Cocaine: Withdrawal Symptoms And Timeline

Cocaine is a powerful stimulant used by people around the world. People can become addicted quickly because of how it impacts brain cells (neurons).

Cocaine works by increasing dopamine, a chemical that passes messages between neurons. Dopamine typically helps to reinforce and signal when behavior is “good” or “helpful for survival.” Prolonged use of cocaine leads to dangerous dependence, which is the state when the body, specifically the brain, needs the drug to function normally. Once a person is dependent, they will experience withdrawal symptoms if they stop the use of cocaine.

Understanding Cocaine Withdrawal

Using cocaine increases the amount of the “feel-good” chemical dopamine in the brain. When a person uses cocaine for a long period of time, they develop a tolerance to the drug’s euphoric effects, leading them to take even more to keep the rush going. Eventually, the cocaine user’s brain needs the drug to produce any dopamine or even to feel “normal.” As a result, withdrawal symptoms, which could be very uncomfortable for the user, emerge when someone stops using cocaine. Many addicted people continue abusing cocaine just to avoid these side effects.

Stopping cocaine can cause withdrawal symptoms like fatigue, sleep disturbances, and agitation, and these symptoms of cocaine withdrawal are some of the primary reasons people have trouble quitting the drug. People often report that cravings to use cocaine are strong during the detox process. Cravings can quickly hijack the recovery process, resulting in a relapse.

Many people who use cocaine are unable to stop when trying to do it alone. The side effects and cravings caused by withdrawal are more uncomfortable than many people realize. With physician-assisted detox and close supervision, patients can safely flush the drugs from their system and prepare their bodies and mind for the recovery process.

Signs And Symptoms Of Cocaine Withdrawal

Withdrawal from certain substances, like alcohol and benzodiazepines, can involve severe physical withdrawal symptoms; however, cocaine detox brings mostly psychological withdrawal symptoms.

Cocaine’s euphoric “rush” fades quickly, meaning withdrawal symptoms follow shortly after the last dose. Many cocaine users “binge,” or take more and more of the drug over a short amount of time, to delay withdrawal symptoms. Cocaine binging can lead to a fatal overdose.

Symptoms of cocaine withdrawal include:

  • Difficulty concentrating
  • Slowed thinking
  • Slowed activity or physical fatigue after activity
  • Exhaustion
  • Restlessness
  • Inability to experience sexual arousal
  • Anhedonia, or the inability to feel pleasure
  • Depression or anxiety
  • Suicidal thoughts or actions
  • Vivid, unpleasant dreams or nightmares
  • Physical symptoms, such as chills, tremors, muscle aches, and nerve pain
  • Increased craving for cocaine
  • Increased appetite


cocaine withdrawal

Cocaine Withdrawal Timeline

The symptoms of acute cocaine withdrawal often resolve after about 7-10 days. However, like with many drugs, cravings for cocaine may persist for longer periods of time and could develop suddenly, years after individuals have gotten sober. 

Cocaine has a relatively short half-life and, in people with significant dependence, withdrawal symptoms can begin as soon as 90 minutes after the last dose. Withdrawal symptoms start within hours of stopping use. However, the worst cravings and withdrawal symptoms appear during the first month of quitting. Withdrawal symptoms can last for months after the last dose. Some symptoms can be uncomfortable, making cocaine a difficult drug to quit. Severe depression and suicidal thoughts are the most dangerous side effects of quitting cocaine “cold turkey.”

The timeline for withdrawal symptoms varies depending on the individual and their relationship with the drug. Here are some factors that may influence the timeline for cocaine withdrawal:

  1. Length of use: For people who abuse cocaine for a short period of time, withdrawal symptoms may be relatively short in duration. People who have used cocaine for years may continue to suffer lingering withdrawal symptoms for weeks, perhaps in part due to a buildup of the drug in their bodies.
  2. The average dose used: People who’ve used very large amounts may experience more intense withdrawal symptoms than someone who used lower doses.
  3. Polysubstance dependence: Someone who has developed physiological dependence on 2 or more drugs may experience withdrawal symptoms related to both, potentially complicating the course of withdrawal and worsening the experience for the detoxing person.
  4. Environment: If cocaine was used as a means of escape from a stressful environment, stress may trigger the urge to use again. As a result, environmental factors that lead to stress – such as relationship issues, work troubles, or other factors – may lead to intense cravings for cocaine, complicating the psychological withdrawal process.
  5. Co-occurring medical or mental health issues: If an individual suffers from any co-occurring medical conditions such as cardiovascular disease or mental health issues, such as depression, anxiety, an eating disorder, or personality disorder, the withdrawal process from cocaine could be more complicated. The same is true for those suffering from polydrug addictions.

