Key takeaways:

  • While withdrawing from cocaine isn’t medically dangerous, it can be uncomfortable and many users will continue using it to avoid withdrawal symptoms
  • Some cocaine users develop Post-Acute Withdrawal Symptoms (PAWS) which describes withdrawal symptoms that persist after the drug is detoxed from the system
  • During cocaine detox, the drug is cleared from the body while a healthcare professional manages withdrawal symptoms and keeps the patient calm and comfortable

Cocaine is a highly addictive stimulant drug that is usually either snorted (powder cocaine) or smoked (crack cocaine). While there aren’t many physical withdrawal symptoms from cocaine, the psychological symptoms can have severe effects on mental health.

What causes cocaine withdrawal?

Using cocaine increases the levels of dopamine, a biochemical that is associated with the pleasure and reward centers in the brain, creating a sense of euphoria.

After prolonged cocaine abuse, the brain will build up a tolerance to dopamine production, meaning the normal senses of gratification achieved without the drug are reduced and the user will often feel like they require cocaine to feel a sense of normality. This is what leads to withdrawal symptoms when someone with a cocaine use disorder tries to stop using. 

While withdrawing from cocaine isn’t medically dangerous, it can be uncomfortable and many users will continue using it to avoid withdrawal symptoms.

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Cocaine withdrawal symptoms

The euphoric sensation felt when taking cocaine is fleeting. Depending on whether the user snorts or smokes the drug, the most intense effects last between 5-30 minutes, and the withdrawal process will begin to set in quickly after usage is stopped.[1] This often causes cocaine users to binge in order to keep the euphoria going over a long time or to take larger amounts to delay withdrawal. Cocaine binging can lead to permanent health problems or fatal overdose.

Common symptoms of withdrawal from cocaine include:

  • Increased appetite

  • Fatigue

  • Depression

  • Agitation

  • Restless behavior

  • Nightmares

  • Anxiety

  • Suicidal thoughts

Duration of withdrawal

Cocaine withdrawal symptoms can start as soon as the drug wears off, usually an hour, and mostly affects people who are regular, frequent, or heavy users. The most intense symptoms of withdrawal wear off in a few days to a week. The intensity and duration of withdrawal depends on the frequency and volume the cocaine user has taken the drug in, and for how long. Those with intense cocaine addictions will likely experience worse acute withdrawal symptoms.

Some cocaine users develop Post-Acute Withdrawal Symptoms (PAWS) which describes withdrawal symptoms that persist after the drug is detoxed from the system. PAWS can last up to a year or more after a person stops using cocaine and usually include depressed mood, fatigue, brain fog, or weakness. These symptoms may be persistent or they may come and go and can make it hard for people to function normally.

Cocaine withdrawal timeline

Below is the expected timeline for people who are withdrawing from cocaine:[2]

The Crash: Symptoms develop within 1-3 hours of last use and involve the user coming down from the drug. Feeling irritable, anxious, exhausted, and having an increased appetite are common during the cocaine crash, and drug cravings tend to be low.

Acute Withdrawals: Symptoms begin after the crash and usually last 3 days to a week. During this period, the cocaine craving becomes intense. Other symptoms include fatigue, trouble concentrating, and feeling irritable, down, or moody.

Post-Acute Withdrawals Syndrome: A small number of users develop prolonged symptoms of withdrawal. The most common symptoms of PAWS for cocaine users are depression, irritability, fatigue, trouble focusing, and weakness. These symptoms persist after the acute withdrawals and can last up to one year.

Cocaine detox and treatment

Unlike some other stimulant withdrawal, withdrawing from cocaine is relatively safe, but users may still prefer to detox in a structured setting, such as at inpatient treatment or detox facilities. Some treatment programs offer medication to ease symptoms, reduce cravings, and help those quitting, though this is not always necessary.

Similarly, some with cocaine use disorders may not need inpatient treatment but may not be able to detox safely alone. For those, there are outpatient cocaine detox programs that offer similar benefits without being overly time-consuming. Treatment improves the likelihood of achieving long-term sobriety and is recommended for people trying to overcome an addiction.

Cocaine detox and withdrawal management

The first stages of cocaine addiction treatment begin with an initial detox. During cocaine detox, the drug is cleared from the body while a healthcare professional manages withdrawal symptoms and keeps the patient calm and comfortable. 

Treatment will move on to managing cravings and developing coping systems as cocaine leaves the system, through therapies such as cognitive-behavioral therapy (CBT). This can involve therapies and medication as well as creating a plan for continued sobriety.

Get help with cocaine addiction today

While there aren’t any life-threatening effects of cocaine withdrawal and detox, it may still be preferable to get professional help to stop abusing. Those who attend cocaine rehab and addiction treatment centers are 20% less likely to relapse (after a year of sobriety) and can begin to live a normal life after addiction.[5]

Though, for most, it will require continuous monitoring and additional support to stay clean, such as from therapy to find the underlying cause of addiction or 12-step programs for group support. If you or someone you care about is suffering from cocaine use disorder, cocaine dependence, or are a cocaine addict, speak to a treatment center today.