Cocaine is a powerful stimulant that is commonly abused in the United States. If you or someone you know is addicted to cocaine, they will most likely experience withdrawal symptoms when they stop using. Cocaine withdrawal can be a difficult process, not only due to the strong chemical dependence and addiction that the drug itself causes, but also because of the severity of withdrawal symptoms.
Gaining a better understanding of both the symptoms of cocaine withdrawal and the dangers of cocaine withdrawal is important for individuals that are currently using cocaine. Many individuals that use cocaine regularly and would like to stop have powerful feelings of anxiety associated with the prospect of quitting. This is understandable given the fact that navigating cocaine withdrawal can be a difficult process. In fact, many people who are addicted to cocaine have quit and relapsed once or more times in the past. The symptoms associated with cocaine withdrawal, and the intensity of those symptoms, is an important contributing factor in the prevalence of relapsing.
There are both physical and mental symptoms that individuals experience when going through cocaine withdrawal. Throughout the course of this article, we will explore both mental and physical symptoms. However, given that each person is unique, the actual symptoms a person experiences can vary greatly. While some individuals may experience all of the signs and symptoms we outline, others may only experience some of them. There is also a variation in the intensity of cocaine withdrawal symptoms someone may experience. Due to these variations, understand that we will be providing a broad overview that may differ from the subjective experience of going through withdrawal and cocaine addiction treatment.
What is Cocaine?
Cocaine is one of the most abused drugs in the United States. Given this, you’ve probably heard of cocaine. But what exactly is it? Cocaine is produced from the coca plant and is indigenous to South America. Historically, the coca plant has experienced widespread use throughout indigenous cultures in South American regions. The most well-known of these were the Incas, who regulated the cultivation of the coca plant.
Due to both the longstanding historical use of the coca plant, as well as its continued use throughout South America, it is important to separate use of the coca plant from cocaine abuse. The coca plant is typically used by being chewed, although they can be used to brew tea. The use of coca leaves themselves continues to remain widespread throughout South America, with an estimated 3 million people using coca leaves on a daily basis. Historically, there were many uses for coca leaves, including in religious ceremonies, as a stimulant, as a medicine, and as an alternative food source during times of famine.
There are key differences between the chewing of coca leaves and the consumption of cocaine itself. Let’s take a look at some key facts about cocaine.
- Alkaloid – Cocaine is one of 14 alkaloids present in coca leaves with a chemical structure that is technically known as benzoylmethylecgonine. Alkaloids are nitrogen-containing compounds that are believed to form as a defense mechanism by plants. Typically, alkaloids are bitter tasting, making the leaves less desirable for predators. Most alkaloids, cocaine included, have psychoactive properties as well.
- Production – Cocaine is produced through an elaborate process that extracts the cocaine, along with other alkaloids and oils, from the leaves. The leaves are first mixed with calcium carbonate to draw the alkaloids to the surface, then soaked in kerosine to dissolve the alkaloids. The alkaloids are then separated from the kerosine and dried into a paste. This paste undergoes a further refining process until it becomes the powder that we traditionally associate with cocaine.
- Drug Scheduling – Cocaine is currently a Schedule II drug according to the Drug Enforcement Agency (DEA). This means that cocaine can be used in certain medical treatments, but also has a high potential for side effects of cocaine abuse.
- Effect – In both its natural form within the coca leaf and once it has been refined, cocaine functions as a stimulant. Within the coca leaf, the stimulant properties of cocaine are relatively subdued, though still present. Once cocaine has been extracted from the leaf and refined, it interacts powerfully with the central nervous system and exhibits strong stimulant properties. While there are many other physiological effects associated with cocaine abuse, suffice it to say that the use of cocaine is markedly different than traditional uses of the coca leaf.
- Method of Consumption – While coca leaves are generally chewed or brewed into a tea, cocaine is consumed in different ways. Powder cocaine, which is a salt, is typically snorted. Due to the fact that it is salt cocaine taken in this method of delivery is capable of passing through the mucous membranes in the nose and subsequently entering the bloodstream. Freebase cocaine, which appears to be crystalline, is typically smoked. This type of cocaine is also known as “crack”. The methods of consumption associated with cocaine ensure that it enters the body quickly and interacts with the central nervous system powerfully.
What are the Symptoms of Cocaine Withdrawal?
The withdrawal symptoms associated with cocaine and drug abuse can present significant challenges for individuals who are looking to permanently stop the use of the drug. Although cocaine has seen wide use both pharmacologically and in retail products within the United States throughout the 20th century, it wasn’t until the 1980’s that researchers began exploring whether cocaine users who ceased use of the drug experienced withdrawal effects. Oddly, many people believed that cocaine didn’t produce withdrawal symptoms, particularly when compared to withdrawal symptoms associated with opiates or alcohol.
Through the work of researchers in the 1980s, a withdrawal syndrome associated specifically with cocaine was identified. Cocaine withdrawal follows three main phases: a crash shortly after cessation, a longer period of withdrawal where more mild symptoms manifest, and finally a third phase where cravings for the drug continue to persist. Throughout each of these three phases, relapse remains a persistent problem. Relapsing holds a special danger for recovering addicts, as the user typically returns to the same dose they had been taking when they stopped the use of the drug. However, due to the fact that they had stopped taking the drug for a period of time their tolerance becomes lower, which ultimately increases the risk associated with overdosing.
