure from the high anymore, but must continue taking the drug to avoid withdrawal symptoms.

Withdrawal symptoms are the result of the brain no longer working as it should. In the sudden absence of the drug, the brain is left with an impaired pleasure center. It can’t change back to normal in an instant; this process takes time. Until the brain is back to the state it was in before the individual started taking cocaine, that person will suffer from withdrawal.

Cocaine Withdrawal Symptoms

Drug withdrawal symptoms tend to be opposites of the effects of the high. This is definitely true when it comes to cocaine withdrawal, which often causes lethargy and negative emotional symptoms during detox. Common symptoms include:

  • Restlessness
  • Agitation
  • Fatigue
  • Depression
  • Slowed activity
  • Discomfort
  • Chills
  • Tremors
  • Muscle aches
  • Nerve pain
  • Increased appetite
  • Vivid dreams or nightmares

Unlike that of some intoxicants, cocaine withdrawal is not considered to be directly dangerous. The only real danger comes from a combination of depression and anhedonia, especially if the latter is prolonged. The belief that one might never feel any form of emotional pleasure or happiness again can lead to suicidal thoughts and urges. Even worse, it’s been found that one in three suicides is connected to drug abuse.

Withdrawal Timeline

Cocaine withdrawal often follows the same general timeline. However, there are a number of factors that can affect the length and severity of the detoxification process. The biggest factor is typically the severity of the drug abuse and tolerance, which also depends on the length of time that the drug abuse took place. The timeline can also be affected by the person’s overall physical health, physical characteristics, and genetic factors. Someone can also experience withdrawal symptoms even if they haven’t been using the drug for long if they engaged in an intense binge.

The typical timeline for cocaine withdrawal looks something like this:

  • 1.5-3 hours: Cocaine leaves the body very quickly compared to most drugs; therefore, a user will experience the initial “crash” in as little as 90 minutes after the last dose was taken. This tends to consist of fatigue, slowed activity, discomfort, and possibly depression.
  • 3 hours to 7 days: This can be the most intensely unpleasant period, with acute physical symptoms peaking, including pain, restlessness, and tremors. Cravings also tend to peak at this point, making it difficult to avoid relapse without help. Nightmares are also most likely to occur during this period.
  • 7-10 days: Symptoms are likely to diminish after seven days until they’re mostly gone by 10 days. Strange dreams, depression, and anhedonia may linger the longest, but the physical symptoms should disappear.
  • 10 days and beyond: In rare cases, depression and anhedonia can continue for several weeks after the last dose of cocaine was taken. If this occurs, affected individuals may need special treatment to overcome these symptoms. Cravings can also reappear due to certain triggers for months or years after getting clean, which is common with any addictive drug.

Though not as long or difficult as withdrawal from some substances, cocaine withdrawal can still be very unpleasant, and people attempting to endure it on their own often end up relapsing. This is dangerous due to the fact that even going a couple days without a drug like cocaine can reduce a person’s tolerance, risking overdose if they go back to the same dose they were taking before they tried to quit. This is another reason why utilizing professional treatment methods is a good idea. According to the Centers for Disease Control and Prevention, 47,055 people died from a drug overdose in the US in 2014.

Treatment Options

Many addiction treatment centers and some hospitals offer medically supervised detox for addicted individuals. This is a service in which people can stay in a hospital or other medical center for the duration of the acute withdrawal symptoms. They’re monitored 24 hours per day to keep an eye out for dangerous symptoms, and other symptoms are treated as they appear.

For people going through cocaine withdrawal, aches and pains can be treated with NSAID pain medications like aspirin; depression and agitation can be treated with antidepressants; and sleep disturbances can be alleviated with non-habit-forming sleep aids. The goal of medically supervised detox is to make the withdrawal period as comfortable as possible, minimizing the risk of relapse. Any sign of discomfort is taken as an indication that the treatment is not ideal.

Unfortunately, there is currently no approved medication for the direct treatment of cocaine withdrawal like there is for withdrawal from opiates like heroin and morphine. The most effective treatments are often antidepressants or anti-anxiety medications. These may be prescribed in advance of the actual medically supervised detox as some of these can take weeks to take full effect.

Once detox is complete, it’s highly recommended that addicted individuals continue with a rehabilitation program. Due to the fact that cravings are very likely to pop up again and again after withdrawal symptoms are over, those who don’t go to rehab are much more likely to suffer from a critical relapse. All addiction treatment centers should have multiple treatment options and be able to craft a personalized addiction recovery plan for each individual.

About The Contributor
Editorial Staff
Editorial Staff, American Addiction Centers
The editorial staff of Greenhouse Treatment Center is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed... Read More