Cocaine Detox and Withdrawal: Everything You Need to Know

Edited by Paul Alexander

Last updated March 26, 2020

Cocaine detox and withdrawal is a painful time. It can last for days, weeks, or even months depending on the situation. There are both physical and mental withdrawal symptoms that occur, each with varying frequency and intensity. Someone who has been abusing cocaine over a long period of time will take longer to go through detox than someone who may not have a deep history of cocaine use. A person’s general health, age, and if they are using other substances all factor into how long detox will last. 

Addition affects millions of people every year. It occurs when there’s frequent use. First, the body becomes tolerant of the drug. With repeated use, it takes more of it to maintain the same high as before. The second stage is cocaine dependence, where the body craves it and relies on it to function. Finally, there’s addiction, where the effects of cocaine abuse on the body result in its inability to function without it. This is despite any damage it creates either for yourself or those around you.

Once addicted to cocaine, withdrawal symptoms will set in within hours after the last dose. They are extremely painful and uncomfortable, which makes a person want to keep using; thus, perpetuating the addiction cycle. In most cases of drug detox for other types of substances, there are physical cocaine addiction symptoms that occur, such as vomiting or shakiness. 

These often aren’t present when it comes to cocaine withdrawal specifically. The psychological symptoms primarily affect a person’s mental health. These include: 

  • Depression
  • Fatigue
  • Vivid and unpleasant dreams
  • Agitation
  • General feelings of discomfort

A person could experience one or all of these symptoms while going through drug detox, which is why relapse is common. Cocaine brings an extreme sense of pleasure that people who are addicted to it crave. When they come down from this high, it’s difficult to face the painful feelings that come with it. 

Cocaine withdrawal symptoms usually peak within 24 hours. This is when they feel the most intense. After a few days, they begin to subside. However, there are post acute withdrawal symptoms, such as anxiety and insomnia, that can last much longer than the initial reactions. These may linger at different levels for months, if not years. 

These residual side effects are hard to manage and require the care of others at a rehabilitation center to help with solutions to overcome addiction permanently. To start the pathway to healing through addiction treatment, it all starts with the question of: how does a person get to the point of addiction?

Signs of Cocaine Addiction and How It Happens

Cocaine stimulates the brain’s reward pathway. Normally, dopamine (a natural, feel-good chemical) is released and binds to dopamine receptors to produce feelings of pleasure and relaxation. It’s the feeling you get when you eat a good meal or have a good workout, for example. 

Drugs, such as cocaine, interfere with this communication by binding to the dopamine transporter. This builds an accumulation of dopamine that delivers the euphoria or high that people who use cocaine crave. Because of this, the brain becomes reliant on the drug for these feelings and always wants more to sustain the short-lived high over and over.

In small amounts, cocaine may make a person feel energetic, talkative, and mentally alert. It may decrease the need for food or sleep. When snorted, the high can last 15 to 30 minutes; when smoked, it may only last 5 or 10 minutes. Signs of cocaine use and addiction include: 

  • Dilated pupils
  • Increased body temperature
  • Increased heart rate and blood pressure
  • Erratic behavior
  • Irritability
  • Restlessness
  • Anxiety 
  • Tremors

Each time a person uses cocaine is dangerous, but prolonged use may lead to cardiovascular problems like abnormal heart rhythms or heart attack. It may result in seizures, a stroke, or coma. There is also the possibility of overdose and/or death. There are multiple signs, in addition to these, that show a person has a problem with substance abuse, whether it’s full-blown addiction or not. On any level, it’s best to seek the help of an addiction treatment facility. 

Seeking Medically Managed Treatment for Cocaine Detox 

The actions or inactions a person takes during drug detox may be unpredictable. It’s safest to undergo a medically managed drug detox program. With the encouragement of medical professionals and therapists who can guide the cocaine treatment and monitor your health on a regular basis, there will be security and supervision if you have an emergency reaction. They will make the process as comfortable as possible for you. If applicable, this may mean administering medication to minimize cravings.

