Cocaine Withdrawal and Seeking Treatment
Cocaine is primarily a drug of abuse, though it has limited clinical application as a local vasoconstrictor and anesthetic used during some medical procedures.1 The substance is derived from the coca leaf and acts as a very strong central nervous system stimulant.1 It is highly addictive when abused.
Cocaine often produces a feeling of elation and increased energy. As someone continues to use cocaine more frequently or at higher doses, their initial high becomes less euphoric as a result of their body developing tolerance.1 Prolonged use can also result in unwanted effects such as paranoia or irritability.1
Cocaine withdrawal symptoms may last for months if someone has used the drug frequently for a sustained period of time.3 The symptoms of withdrawal can be unpleasant, including tiredness and malaise, depression, slowed behavior and movements, agitation, and restlessness.2,3,4,5
Cocaine Withdrawal Symptoms
Cocaine withdrawal symptoms may last for months if someone has used the drug frequently for a sustained period of time.3 The symptoms of withdrawal can be unpleasant, including tiredness and malaise, depression, slowed behavior and movements, agitation, and restlessness.2,3,4,5 When cocaine use ends, symptoms begin very quickly. These symptoms can include:
- Increased need for sleep and food.
- Low energy.
- Strong desire for more cocaine.
- Mood changes.
How Long Does Cocaine Withdrawal Last?
The duration of withdrawal symptoms for cocaine addiction depends on the person. But the withdrawal timeline often begins almost immediately after the last use of cocaine and can last between 7 days and 6 or 7 months.2,3 The mental health symptoms can last much longer than the physical symptoms.
Withdrawing From Cocaine: Options for Help
Treatment programs allow you to first detoxify from the harmful effects of cocaine and start to get your life back under control. The most common types of programs are:5,6
- Detox centers. These facilities support you while you are going through cocaine withdrawal. They can monitor your medical condition, prescribe medications, and prevent relapse by eliminating access to the drug.
- Inpatient/residential treatments. These options will differ in intensity and duration of treatment, but they will all involve living at the treatment center. Some varieties last for a few days while others can last for a year. Inpatient/residential options will commonly offer a range of medical and psychological care to manage symptoms.
- Outpatient treatment. This level of care refers to any treatment that allows the individual to live at home and attend sessions at the clinic or treatment facility. People who have a good support system and do not have severe addiction may find this type of program a good fit.
How Long Does It Take to Detox From Cocaine?
The length of time it will take cocaine to leave a person’s system depends on how frequent and heavily they used cocaine. Cocaine acute withdrawal symptoms commonly last for 1–10 weeks. 8
Treatment After Detox
After the body is detoxed, psychological treatment and addiction recovery can begin. To fully leave cocaine addiction behind, most people continue to work with a team of substance abuse treatment professionals—including doctors, psychologists, and counselors—to address social, psychological, and physical issues. Breaking free from cocaine dependency requires a genuine and sustained effort, and addiction treatment can offer guidance, medical supervision, and support.
Many programs use a variety of behavioral health treatment interventions to help people deal with the underlying stressors and issues that led to cocaine use and dependency. Both outpatient and inpatient treatment options are available. While at these locations, the individual may participate in individual sessions, group sessions, or a combination of both.
Depending on your needs and abilities, you may engage in various treatment styles such as the following:6
- Cognitive-behavioral therapy (CBT). Used for a range of physical, mental health, and substance use disorders, CBT helps identify negative coping skills, correct unwanted behaviors, and enhance self-control.
- Contingency management (CM). This intervention offers tangible rewards to people that engage in drug-free behaviors. These rewards seek to overwhelm the positive effects of cocaine use.
- Community Reinforcement Approach (CRA). A 24-week, structured program that involves family members and people in the community to create more desirable behaviors.
- The Matrix Model. This structured approach combines aspects of relapse prevention, self-help, education, and various therapies to build self-esteem and dignity.
Along with these treatment options, people in recovery may benefit from regular attendance of a 12-step group such as Narcotics Anonymous. These support groups rely on the fellowship and community constructed during meetings. Though 12-step groups may not replace professional treatment, they can complement other treatments.6
|Cocaine Information at a Glance|
|Form, Intake, and Dose||Interactions and Complications|
|Drug Forms: Powder
Administration Routes: sniffed, smoked, injected, eaten 2
|Alcohol Interaction: may increase the toxic effects of cocaine and alcohol on the heart 2
Illicit Drugs: mixing cocaine with other substances, such as heroin, can be dangerous and lead to fatal overdose 2
|Effects and Adverse Reactions||Substance Abuse|
|Short-Term: constricted blood vessels, increased heart rate, feelings of euphoria, extreme energy, irritability, paranoia 2
Long-Term: ulcerations of the nasal mucosa, nosebleeds, higher risk of contracting HIV and/or hepatitis C (If injected), heart problems, mesenteric arterial ischemia, and intestinal tissue death, malnourishment, restlessness, severe paranoia, auditory hallucinations, risk of Parkinson’s disease, impaired cognitive functioning, overdose, death 2
|Risk of Substance Abuse: High 2
Signs of Abuse: nervousness, restlessness, having bad dreams, suspicious of people, strong need or urge to take the drug 3
|Physiological Problem Signs and Symptoms||Dependence and Addiction Issues|
|Withdrawal Syndrome Onset: a few hours to a few days 4
Withdrawal symptoms: apathy, long periods of sleep, irritability, depression, disorientation 1
Tolerance: Yes 
|Physical Dependence: Yes 1
Psychological Dependence: Yes 1
|Legal Schedules and Ratings|
|Controlled Substances Act Rating: Schedule II (for pharmaceutical cocaine—high potential for abuse, limited medical use) 1|
. Drug Enforcement Administration. (2013). Cocaine.
. U.S. National Library of Medicine: MedLinePlus. (2015). Cocaine Withdrawal.
. Australian Government: The Department of Health. (2004). Models of Intervention and Care for Psychostimulant Users, 2nd edition: The Cocaine Withdrawal Syndrome.
. Substance Abuse and Mental Health Services Administration. (2001). Treatment for Stimulant Use Disorders: Quick Guide for Clinicians.
. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.
. World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Setting.
. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal.
Cocaine Information at a Glance Sources
. Abadinsky, H. (2010). Drug use and abuse: A comprehensive introduction. Nelson Education.
. National Institute on Drug Abuse. (2016). What is cocaine?
. National Institute on Drug Abuse. (n.d.). Signs of Cocaine Use and Addiction.
. Australian Government Department of Health. (2004). The cocaine withdrawal syndrome.