Cocaine Withdrawal: Symptoms, Timeline & Treatment

It was a rough night. Jeff didn’t sleep well, and his dreams were disturbing. Now, he was lying in bed, feeling tired but not rested. He also felt anxious – about what, he didn’t know. Hunger finally motivated him to get out of bed. He ate a huge breakfast (unusual for him), and it took a while because he was moving very slowly. His eggs and bacon tasted ok, but what he was really craving was more cocaine. He hadn’t used any in almost 24 hours.

Jeff wondered what was going on, so he Googled his symptoms. It turns out, that Jeff was experiencing cocaine withdrawal. 

Cocaine Withdrawal Symptoms

Jeff had not considered that withdrawal could be the problem. After all, people in withdrawal feel nauseated right? They throw up, feel sick, and have the shakes. That’s not the case with cocaine withdrawal. This drug typically causes few physical symptoms like the ones associated with withdrawal from opioids or alcohol. Symptoms are usually more psychological.¹

Jeff’s feelings included many on the list of common cocaine withdrawal symptoms:^1,2,3,7

• Lethargy
• Fatigue
• Anxiety
• Mood changes
• Depressed mood
• Irritability
• Sleep disturbance
• Vivid and unpleasant dreams
• Agitation and restless behavior
• General feeling of discomfort
• Increased appetite
• Slowing of activity (psychomotor retardation)
• Paranoia
• Strong cravings for cocaine

Jeff wondered how long these effects would last. 

Timeline for Cocaine Withdrawal & Detox

Jeff discovered that the cocaine withdrawal process typically happens in three phases: the crash, withdrawal, and extinction.

The Crash

Once a person stops using cocaine, the crash happens almost right away (within 24 hours of the last dose). During this phase, Jeff can expect to have strong cravings for cocaine. Sleepiness, irritability, fatigue, anxiety, and paranoia are also common. These symptoms may last from seven to 10 days.

Withdrawal

Withdrawal may continue for up to 10 weeks. During that time, Jeff may feel depressed, tired, and uneasy, and he may experience sleep disturbances and changes in appetite. He will probably continue to experience cravings for cocaine.

Extinction

This final phase can last between one and six months after Jeff’s initial withdrawal. During this phase, cravings are the main concern. With time, cravings will lessen, but they can return if Jeff encounters a trigger.

Bottom line: Withdrawal can start as quickly as a few hours after the last dose of cocaine. Initial symptoms usually last a few days, and prolonged symptoms can last up to two months.

Medications and Treatment for Cocaine Withdrawal

Jeff thinks he will need support to work through the next few weeks. He doesn’t want to use cocaine again, so he decides to look for treatment to help him with the withdrawal.

Currently, there are no FDA-approved medications for the treatment of cocaine use disorder.⁴ Additionally, there is no standardized medication that is prescribed for cocaine detox.⁵ However, treatment is available.

Medically supervised detox offers a safe and comfortable place for Jeff to remain under the care of medical professionals as his body clears itself of the cocaine. Staff can prescribe medication to treat specific symptoms of cocaine withdrawal, such as fatigue, depression, and insomnia. Many of the symptoms are often treated with a healthy diet, rest, and exercise.⁶

Counseling is an additional treatment option, to manage the cravings and other mental and behavioral concerns. Cognitive behavioral therapy is often an effective method.⁵ Counselors may also apply relapse-prevention techniques and other psychiatric care.⁶  

Bottom line: There are no standard medications to treat cocaine withdrawal, but medications, counseling, and healthy lifestyle habits can effectively treat withdrawal symptoms. 

Can You Die from Cocaine Withdrawal?

While the cravings can feel intense, the physical effects of cocaine withdrawal typically are not life-threatening. Any physical symptoms don’t pose an immediate medical danger. However, some people may experience severe depressive symptoms and negative thoughts. In this state, they may be at risk of harming themselves.⁷ Medical supervision is helpful in these situations. Clinicians can help monitor the individual and manage symptoms with treatment. 

Bottom line: The physical effects of cocaine withdrawal aren’t life-threatening, but supervision and treatment are helpful in managing the psychological effects, which can become life-threatening.

Next Steps

After learning about cocaine withdrawal, Jeff decides to get support. He contacts a local rehab facility, where medical staff can treat his physical symptoms, and he can connect with a counselor for ongoing therapy. 

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-996-6135(Who Answers?) today to learn about your treatment options.

Sources:

1. Cocaine withdrawal: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved January 24, 2024, from https://medlineplus.gov/ency/article/000947.htm
2. Kampman, K. M. (2005). New medications for the treatment of cocaine dependence. Psychiatry (Edgmont (Pa. : Township)), 2(12), 44–48. 
3. Rowden, A. (2023, August 14). Cocaine withdrawal explained. Medical News Today. https://www.medicalnewstoday.com/articles/cocaine-withdrawal#timeline
4. Schwartz, E. K. C., Wolkowicz, N. R., De Aquino, J. P., MacLean, R. R., & Sofuoglu, M. (2022). Cocaine use disorder (CUD): Current clinical perspectives. Substance Abuse and Rehabilitation, 13, 25–46. https://doi.org/10.2147/SAR.S337338
5. Srakocic, S. (2022, November 28). What are the symptoms of cocaine withdrawal? Healthline Media. https://www.healthline.com/health/cocaine-withdrawal-symptoms#treatment
6. Hays, L. R. (2010). Principles of Addiction Medicine edited by Richard K. Ries, MD, Shannon C. Miller, MD, FASAM, FAPA, CMRO, David A. Fiellin, MD, Richard Saitz, MD, MPH, FACP, FASAM. The American Journal on Addictions. https://doi.org/10.1111/j.1521-0391.2009.00028_1.x
7. SAMHSA. (2015). TIP 45 detoxification and substance abuse treatment. https://store.samhsa.gov/sites/default/files/sma15-4131.pdf