Additionally, seeking the aid of others has a greater chance of recovery than trying to go through the detox treatment process alone. Battling addiction in the same environment without any support to see you through the withdrawal process can be isolating and feel nearly impossible. The cravings are strong for those who are addicted and can last for a long stretch of time. Battling these day in and day out can easily become overwhelming. 

This has the strong potential to lead to not only relapse, but overdose. Once a person has abstained from use for a short period of time, it’s likely they’ll want to take a larger amount at greater frequency to reach the high as soon as possible. Medical monitoring is crucial for your physical state of being, but having the emotional support available is equally important.

Overview of a Medically Managed Detox Program

Choosing a safe, secure treatment option allows for healing in a controlled environment. This helps to maintain accountability and provide round-the-clock medical attention should there be relapse or another type of reaction to detoxification. It is a place where a person can feel stable and as comfortable as possible. Having people ready to support you in the best way possible in a chaotic-free environment without temptation is the best place to be when trying to heal. 

First, the body must be completely rid of the drug and other toxins before cocaine treatment can continue, which is why every plan must start with the detoxification process. Following that, the recommendation is residential rehab. This program is 90 days (depending on what your care plan calls for) and is situated in the coastal region of Orange County, California. It’s a calming atmosphere to start your healing. 

There’s a dedicated support team of up to six specialists for each person who seeks care. This involves a case manager, ASAM certified addiction psychologist, licensed drug addiction counselor, and other therapists who specialize in different areas of treatment. Together, you’ll decide the best course of care and plan of action. 

A typical day includes group foundational intensives, individual therapy, physical exercise, and outdoor experiential group activities, as well as meals, meditation, and free time. The goal is to address both your physical and mental health as you go through the program. Each person goes at their own pace, depending on their specific history with cocaine addiction and goals for treatment.

During this time, you’ll dig into the triggers and reasons behind the addiction. By exploring addiction at its core, it allows you to learn tools to prevent future behavior or know how to respond when temptation occurs in the future. This period of time may not be a consecutive 90 days. It’s normal to have setbacks as you go through the withdrawal process and this first phase of treatment. But every chance is an opportunity to start a path toward sober living. 

Solidifying a Sober Path with Intensive Outpatient Care

After the first three months of rehab, intensive outpatient treatment is recommended for approximately a four-month time period. This is the transitory time when a person secures safe and sober living. It requires at least 12 hours of participation in the program per week, but there’s flexibility with scheduling to accommodate different schedules. Staying the course with intensive outpatient treatment provides a better likelihood of sustained sobriety. 

Outpatient care is part of the full treatment cycle which ends with drug addiction support services. The goal is to have a full year of sobriety before continuing independently using the tools and coping skills you’ve learned. The support services are available for those who have graduated from residential rehab and outpatient programs. It requires self-accountability with outpatient meetings and sober living housing as options to provide the return to real-life independence. 

Going through a cocaine detox timeline is a trying time. There’s no way to predict exactly how it’s going to go or when you’ll be able to reach the next step. There’s no guarantee that relapse won’t occur and you’ll have to begin again. However, despite the challenges, there is a team of people ready and capable to walk you through the various stages of recovery so you can live a healthier, sober life. 

At the moment it may seem like time is moving slowly, but the time spent in rehab is worth the years you’ll have in the future without the presence of drugs to mar your experiences, cloud your mind, and hold you back from all that you’re meant to do. It’s not a quick or easy process, but it is achievable. Cocaine addiction is a downward spiral headed nowhere, but you can overcome it and thrive.


Article Reviewed by Paul Alexander

Paul AlexanderPaul Alexander is the founder and CEO of Northbound Treatment. He received his Certified Addiction Treatment Specialist training at Saddleback College in Mission Viejo, CA, and was awarded Outstanding Alumni Service Award in 2002. Paul holds a Bachelor of Arts degree in Criminology, Law and Society, Summa Cum Laude, from University of California, Irvine, and a Juris Doctorate degree from Loyola Law School of Los Angeles. He believes wholeheartedly in transformational leadership, organizational health and effective, fully integrated substance use disorder treatment.


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