Cocaine Detox, Withdrawal and Treatment Options

Anyone using cocaine for any length of time is at risk of developing a dependency on the drug: the user’s mind and body adjust to the continual presence of cocaine in the system until that becomes the “normal” state of affairs. If and when the user then suddenly stops taking cocaine, they will enter a state known as withdrawal, when their body and brain react to the absence of the drug in a variety of ways. The symptoms of withdrawal will vary from person to person, and their severity and duration will depend in large part on how long the person has been using cocaine; their method of consumption (intravenous users typically feel more pronounced and unpleasant withdrawal symptoms, for instance); and the quantity of the drug that the user has been consuming.

Cocaine’s withdrawal symptoms are primarily psychological; unlike certain other substances such as heroin and alcohol, cocaine dependency is not especially physical in nature, although that does not mean that physical symptoms will not manifest themselves. Nor does it mean that those symptoms will not be difficult to deal with; withdrawal from cocaine can be a profoundly unpleasant experience and those going through it might well feel an impulse to self-harm or even a degree of suicidal ideation. For this reason, it is always recommended that a person going through detoxification does so with the assistance of a medical professional who will be able to recognise the warning signs and take steps to prevent disaster.

Some commonly experienced symptoms of cocaine withdrawal include:

  • Exhaustion/fatigue: the person may feel an overwhelming lack of energy.
  • Insomnia/hypersomnia: despite their fatigue, they may be unable to sleep at all, or only for short periods; on the other hand, they may find themselves sleeping for much longer than would normally be the case.
  • Lethargy: they may feel unable to summon up the effort to do even the most basic tasks.
  • Restlessness/agitation: they may find themselves unable to settle, and feel like constantly moving their body or specific body parts (ie restless leg syndrome)
  • Cravings: they may feel an intense need to consume more cocaine which dominates their every thought.
  • Suicidal ideation: they might find themselves dwelling on thoughts of killing themselves as a way of escaping their withdrawal and their unhappy life, perhaps visualising certain scenarios and methods obsessively.
  • Depression: they might feel a complete lack of enthusiasm for anything in life – even things which were previously very important to them – and a pronounced sadness which they can’t seem to escape.
  • Anhedonia: it may seem impossible to feel any pleasure, even when doing things which might previously have been very enjoyable to them (such as socialising, having sex, eating fine food, going for walks etc).
  • Anorgasmia: it might be impossible to achieve an orgasm even through masturbation.
  • Decreased libido: they may feel utterly uninterested in sex, even if they enjoyed a high sex drive prior to their addiction.
  • Nightmares: sleep might be plagued with terrifying and very vivid dreams.
  • Fluctuating appetite: they may not feel like eating anything for long periods; alternatively they may feel ravenous even having eaten very significant quantities.
  • Confusion: they may not be able to follow a train of thought to its conclusion, being unable to come up with answers to even relatively simple questions.

Cocaine Withdrawal Timeline

Due to its very short half-life, withdrawal from cocaine can begin as soon as a couple of hours after the user’s last dose, in the forms of cravings for more of the drug which intensify over time. However, the majority of the symptoms listed above, if they manifest at all, will take a while longer to present themselves.

There’s no firm rule for how quickly withdrawal symptoms will commence, nor for how long they will last; as noted above, the depth of a person’s withdrawal will vary from one individual to another and will depend upon the intensity and duration of their addiction. As such, any withdrawal timeline should be taken as a rough guide only, and anyone going through withdrawal should be prepared for their own experience to differ significantly. With that caveat in mind, a timeline for cocaine withdrawal might look like this:

  • Days 1-2: During the initial “crash” period cravings for cocaine will grow in severity and the addict may display intense irritability and agitation, possibly even manifesting in aggression. They may experience pronounced fatigue but might find sleep impossible. They will begin feeling very low emotionally.
  • Days 3-6: Cravings will continue, but will begin to decrease in intensity, frequency and duration after a few days. Fatigue may become exhaustion as sleep continues to prove elusive. The addict may find it impossible to find pleasure in anything and might exhibit signs of profound depression, potentially feeling suicidal. Eating patterns are likely to be very disrupted.
  • Days 7-14: Most symptoms decline in severity and sleep and eating patterns return towards normality. Energy levels increase. Nightmares may still occur, but cravings will subside until long stretches may pass without thoughts of taking the drug appearing.
  • Day 15 onwards: The body will have detoxified, and most withdrawal symptoms will disappear. Nevertheless, some – including depression and effects on the libido – may remain as post-acute withdrawal symptoms (PAWS) which could last months or years.

