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Everything You Need to Know About Cocaine Withdrawal

April 27, 2021
Reviewed by: Lisa Misquith

When a person uses cocaine, it reaches the brain within minutes and starts euphoric effects. Even though the effect doesn’t last long, it affects severely after binge use. After a couple of days or months when a person builds tolerance against the cocaine, they start using it more often and in high doses to feel the effect. 

After using cocaine frequently, an individual starts craving for it and if the person stops using cocaine,  withdrawal symptoms begin to kick in.  Many cocaine users start using more cocaine to avoid cocaine withdrawal.  

Withdrawal effects and cocaine cravings are more uncomfortable than realizing it, but they can be controlled after seeking medical recovery. 

Are you using cocaine or you’re looking to find answers for your cocaine withdrawal-related questions? No worries, you’re at the right place as today in this blog, we will cover these topics about cocaine withdrawal:

  • What are the signs and symptoms of cocaine withdrawal
  • Can you die from cocaine withdrawal?
  • What is Cocaine Withdrawal Timeline? Phases
  • Factors to Determine the Severity and Timeline of Cocaine Withdrawal
  • What Are the Diagnosis and Treatment Process for Cocaine Withdrawal
  • Long-Term Recovery Approaches Behavioural Treatment 
  • Possible Complications While Treatment for Withdrawal
  • How to Care for Someone Going Through Cocaine Withdrawal?

Continue reading to know the right way to seek medical help. 

What Are the Signs and Symptoms of Cocaine Withdrawal

Unlike alcohol and opioid withdrawal, cocaine withdrawal doesn’t have any visible symptoms such as vomiting or shaking as the individual is more vulnerable to psychological symptoms. Below are the signs and symptoms mentioned in detail. 

Common symptoms can include:

  • Anxiety/ Depression — It is common to feel either anxiety or depression on the onset of a few days without substance consumption. This could range from minor to extreme levels of episodes of anxiety-related symptoms such as flashbacks and nightmares, the feeling of dying if the individual does not consume cocaine for that day. However, it eventually gets normal when the person learns to cope with the withdrawal with constant self-assurance.  
  • Increased hunger — This especially happens during earlier phases of withdrawal. Until it goes away, people might face issues in managing to maintain a healthy diet in their routine life.
  • Restlessness — Many people become restless after they stop using cocaine, they can’t sit still either stay calm. 
  • Retarded thinking — During earlier stages of cocaine withdrawal, people tend to have difficulty with their motor functioning, and due to this, they are unable to process thoughts w.  
  • Chills — the individual experiences bouts of shivers and body chills during most parts of the day and especially at night. 
  • Muscle aches — Some people may experience muscle aches and pains throughout their body. These aches range from mild, severe and extreme depending on the severity of cocaine withdrawal.  
  • Craving for cocaine — This craving for cocaine during cocaine withdrawal tends to be very extreme, and people may feel like returning to cocaine use. 
  • Fatigue — Feeling lethargic and fatigue every time during cocaine withdrawal is a very common symptom.  
  • Trouble concentrating — People commonly experience trouble while staying concentrated on any specific thing. 
  • Agitation — After stopping using cocaine, people may get very agitated, and this may interfere in a person’s other activities and make his/her life much difficult to live until proper medical treatment.   
  • Paranoia — becoming paranoid in the acute stage of cocaine withdrawal is pretty common, and the person may become violent due to paranoid delusions. 
  • Irritability — an individual may become irritable, and anything may upset them very early in cocaine withdrawal. This tends to get better after a time.  

Can You Die From Cocaine Withdrawal? 

Cocaine withdrawal is not usually life-threatening, and dying due to cocaine is very rare. However, there are some significant physical and medical complications that may arise in certain situations after cocaine withdrawal. 

Physical Health Dangerous Effects

  • Using cocaine with other highly affecting substances such as alcohol, opioids, etc., can be dangerous for physical health. They run a high risk of cardiac issues in a cocaine abusing person. People may develop a heart infarction or arrhythmia.
  • Severe seizures are a second highly risked physical health effect due to cocaine withdrawal as well as while using cocaine as well. 

