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The Process of Cocaine Detox and Withdrawal

Cocaine Metabolism

Supervised medical detox provides the safest form of recovery for a person struggling with physical dependence on a substance of abuse. During detox, use of an abusive substance stops, and the body is able to process the drug from its system. During this natural process, supportive measures – such as medication and various therapies – are given during medical detox. Medical detox is required for certain substances of abuse, such as alcohol and benzodiazepines, due to the potential for life-threatening withdrawal symptoms; however, it is recommended in other instances, such as for cocaine withdrawal.

While cocaine withdrawal doesn’t generally come with life-threatening withdrawal symptoms, the experience can be unpleasant and often prompts individuals to use again in an effort to avoid this discomfort. With medical supervision, those detoxing from cocaine are more likely to make it through the withdrawal process and continue into a complete rehabilitation program.

Cocaine Withdrawal Symptoms

The most common cocaine withdrawal symptoms are broken down into two primary categories: physical and mental. The most common physical symptoms of withdrawal include:

  • Fatigue
  • Nausea
  • Body aches
  • Tremors
  • Restlessness
  • Chills
  • Insomnia

Cocaine Withdrawal SymptomsCocaine use stresses an individual’s body long before detox begins. Individuals who use cocaine regularly suffer from insomnia and fatigue in between bouts of cocaine use as the drug’s stimulant effects wear off. Lack of sleep that often results from cocaine use causes the immune system to work inefficiently, which makes people more susceptible to illness. Physical symptoms, such as insomnia and fatigue, already present in a person’s life are magnified during detox.

The first physical symptoms to manifest throughout withdrawal are restlessness, fatigue, nausea, and chills. These are quickly followed by body aches and tremors, and insomnia usually presents itself throughout the night.

Mental symptoms are often worse for individuals in cocaine detox. The most common mental withdrawal symptoms include the following, and they tend to appear in this particular order:

  • Depression
  • Anxiety
  • Irritability and/or agitation
  • Increased appetite
  • Vivid dreams
  • Fear
  • Paranoia
  • Cravings for cocaine
  • Suicidal thoughts, in some cases

One of the primary reasons people use cocaine is because of the euphoria it brings. The results are immediate, causing individuals to experience feelings of heightened wellbeing. When the drug is no longer present in a person’s system, the feelings they experience are quite the opposite of those experience with the “high.” Withdrawal brings about an exceptional craving for more cocaine, in order to avoid the “down” symptoms of the crash. Feelings of depression, anxiety, and extreme mood swings are common.

Over the course of the withdrawal process, insomnia abates, but sleep is often accompanied by intense, vivid dreams that don’t for adequate rest. Sleep deprivation, cravings for the drug, and overall malaise can make the withdrawal process tough if medical supervision and support aren’t provided.

Cocaine withdrawal is unpleasant, but it’s not life-threatening unless an individual suffers from and acts on suicidal thoughts. Some people who abuse cocaine regularly suffer from dual diagnoses, often anxiety disorders. Those who have co-occurring disorders need specialized care during withdrawal.

How Long Detox Lasts

Most people begin experiencing cocaine withdrawal symptoms within hours of ceasing use of the drug. Overall, the withdrawal process takes 5-10 days on average; however, the specific timeline will vary according to each individual.

Certain groups of people are more likely to experience withdrawal symptoms for a longer period of time and with more severity. These groups include:

  • People with a long-term history of cocaine use
  • Older individuals
  • People with a poor health history
  • Severity of use

The length of time withdrawal lasts also depends on the severity of symptoms, which are divided into two categories. Acute withdrawal symptoms are mild, and they last only a few days. Post-acute withdrawal symptoms are more serious, and they last much longer. Cravings for cocaine and mood swings can appear anywhere from one month to one year following completion of detox in some individuals.

Medications Used in Cocaine Detox

Medical detox is supervised at all times, allowing medical professionals to manage the most troubling symptoms of cocaine withdrawal. If deemed necessary during supervised medical detox, the use of medication is provided to individuals. While there is no FDA-approved pharmaceutical available for cocaine addiction treatment, medications designed for other health issues are often used to counteract the effects of certain withdrawal symptoms through the detox process.

  • Diazepam, desipramine, or a mixture of fenfluramine and phentermine are sometimes used to treat symptoms of depression and anxiety in individuals going through cocaine detox.
  • Amantadine, gabapentin, vigabatrin, baclofen, and N-acetylcysteine may be used to help individuals experiencing extreme cocaine cravings during the detox process.
  • Bromocriptine may be prescribed to calm clients who are dealing with severe mood swings.
  • Modafinil may be used during cocaine withdrawal to decrease fatigue. It can promote better sleep.

Medication is only issued when symptoms are severe, and only then is it provided to individuals whose medical history shows it’s safe for the individual to consume specific types of medications.

The use of certain medications isn’t without side effects. Most common side effects from these medications include sleepiness, dizziness, blurred vision, constipation, headaches, and diarrhea. Most withdrawal symptoms are more concerning to individuals than the side effects associated with medication, which makes the decision to rely on medication during withdrawal simpler. The use of medication is determined on a case-by-case basis by medical providers in consultation with the client.

Ongoing Treatment

ongoing support

Cocaine withdrawal symptoms are not life-threatening, which means many individuals are given an opportunity to undergo withdrawal on an inpatient or outpatient basis. While outpatient detox works for some, particularly those who have a strong support system at home, it’s recommended that people who use cocaine regularly opt for an inpatient detox program. The round-the-clock supervision provided helps to guard against relapse that is often triggered by the strong cravings that can occur.

Detox is not enough on its own; it must be followed by a complete treatment plan based on the individual’s needs. No two treatment plans should be the same, but specific forms of therapy are common in addiction recovery treatment. Based on the needs of the individual, treatment could include individual therapy, group therapy, or family therapy, often with a focus on Cognitive Behavioral Therapy.