Treatment Options for Cocaine Addiction

There are various different approaches to the treatment of cocaine addiction; unfortunately, it has been a common problem for many years and much work has been done in this area. While each case is unique, it’s generally accepted that a combination of rehabilitation and ongoing therapy is most effective in producing a permanent recovery.

Rehab

Rehabilitation – “rehab” – usually refers to facilities which an addict can attend (either on an inpatient or outpatient basis) to get a combination of treatments for their addiction. Rehab begins with a medically supervised detoxification, during which an addict has the benefit of medical attention as their body is cleansed of cocaine before moving into therapy. Various different therapy models are typically available, including individual and group sessions, which are aimed at addressing the underlying causes of a person’s addiction so that they do not simply return to their cocaine habit when treatment is over. Patients enjoy treatment in a relaxed, attractive and peaceful environment, with fitness and dietary programmes designed to lead them into healthier lifestyles.

Inpatient rehab ensures that a patient is safely isolated from cocaine and destructive habits for a period (usually 28 days but occasionally significantly longer) long enough to enable them to go through detox and enjoy the benefits of focussed therapy. Outpatient rehab may be more appropriate for those with work or family commitments who prefer to attend therapy sessions and other treatments but don’t want to stay in the facility 24/7, but this might leave them dangerously exposed to temptation outside the facility.

Rehabs typically offer a period of aftercare (usually up to a year) after the main treatment is concluded. Throughout the whole process, patient confidentiality is paramount.

Our drug rehab programme has helped thousands of people break away from the cycle of addiction.

Medication

There is no “magic bullet” medication for cocaine addiction: addicts will need to go through detox and, usually, therapy (either inside or outside rehab) to overcome their addictions. However, certain medication may be prescribed to deal with specific symptoms of withdrawal. For example, a doctor may feel that benzodiazepines such as diazepam might be appropriate to treat agitation and irritability. A variety of medicines could help treat sleep disorders. For patients experiencing prolonged and severe depression, a range of antidepressants is available (although prescribing any of these to deal with depression during the acute withdrawal phase is unlikely since they are intended to deal with long-term conditions).

Doctors will address each case on its merits and must take into account any pre-existing conditions which could cause complications. Because of the risk of such complications, and because some medications which might help ease withdrawal symptoms are themselves addictive, addicts should never attempt to self-medicate and should always consult their GPs before attempting to break an addiction independently.

Therapy

Therapy is a vital component of cocaine addiction treatment because the addiction is so psychological in nature: only by dealing with the fundamental causes of the addiction can a person be confident that they will be able to stay “clean” after detox and, where appropriate, rehab. A wide range of therapy models are deployed to treat cocaine addiction and, as with much else, the efficacy of any of these will depend on the specifics of the case and the individual patient. Therapy models such as cognitive behavioural therapy (CBT) and motivational therapy (MT) have proved especially efficacious in many cases but they are by no means the only viable options, and it may be that lesser-known models such as hypnotherapy have the greatest impact in certain cases.

Because cocaine is such a popular drug, unfortunately, there are a large number of people going through recovery at any one time; one silver lining to this cloud is that this means that group therapy can often be cocaine-specific, with only recovering cocaine addicts taking part, and therefore the learnings and advice shared within the group will be of much more specific relevance to an addict’s individual situation. Similarly, support groups such as Narcotics Anonymous are likely to contain a good proportion of recovering cocaine addicts who can help each other from a position of greater understanding of the specifics of the addiction.

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