Cocaine Withdrawal Timeline

First 1-3 hours

Symptoms emerge as soon as usage stops. Users start to feel irritable, anxious, exhausted and have an increased appetite. Cocaine cravings actually decrease during this period.

Week 1

Intense cocaine cravings arise. Users feel exhausted but have trouble falling asleep. Vivid, unpleasant dreams are common, as well as depressive mood swings.

Weeks 2-4

Depression and strong cocaine cravings continue. Recovering users might find it hard to concentrate or stay on an “even keel” emotionally. Irritability and agitation are also common.

Weeks 5-10

The mind and body begin to heal, and withdrawal symptoms diminish. Cocaine cravings can still crop up during this period. General anxiety and uneasiness sometimes return as well.

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Cocaine Withdrawal Management

While cocaine detox may be completed on an outpatient basis, medical detox is recommended in some instances. For example, if a person has relapsed during past withdrawal attempts, the 24-hour supervision afforded by medical detox can prove invaluable. In addition, if the person suffers from any co-occurring mental health disorders, medical detox followed by comprehensive inpatient addiction treatment can effectively address both withdrawal management and mental health treatment needs.

One of the more problematic withdrawal effects associated with acute stimulant withdrawal is an increased risk of suicide. People who attempt to stop cocaine use after addiction has taken hold can suffer from severe depression and mood swings, including thoughts of suicide. With regular cocaine use, the brain adapts to the consistently elevated dopamine activity associated with the drug. Over time, the reward circuit is disrupted and becomes less sensitive to dopamine, per the National Institute on Drug Abuse. At this point, a person often needs increasingly large amounts of cocaine to feel good; without it, they may feel profoundly depressed and dissatisfied with life.

Medications and Treatments for Cocaine Withdrawal

Unlike some drugs, such as opioids, there are no FDA-approved medications that specifically treat cocaine withdrawal. However, there are some promising medications that may help individuals overcome cocaine addiction and work through withdrawal symptoms.

Some medical research on animals has shown that both buprenorphine and naltrexone may offer some assistance for people in cocaine withdrawal. Both of these medications are approved to treat other types of addictions, but findings relevant to cocaine abuse and addiction are in the very early stages.

 One of the major concerns with cocaine withdrawal is the risk of a person developing serious anxiety, depression, or suicidal thoughts. If anxiety and restlessness are reduced, other symptoms of withdrawal may be easier to manage and the entire withdrawal experience will be less unpleasant.

Medications to treat depression and anxiety could be useful for people undergoing cocaine withdrawal, as they could stabilize their moods and reduce depression. They could be particularly helpful for people whose withdrawal symptoms last longer than 7-10 days. However, medical professionals should consider these cases individually and carefully monitor patients for side effects, further addictive behaviors, and psychological changes that are detrimental to the overall goal of managing the addiction.


Detox Process

The recovery process is broken down into a few steps: medical detox, treatment, and aftercare. Not everyone needs medical detox, but it may be a critical step in the treatment of moderate to severe cases of cocaine addiction. Those who are still using cocaine when they enter treatment will usually start with medical detox.

Detox is when the body metabolizes cocaine and removes it from the body. Since cocaine metabolizes quickly, it leaves the body in approximately 8 hours, based on the half-life of the drug.

People often detox from cocaine at home because it does not take long. They can fully detox in a day or two, with some symptoms lingering for the next few weeks. In contrast, medical detox is a supervised version of detox where a medical team oversees the process. Medical detox includes support to ease a person through withdrawal symptoms as well as medical support. Typically, detox happens in a hospital or inpatient rehab center. People with life-threatening problems will detox in a hospital, while those who are medically stable will do so in a rehab facility.

During medical detox, a person will experience some or many of the withdrawal symptoms of cocaine. Cocaine detox is not long but can be uncomfortable for some people.

Those in detox can expect medical, nutritional, and addiction support. Treatment centers may take the opportunity to screen for and treat infectious diseases. Detox is also an opportunity for physicians to diagnose and treat chronic diseases, since it may be the first time someone with SUD is seeing a doctor in years.

In medical detox, diets are designed and administered by the treatment team. An individual will have more time to focus on their recovery and will be better equipped to maintain a healthy diet once they leave.

After medical detox is complete, patients will be screened for entry into substance use disorder treatment. Treatment plans may continue in an inpatient (in the facility) or outpatient (live at home and commute to the facility) manner. Those who are ready for continued care can be admitted into a program at this time.




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Ben Fisher

Ben Fisher

Ben is a content creator with multiple years in recovery. Ben has been writing content and managing instagram and facebook pages that provide hope and healing information to individuals seeking help for substance use disorder. In addition to his work in behavioral health, Ben loves to play guitar and hangout with his kids.

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