Understanding Cocaine Withdrawal: Symptoms and Timeline

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Cocaine withdrawal can be a tough hurdle for many, with unpleasant psychological symptoms. In this article, we’ll take a look at the basics of this condition so you know what to expect if you choose to attend drug addiction treatment. Addiction therapy in drug rehab can help anyone turn things around.

What Is Cocaine Withdrawal?

Cocaine affects the brain by increasing levels of dopamine, a neurotransmitter associated with pleasure and reward. Normally, dopamine is released in response to potential rewards and then recycled back into the cell that released it, shutting off the signal between nerve cells. Cocaine prevents the reuptake of dopamine, leading to excessive amounts in the brain. This disrupts normal brain communication and causes cocaine’s high.

Over time, the brain adjusts to these high levels of dopamine, leading to dependence and, eventually, the need for more of the drug to achieve the same effect (tolerance). When cocaine use is stopped, the brain experiences a significant drop in dopamine levels, leading to cocaine withdrawal symptoms such as depression and irritability.

What Are the Signs of Cocaine Withdrawal?

Unlike some other drugs, symptoms of cocaine withdrawal aren’t primarily physical but rather a rollercoaster of emotional and mental effects.

However, there are still some physical effects, such as:

  • Fatigue – The body may feel extremely tired as it adjusts to the absence of cocaine’s stimulant effects.
  • Increased Appetite – Cocaine suppresses appetite, so withdrawal often causes a rebound increase in hunger.
  • Sleep Disturbances – Insomnia or hypersomnia can occur as the body’s rhythm adjusts.
  • Physical Sluggishness – Reduced physical energy and slow movements are common as the stimulant is no longer present to boost activity levels.


Behavioral signs of cocaine withdrawal include agitation or irritability, as well as a general lack of motivation due to the person’s crashing dopamine levels.

The primary mental signs of cocaine addiction are:

  • Depression – The sudden drop in dopamine levels can lead to feelings of sadness or depression, sometimes severe.
  • Anxiety – Anxiety is a common symptom, partly due to uncertainty about coping without the drug and the physiological changes occurring in the brain.
  • Difficulty Concentrating – Withdrawal can impact cognitive functions, making it hard to focus or think clearly.


These symptoms, while challenging, are a normal part of the detox process as the body works to regain balance and function without cocaine.

What Is the Timeline for Cocaine Withdrawal?

The effects of cocaine withdrawal can begin as soon as a few hours after the last dose.

Here’s what to expect:

  • First 24 Hours (The Crash) – This initial phase begins within hours of the last dose. Users often experience a “crash” characterized by intense cravings for more cocaine, anxiety, fatigue, sleepiness, and sometimes depression. Physical symptoms are generally less pronounced compared to other substances like opioids or alcohol.
  • Days 1-3 – During these first few days, the acute symptoms of fatigue, irritability, and anxiety continue. Sleep disturbances are common, with individuals experiencing either insomnia or hypersomnia (excessive sleep). Mood swings and cravings can be intense.
  • Days 4-7 – Many of the physical symptoms start to decrease in intensity during this period, but psychological symptoms can remain strong. Cravings may persist, and users might experience emotional fluctuations, including feelings of depression or lack of motivation. Increased appetite and disturbed sleep patterns may continue.
  • Weeks 1-4 – The first month can bring a continuation of cravings and mood disturbances. Users might experience what is known as “anhedonia,” which is the inability to feel pleasure from activities that were previously enjoyable. Cognitive impairments, such as difficulties with concentration and memory, can also be noticeable.
  • First Month and Beyond (Protracted Withdrawal) – Some individuals may experience prolonged withdrawal symptoms, known as Post-Acute Withdrawal Syndrome (PAWS). These can include ongoing depression, anxiety, mood swings, and cravings. These symptoms can wax and wane over a period of several months. It should be noted this does not happen to everyone.

If you or someone you know is going through cocaine withdrawal, it’s important to seek professional help to effectively manage the symptoms and prevent relapse.

What Factors Influence the Cocaine Withdrawal Timeline?

The severity or duration of cocaine withdrawal will depend on several factors:

  • Duration and Intensity of Use – Those who have used cocaine for a longer period or at higher doses tend to experience more severe and prolonged withdrawal symptoms.
  • Method of Use – The way cocaine is consumed (snorting, smoking, injecting) can affect how quickly it enters the bloodstream and how fast the body becomes accustomed to its presence, impacting the onset and duration of cocaine withdrawal.
  • Support Available – Access to a supportive environment and professional help can significantly affect the course of withdrawal. Those who engage in a structured detox program may have a more managed and potentially shorter withdrawal process.
  • Polysubstance Abuse – Use of other drugs in combination with cocaine can complicate the cocaine withdrawal process, leading to more complex and extended symptoms.

Overall, cocaine withdrawal will take roughly a month but can be longer depending on factors such as these. Understanding the factors involved in cocaine withdrawal can help individuals and healthcare providers better prepare for and manage the withdrawal process.

What Happens After Cocaine Detox?