Mental health complications

  • Cocaine mainly affects an individual’s mental health as cocaine withdrawal increases a high risk of developing anxiety or depression for a long time. Some people may report suicidal thoughts during cocaine withdrawal.
  • Being aggressive and violent, while cocaine withdrawal can also occur in an individual. It can be dangerous to the person suffering from withdrawal as well as the people around him/her. 

However, they can be reduced and controlled during cocaine detox or medical treatment.

What Is Cocaine Withdrawal Timeline? — Phases 

Usually, the symptoms of acute cocaine withdrawal may resolve after 1 week, but craving for cocaine may persist for a longer span. Even a person can suddenly develop a cocaine craving with no signs of cocaine withdrawal symptoms.

Cocaine is a stimulant drug that has a very short half-life, which means it doesn’t stay in the human’s system for a very long time. It is also clear that the onset of cocaine withdrawal symptoms can be seen very rapidly after a person stops using it. It is also a big reason behind the binge practice of cocaine after the onset of negative withdrawal symptoms while stopping it. 

In 1986, Gawin and Kleber undertook the most commonly cited study of cocaine withdrawal. They have used collected data of 30 cocaine-dependent outpatients and reported three distinct phases of the cocaine withdrawal process includes:

Phase I – Crash 

Phase II – Withdrawal

Phase III – Extinction  

The phrasal model is pictorially represented in the below-given figure:

  1. Crash (Phase I) — In this phase, a person experiences a “Crash”  after he/she initially stops using cocaine. However, if they are a cocaine addict, their initial phase of withdrawal may become severe. In this crash phase, an individual tends to feel withdrawal symptoms within 24 hours after a binge use of cocaine or a sustained period of high-intensity use, ends. 

As a phrasal model of cocaine withdrawal says different phases have different symptoms, so onset within hours to a few days ‘Crash’ has below-mentioned symptoms:

  • Exhaustion
  • No cravings to use
  • Dysthymia
  • Irritability
  • Hypersomnia
  • Increased appetite 
  • Restlessness 
  1. Withdrawal (Phase II) — The next phase is “Withdrawal,” and it will begin within a week of last use. The withdrawal phase may last for up to 10 weeks. Once symptoms reach a peak during the crash, the formal withdrawal phase starts.

According to the phrasal model ‘Withdrawal Phase’ will show these symptoms in the patients:

  • Lethargy 
  • Irritability
  • Strong craving
  • Emotional lability
  • Depression
  • Anxiety
  • Erratic sleep
  • Poor concentration 
  1. Extinction (Phase III) – It is the last phase according to the phrasal model in which a person faces withdrawal symptoms up to 28 weeks. Craving for cocaine increases, and maybe people will face long-term issues with mood swings and irritability. 

The phrasal model says that the ‘Extinction Phase’ shows these symptoms: 

  • Episodic cravings
  • Some dysphoria 

What Factors Determine the Severity and Timeline of Cocaine Withdrawal?

There are many factors that help in the diagnosis of cocaine withdrawal during patient’s analysis:

  • Duration of cocaine use in one sitting
  • How frequently it is used
  • The purity of the used cocaine
  • The total duration of action
  • Route of administration
  • Other medical and physical health histories of patient
  • The manner

What Is the Diagnosis and Treatment Process for Cocaine Withdrawal?

Cocaine withdrawal is not considered potentially dangerous, but it might get severe in a few cases due to dehydration in the body or person with other physical or mental illness histories such as severe heart (arrhythmia) and psychiatric disorder (anxiety/depression). 

Also, relapsing is quite common during the withdrawal period of cocaine, and the potential for cocaine overdose is increased during a relapse. It may lead to fatal consequences, so undergoing the diagnosis and treatment process is important. 

