Crack Cocaine Detox, Withdrawal and Treatment Options

Crack is a more intense, more addictive form of cocaine – and in consequence, the withdrawal symptoms from crack are more pronounced than those of “normal” cocaine. Withdrawal occurs when the user develops a dependency on crack – that is, their body and mind become used to the presence of crack in the system and behave as though that is the normal state of affairs, adjusting brain chemistry accordingly. When a user suddenly ceases taking crack, their brain and body react to its absence and have to readjust to the “new normal” while the process of detoxification (the “cleansing” of the body) takes place; this readjustment is known as withdrawal and can involve some deeply unpleasant sensations and symptoms.

Cocaine addiction is primarily psychological, and most of the withdrawal symptoms associated with it are likewise psychological in nature; this is also true for crack, although crack addicts may display more pronounced physical symptoms. However, psychological symptoms do not mean that a person going through withdrawal is safe from physical harm: unfortunately withdrawal is often accompanied by depression and thoughts of suicide, and it is always recommended that a crack addict goes through the detoxification process assisted by a medical professional who will be able to step in and take the necessary steps if such thoughts escalate to a dangerous level.

Some commonly experienced symptoms of crack cocaine withdrawal include:

  • Cravings: the addict will feel an overwhelming need to consume more crack.
  • Exhaustion: they may feel an almost total lack of energy.
  • Lethargy: they may find it impossible to summon up the effort to do even the simplest things.
  • Restlessness: they might find it impossible to settle in one position for more than a few moments and may feel the need to move around constantly; they may also suffer from the impulse to move or shake parts of their body (restless leg syndrome).
  • Insomnia: it may be impossible to get to sleep despite their feelings of extreme tiredness.
  • Hypersomnia: conversely, they might sleep for great stretches of the day and night.
  • Suicidal ideation: they may entertain thoughts of killing themselves, either to escape withdrawal or because they cannot handle the damage their addiction has caused to their lives and prospects.
  • Vivid nightmares: when they manage to sleep they may be disturbed by terrifying dreams.
  • Depression: they may be able to find little or no enthusiasm for anything and a deep sense of sadness.
  • Anxiety: they might feel very anxious about things which might seem of little consequence; more serious issues may provoke panic attacks.
  • Anhedonia: they may find it impossible to experience pleasure, even in things which they previously found extremely pleasurable such as sex, fine food and good company.
  • Reduced appetite: they may not feel like eating anything for long stretches at a time.
  • Increased appetite: conversely they may feel constantly hungry.
  • Lowered libido: they may be wholly uninterested in sex even if they enjoyed a very active sex life prior to and during their addiction.
  • Anorgasmia: they may be unable to achieve orgasm, even through masturbation.
  • Attention deficit: they might be unable to maintain a train of thought or conversation for longer than a couple of minutes.

Each person experiences withdrawal differently, depending on factors including their physiology and the extent and duration of their addiction. A person going through withdrawal may only experience a few of the above symptoms, and only comparatively lightly; on the other hand, a different person may feel many of them very profoundly.

Crack Cocaine Withdrawal Timeline

The crack “high” is a very short-lived experience and users may feel cravings for more only minutes after taking the drug. If they have not developed a dependency, those cravings will subside relatively quickly (within a matter of half an hour or so); however, a crack addict will move into the withdrawal phase within a couple of hours as those cravings become more intense and hard to ignore.

Just as any one person’s withdrawal symptoms will vary from the next, so too will the timescale over which they manifest themselves, and their duration: any proposed withdrawal timeline should be taken as guidance only. With that in mind, a timeline for crack withdrawal could be as follows:

  • Days 1-2: Cravings for crack become increasingly intense and the addict may exhibit extreme agitation and anxiety. The need for crack may feel irresistible and they may be unable to settle for more than short periods at a time.
  • Days 3-6: Cravings continue – although after a few days they will start to become less severe and less frequent – but other symptoms become more prominent and more uncomfortable: exhaustion may combine with insomnia to devastating effect, while anhedonia and depression could provoke suicidal ideation. Eating patterns may fluctuate wildly.
  • Days 7-14: The worst has passed as regards most symptoms, and energy levels will begin to increase as sleep and eating patterns normalise. Cravings still recur but are much less frequent. Depression and anhedonia may persist.
  • Day 15 onwards: the detoxification process is likely to be complete and most withdrawal symptoms will disappear from here on. However, post-acute withdrawal symptoms (PAWS) may persist for months or years, including depression, lowered libido and anorgasmia.

Treatment Options for Crack Cocaine Addiction

Because crack addiction has been a prominent problem for several decades, a broad range of treatments has arisen. As with so much else, each person will respond differently to different forms of treatment; generally speaking, however, a combination of residential rehabilitation and therapy is considered most likely to result in permanent success.

Rehab

Rehabilitation – “rehab” – usually refers to a facility which an addict can attend (either as an inpatient or an outpatient basis) to get treatment for their addiction. Such a facility will offer relaxed, aesthetically pleasing and confidential environment in which an addict’s recovery can begin – invariably with a medically assisted detox, to get the patient’s system clean of crack cocaine (as noted above, detoxification without medical assistance can be very dangerous and is never advised). After detox, the patient will have access to a range of therapy options aimed at getting to grips with the basic causes of their addiction and to equip them with a variety of tools and techniques to help them resist the temptation to relapse in future. They will also be placed on bespoke nutrition and fitness plans as a healthy body is a critical component of the fight against addiction.

Inpatient rehab sees the patient staying on-site at the facility 24/7 for a certain period (usually a minimum of 28 days), which keeps them in a secure and drug-free environment where assistance is always at hand. Outpatient rehab might be more appropriate for patients with work and/or family commitments which mean that staying on site 24/7 is impossible; however, this does leave them at greater risk of relapse as they will not have removed themselves fully from the environment within which their addiction grew to unsustainable levels.

Medication

There is no medication used to treat crack addiction directly; unfortunately detox and associated withdrawal symptoms are an inescapable part of the recovery process. However, various medicinal approaches can be taken to ease some of the individual symptoms of withdrawal. For example, antipsychotics might be prescribed to deal with agitation or any aggressive behaviour; benzodiazepines (such as diazepam) could be used to treat anxiety, agitation and sleep disorders. Antidepressants may be considered a good solution to some of the emotional consequences of withdrawal (though it’s unlikely that doctors would consider this to treat acute symptoms, and it should be remembered that they might also worsen some symptoms including anorgasmia and depressed libido).

It’s vitally important that an addict does not self-medicate, as some medications may be very dangerous if there are pre-existing conditions, and others may themselves be addictive (potentially leading to the addict merely swapping one addiction for another). A GP should always be consulted about any possible independent approach to fighting an addiction.

Therapy

Therapy is an indispensable part of treating crack addiction: the addict needs to understand how and why the addiction first emerged in order to ensure that it doesn’t happen again, and once they have been through detox the focus needs to be firmly on addressing those root causes. Therapy models such as cognitive behavioural therapy (CBT) and motivational therapy (MT) have been demonstrated to be very effective in many cases of crack addiction, although they’re only two of a dizzying array of potential approaches, many of which are available in rehab while others may be accessed independently.

Group therapy can be extremely useful, both for its immediate therapeutic benefits and thanks to its ability to provide a peer group from which an addict can take support and advice. While many people may initially shy away from discussing such personal problems in front of a group of strangers, the skills developed during group therapy can stand an addict in good stead over the course of the months and years after stopping taking crack, and institutions such as Narcotics Anonymous (with branches across the UK) have proved invaluable to countless crack addicts in recent years.

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