Early Withdrawal Symptoms
This is often referred to as the “crash” phase of cocaine withdrawal. This is most obvious after a period of repeated, high doses of cocaine within a short period of time which is known as a “binge”. Early withdrawal symptoms associated with cocaine will begin to occur within hours of the last dose, and will include:
- Lack of hunger
- Strong desire to use again / craving
Within a short period of time, these symptoms will begin to transition to a different set of equally intense symptoms. These include:
- Profound fatigue
- No craving / little desire to use cocaine again
- Difficulty sleeping
Late during the crash stage, symptoms will continue to change. Common symptoms many individuals experience towards the end of the first stage of cocaine withdrawal include:
- Excessive sleeping (hypersomnia)
- Excessive hunger (hyperphagia)
- Low desire to use again
Advanced Withdrawal Symptoms
After about a week, individuals who have transitioned away from using cocaine often experience different symptoms than they experienced during the initial days after cessation. These symptoms are characterized by an increased level of anxiety. Like the early stages of cocaine withdrawal, many individuals experience periods of intense craving followed by periods of a complete lack of craving to use the drug again. These advanced withdrawal symptoms can last up to 10 weeks, although the length of time you may experience withdrawal symptoms may be shorter than this. Early on, many users experience:
- A return to a normal sleep pattern
- Mental clarity and a more relaxed mental state
- Low desire to use
As more time progresses from the last dose of cocaine, users may experience some or all of the following symptoms:
- Decreased ability to feel pleasure (anhedonia)
- Lack of energy (anergia)
- Intense anxiety
- Strong cravings
Key Things to Note About Cocaine Withdrawal
Looking at the symptoms, it is quickly apparent that withdrawal from cocaine doesn’t track closely to withdrawal from many other drugs. Cocaine withdrawal is different from withdrawal from opiates, alcohol, and even other stimulants such as methamphetamine. Withdrawal from these drugs often produces profound physiological symptoms, such as nausea, vomiting, or excessive sweating. While cocaine withdrawal syndrome isn’t typically associated with these symptoms, this doesn’t mean that cocaine withdrawal is easy or less dangerous for the person’s health.
While withdrawal symptoms associated with cocaine are often not physiological, the psychological symptoms can be very intense. Many users experience periods of intense anxiety. Some users experience insomnia, depression, and loss of appetite. In rare cases, individuals can experience intense paranoia. Each of these psychological symptoms can be debilitating in their own way, and are a key reason why treatment for cocaine withdrawal should be conducted under medical supervision.
A second thing to note about cocaine withdrawal is that many individuals experience intense periods of craving followed by a complete lack of desire to use the drug. This presents unique challenges for individuals that are pursuing sobriety, as it can seem like the most difficult period is behind them when they are suddenly hit with a strong desire to use again. As we mentioned, relapse is a persistent risk with cocaine withdrawal and can be dangerous. Relapsing has a higher likelihood of resulting in an overdose, so mitigating the opportunity to relapse is essential when dealing with cocaine withdrawal.
Cocaine Treatment Options
Navigating cocaine withdrawal can present unique challenges that make staying sober difficult. Although cocaine withdrawal doesn’t have the intense physical withdrawal symptoms that are associated with other commonly abused drugs such as opiates and alcohol, achieving sobriety from cocaine abuse is a difficult undertaking. A core component of cocaine withdrawal that lends difficulty in staying sober is the persistence of psychological effects. Many individuals struggle with intense anxiety, and some experience depression, fatigue, and insomnia. Each of these can, along with cravings, lead to a resumption of cocaine use.
There are many treatments for cocaine addiction. Just as your addiction is unique, each individual has unique needs when it comes to overcoming cocaine addiction and recovery. Although it is possible to cease cocaine use on your own, often referred to as quitting “cold-turkey”, the reality is that undergoing detox in a treatment facility will give you the best chance for a successful recovery. This is important because it provides the foundation for moving forward with your recovery. If you undergo detox in a treatment facility, you will be less likely to relapse due to the fact that drugs aren’t available.
While cocaine detox is important, it is only one step on the road to life-long sobriety. There are many components to a recovery program. Important among these are different therapy modalities, including individual therapy, group therapy, family therapy, and cognitive-behavioral therapy. Through these therapy sessions, recovering addicts can work to uncover the underlying issues that gave rise to their addiction. Treatment modalities such as cognitive-behavioral therapy have been demonstrated to be an effective method for treating cocaine addiction.
If you or a loved one is struggling with an addiction to cocaine, getting the help you need to pursue lifelong sobriety should be a top priority. Cocaine is a stimulant that interacts quickly and powerfully with the central nervous system. This interaction, along with the feelings of euphoria and stimulant effects quickly lead to chemical dependence and addiction.
Cocaine withdrawal can be very challenging for many habitual users of cocaine. Throughout withdrawal doesn’t produce intense physical symptoms, most individuals will experience powerful psychological effects shortly after they stop using cocaine. These symptoms can persist for weeks following cessation. Alongside these symptoms, there is a persistent risk of relapse which can be extremely dangerous.
The good news is that with the right treatment plan in place, successful recovery and lifelong sobriety is achievable. Through the use of cutting-edge treatment modalities, individuals can address the underlying issues that gave rise to their addiction in the first place.
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- Freye, Enno. “The Making of Cocaine in the Jungle.” In Pharmacology and Abuse of Cocaine, Amphetamines, Ecstasy and Related Designer Drugs: A Comprehensive Review on Their Mode of Action, Treatment of Abuse and Intoxication, edited by Enno Freye, 29–41. Dordrecht: Springer Netherlands, 2010. https://doi.org/10.1007/978-90-481-2448-0_6.
- Yue, Lili, and Xi Chun Fang. Cocaine Abuse : Pharmacology, Treatment and Relapse Prevention. Public Health in the 21st Century. New York: Nova Science Publishers, Inc, 2012.