Medical staff will recommend the treatment process after the diagnosis of the patient. A person who has experienced numerous relapses or who have a high risk of relapse can initially be treated for their cocaine withdrawal symptoms in an inpatient or residential unit; however, many people might be recommended for outpatient withdrawal management. And, if a person has any history of depression thoughts, then medical detox might be recommended to ensure safety throughout the cocaine withdrawal.

While getting through the withdrawal phase of cocaine, the person needs to seek a medical assistant. Going through a diagnosis process will help him/her to understand how severe their condition is and what treatment they should prefer as per the doctor’s suggestion.

Medications Used for Cocaine Withdrawal? 

Even though cocaine is a stimulant drug and may cause severe issues after withdrawal, the Food and Drug Administration has not explicitly approved it for cocaine withdrawal. However, different medications can reduce severe cravings and other symptoms in an individual associated with cocaine withdrawal. 

Here are a few of them with their purpose to use:

  • Vigabatrin — It is a type of anticonvulsant that is found to be useful to reduce cravings for cocaine during the cocaine withdrawal period.
    • Brand Name Sabril 
  • Gabapentin — It is another type of anticonvulsant that is also useful in reducing cocaine cravings and other symptoms as well that occurs during withdrawal.
    • Brand Name Nurotonin
  • Modafinil This is a mild stimulant, and it can be used to treat lethargy, sleepiness, and other symptoms as well without any major side effects. 
    • Brand Name Provigil
  • Disulfiram It is a drug that is used to help relapse in any person associated with alcohol abuse, and can be used for cocaine withdrawal as well. 
    • Brand Name Antabuse
  • Baclofen This is a muscle relaxant and also used to reduce some of the cocaine withdrawal effects.
    • Brand Name Gablofen 

Note: these medications can only be taken under medical observation, knowing their effects aren’t enough to use them so contact your physician for a proper diagnosis and medication process.

Long-Term Recovery Approaches — Behavioural Treatment 

If medication treatment didn’t work for the person or if he/she has any consequences not to be able to treat with medications, then medical facilities rely on behavioural treatment for long-term recovery approaches. It may include –

Matrix model — It is commonly used for the treatment of the issues associated with cocaine. In this therapist plays two roles in the patient’s treatment one as a coach and another one as a teacher and focuses on fostering empowerment surrounding for the patient to increase their self-esteem.

Cognitive-behavioural therapy (CBT) — Is a therapy that is goal-oriented therapy – focuses on identifying feelings, thoughts, and behaviours of the patient that contribute to cocaine use. A therapist helps people to replace their drug-related habits with healthier ones. They may teach about triggers — how to identify and cope with them without using cocaine. 

Possible Complications While Treatment for Withdrawal

There are a number of complication possibility in a patient while going through cocaine treatment, including:

Co-occurring substance use — If the patient isn’t getting cocaine and they abuse any other substances regularly while going through the treatment for cocaine withdrawal; it can increase the chances of the severity of withdrawal symptoms and will add new symptoms related to that substance. For instance, using alcohol during cocaine withdrawal treatment. 

Co-occurring mental health disorders — If a person has any mental health disorder or it starts occurring again while going through withdrawal treatment, it can complicate the patient’s condition. It increases the timeline of withdrawal symptoms, and especially if the patient is not going for inpatient treatment.

How to Care for Someone Going Through Cocaine Withdrawal

Being a family member or close friends, you might feel like helping your loved ones if they’re going through cocaine withdrawal. Here are a few things you can do as a help –

  • If you see any cocaine withdrawal symptoms call for a medical emergency immediately.
  • Help them to deal with their mood swings and irritability.
  • Understand and don’t leave them alone to crave more doses of cocaine.
  • Take care of them while being with them to let them deal with their depression/anxiety.
  • Sit and talk with them about it openly to comfort them and not let them feel guilty.
  • Help them to understand how bad it is and convince them for a medical diagnosis.

Remember, no one is suffering alone in this, and everyone deserves to get the right medical help! Take a step back from cocaine abuse to avoid cocaine withdrawal and contact for the medical emergency if you or your loved ones have any kind of cocaine withdrawal symptoms.

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