After treatment is complete, the most important priority is relapse prevention. There are five evidence-based strategies for that:

  1. Education – Education is an important aspect of preventing relapse. Individuals learn to understand and anticipate the subtle cues that can prime them for relapse and drug abuse. The various causes that drive their cocaine use and the necessity for full abstinence from all mood-altering drugs, including alcohol and marijuana.
  2. Twelve-Step Programs – As mentioned earlier, a supportive environment is a key element not just during cocaine withdrawal but the recovery phase as well. Cocaine Anonymous is one such 12-step group that can provide much-needed moral support to those on the same recovery journey.
  3. Coping Skills – Life is full of stressors and temptations, which can lead people to abuse drugs like cocaine. Coping skills can help address this. These include things like positive visualization, meditation, exercise, better sleep, and more.
  4. Ongoing Counseling – Drug abuse often stems from psychological causes. Counseling will help those in recovery understand and tackle the causes underlying their cocaine abuse.
  5. Cocaine Relapse Prevention Medications – Cocaine withdrawal’s unpleasant effects can spur some to relapse. There are a variety of medications out there to prevent this. These include medications that increase GABA, such as baclofen, tiagabine, and topiramate, as well as the anti-narcolepsy drug modafinil. Disulfiram, a relapse prevention medication originally prescribed for alcoholism, has also shown promise.

Cocaine is a very addictive substance, and urges may never completely go away. Long-term rehabilitation with a counseling program, whether inpatient, outpatient, or sober living, can be extremely beneficial to people’s recovery.

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What Therapies Are Used in Cocaine Treatment?

The standard treatment programs for cocaine withdrawal and addiction include a combination of group and individual therapy, along with family therapy, administered in multiple sessions per week. This is known as intensive outpatient therapy (IOT). In the early 1990s, IOT was proved to be as successful as inpatient pharmacological therapy for the first treatment of cocaine addiction.

Although the specific procedures of IOT vary from program to program, most IOT programs consist of a combination of group and individual drug counseling, along with varying degrees of family involvement.

Within IOT, there are some specific, evidence-based modalities that have been shown to help with treating cocaine addiction.

Evidence-Based Therapies

Several federal agencies are involved in research on the treatment of SUD.

These include:


These agencies help determine whether or not a particular treatment is evidence-based.

Regarding specific criteria for a treatment to be considered evidence-based, it must demonstrate efficacy in at least two randomized controlled trials.

Two examples of evidence-based treatments include:

Cognitive Behavior Therapy (CBT)

Cognitive Behavior Therapy, or CBT for short, helps patients recognize and change harmful thoughts and behaviors associated with cocaine use. It’s meant to teach individuals coping strategies to manage cravings and avoid relapse.

Randomized trials show that CBT is an effective treatment for cocaine dependence with long-term, lasting improvements. Notable examples include Project MATCH by NIAAA and the Collaborative Cocaine Treatment Study by NIDA.

CBT was found to be effective in both of these studies for reducing drug and alcohol use while also fostering improvement in other aspects of life. Furthermore, the research demonstrates that it has long-term effects that persist after therapy finishes.

Motivational Interviewing (MI)

Motivational interviewing (MI) has been successful in treating cocaine use disorders and yielded positive results in the NIAAA Project MATCH Study.

Research shows MI is an effective strategy in treating a variety of issues.

Contingency Management

Contingency Management (CM) is a type of behavioral therapy based on the principle of operant conditioning, which uses tangible rewards to reinforce positive behaviors such as abstinence from drug use. This approach is particularly effective in treating substance use disorders, including cocaine addiction.

One study found it was actually the most effective therapy for treating cocaine addiction.

Can I Detox From Cocaine on My Own?

It’s possible to quit cocaine on your own, but cocaine withdrawal is difficult and unpleasant – it’s best done through the guidance of professionals. Detoxing from cocaine without professional supervision can be dangerous due to the intense and unpredictable nature of cocaine withdrawal symptoms.

Cocaine withdrawal symptoms include:

  • Depression
  • Anxiety
  • Strong cravings
  • Fatigue
  • Increased appetite
  • Sleep disturbances.


While death from cocaine withdrawal itself is rare, the potential for severe depression and suicidal thoughts can pose significant risks. There’s also the risk of a lowered tolerance after you detox. If you relapse afterward and use the same amount of cocaine as before, you run a higher risk of overdose, which can be life-threatening.

Given these factors, detoxing under professional supervision is generally safer and more effective. It provides a supportive environment tailored to address the multifaceted challenges of withdrawal, significantly enhancing the likelihood of a successful and permanent recovery.

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What’s the Best Way to Get Through Cocaine Withdrawal?

Cocaine withdrawal is intimidating but can be successfully navigated with the help of experts. These experts, in combination with a structured and safe environment, are crucial for effectively managing the multifaceted aspects of detox. South Coast Behavioral Health offers both of these things.

At South Coast Behavioral Health, we offer a full spectrum of care, beginning with a clinically-certified medical detox program. During your time in this program, our professionals will support you every step of the way as you go through the cocaine withdrawal process.

After completing medical detox, you’ll then be able to take advantage of our other levels of care.

This includes:


All throughout your stay with us, you will take part in individual and group therapy sessions, attend 12-step meetings, and take advantage of holistic and wellness services.

Start Today

You don’t have to go through cocaine withdrawal alone. A recovery center for those addicted to cocaine can help. Substance abuse treatment starts when you give us a call today at 866-881-1184 or fill out our confidential form. We have a rehab program at our treatment center that can help you get through the symptoms of cocaine withdrawal and onto a brighter future. We hope to hear from you soon.

Pierce Willans
Kelly McIntyre
Medically Reviewed by Kelly McIntyre, MS, LMFT
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