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Cocaine Withdrawal Symptoms – An Overview

by Melissa Bell
6 minutes read

Cocaine triggers an intense euphoric feeling that offers the user a spontaneous amount of energy. Usually, when cocaine intake stops, a crash follows immediately. Crash is characterized by an overall decrease in energy, mood, and wellbeing of the user.

The user tends to possess an increased yearning for more cocaine during the crash. Cocaine withdrawal symptoms include paranoia, sleepiness, lack of pleasure, extreme suspicion or agitation, general body weakness, anxiety, and irritability.


Cocaine Withdrawal Symptoms – How It Occurs

An individual’s addiction to any particular drug implies that the individual’s system has become used to the effects of that drug. The person will experience various mental and physical effects as his/her body tries to adjust to the drug. A dependence on the drug is formed when the body tries to adapt to the physiology of the drug in their system. If the individual suddenly stops taking the drug, the body system now develops problems when it tries to adjust without the drug. A lot of side effects ranging from mild to severe and deadly symptoms will be experienced by the person. The process whereby the body tries to reverse back to its normal functioning without the drug is known as withdrawal.

Cocaine addiction withdrawal has physical and psychological effects. But the psychological effects are more intense in cocaine withdrawal. Cocaine withdrawal symptoms include restlessness, incessant hunger, suicidal thought, lack of arousal, exhaustion, Anhedonia, slow thinking, and general body weakness.

Cocaine Withdrawal Symptoms – Phases

The two withdrawal phases are:

  • The acute withdrawal stage;
  • The post-acute withdrawal stage. The acute withdrawal stage is characterised by immediate symptoms. Examples of these symptoms are mood swings, nightmares, and difficulty in concentration.

The post-acute withdrawal stage refers to prolonged psychological symptoms that happen several months after quitting. Examples of protracted withdrawal syndromes are anger, emotional outburst, depression, agitation, insomnia, inability to feel pleasure, anxiety, etc.

Cocaine Withdrawal Timeline

We have three phases.

  • Phase one – Crash phase: This phase is characterised by a feeling of anxiety, depressions, and less tendency of the individual to feel pain or pleasure. It usually lasts from one to several days. Cognitive problems such as memory loss and confusion often occur during this phase.

There is usually a strong craving for the drug by the individual and sometimes they may appear tired, hungry, and sleepy.

Dangerous physical symptoms like heart attack, dehydration, seizures, and arrhythmia may occur in long term users.

  • Phase two: In this phase of the timeline, there are continuous cravings for cocaine and problems with concentration. Mood swings and other physical symptoms start to manifest here. It can last up to ten weeks.
  • Phase three – Extinction phase: Here, individuals still struggle with cocaine cravings. Exposure to things that reminds them of their previous addictions may increase their risk of relapse. They also tend to struggle with their emotions and have problems with apathy after they stop taking cocaine. This is the most important stage because they need all the support they can get.

Phase one to phase three may differ for each person. Some persons might not experience any physical symptoms at all. The tendency to commit suicide and depression is common in the three phases. Individuals who relapse during phase one tend to fatally over-abuse cocaine.

Factors Affecting Cocaine Withdrawal Timeline

The half-life of cocaine is relatively small. Symptoms begin as early as 90 minutes in persons with significant dependence. The timeline for withdrawal differs from person to person. Some factors affect the timeline for cocaine withdrawal.

1.Multi-substance dependence: The withdrawal symptoms are usually complex for persons who have developed a psychological dependence on a wide range of drugs. The individual tends to develop withdrawal symptoms related to those drugs and this further complicates the withdrawal process, worsening the experience for that individual.

  1. Underlying medical/ mental illness: similar to those suffering from multidrug addictions, individuals who suffer from any underlying or co-occurring medical conditions like a personality disorder, depression, eating disorder, anxiety, and cardiovascular diseases. These conditions worsen the withdrawal process.
  2. Duration of use: Individuals who have abused cocaine for several years may suffer lingering withdrawal symptoms for weeks, while withdrawal symptoms may be short in duration for individuals who abused cocaine for a short period of time. The reason for this may be due to the accumulation of cocaine in their respective bodies.
  3. Background/ setting: If the proposed reason for abuse was to get relief from a stressful environment, work troubles, and relationship issues. These factors may trigger its use again thereby complicating the psychological withdrawal process.
  4. Dosage: The amount of drug used varies directly with withdrawal symptoms in individuals. Persons who have abused a large amount of cocaine may witness severe withdrawal symptoms compared to someone who used lower doses.

Is Medical Detoxification Mandatory for Cocaine Withdrawal?

Though cocaine detox may be effective on an outpatient basis, medical detox and subsequent inpatient addiction treatment can effectively address the mental health treatment needs and withdrawal management. Medical detox is recommended for people with a history of depression and suicidal thoughts in order to ensure safety throughout the withdrawal process.

Cocaine withdrawal symptoms – treatment and medication

Overcoming withdrawal symptoms commence with finding a new environment, a positive support system, and healthy lifestyles. There are no specified FDA approved medicines for cocaine withdrawal. Nevertheless, research is still ongoing and some medications are showing good prospects. Propranolol, a beta-blocker has been approved to treat hypertension and ischemic chest pain. Studies have shown that propranolol might have a soothing effect on sufferers of cocaine withdrawal.

One of the foremost risk factors related to cocaine withdrawal is that there is high tendency to develop suicidal thoughts, depression, and anxiety. If those causes are controlled, other symptoms may be easily managed. Buprenorphine and naltrexone have shown promising results for cocaine withdrawal in animal models.

Other drugs used for controlling symptoms of cocaine withdrawal symptom include vigabatrin and Vistaril for controlling anxiety; Seroquel and trazodone for sleep; gabapentin for seizures insomnia and restless leg syndrome, and clonidine for anxiety reduction and high blood pressure. Their usage depends on the person’s peculiar body chemistry and medical history. Counselling may help end the addiction.

Addicts have a good chance of recovery when detoxing is done at a drug treatment facility where therapy is carried out by physicians and therapists who handle recovery based on the individual needs of the patient. Therapeutic techniques like Cognitive Behavioural Therapy, Dialectal Behavioural Therapy, individual psychotherapy, and motivational interviewing aids patients learn good relapse prevention skills. It also helps them to recognise and change the behavioural and thinking pattern that made them abuse cocaine in the first place. Close monitoring of the person’s health and safety after recovery is equally vital.

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