Cocaine is notorious as a powerful, addictive stimulant drug manufactured from the coca plant native to South America. In the 19thcentury, cocaine was used to treat a variety of ailments, but it was discovered to be very addictive and associated with serious, harmful effects. It is currently a Schedule II controlled substance because, despite some medical utility, it has a high potential for abuse and may lead to severe psychological and physical dependence. Currently, it is used as a local anesthetic for very limited surgical procedures, usually involving the ear, nose, and throat.1
Cocaine is commonly encountered as a fine white powder on the street and sometimes cut with other drugs like fentanyl or amphetamines. The drug is commonly snorted through the nose, but it may also be smoked or injected. People who abuse cocaine often use the drug in a binge pattern—taking larger and larger doses over a period of days or even weeks. This pattern of use can have serious psychological and physical consequences, including overdose.1
People who abuse cocaine are at risk of experiencing a comedown, or intense effects that are opposite to those the drug causes during the euphoric phase as the drug wears off. Comedowns are similar to alcohol hangovers for many people, but some symptoms may be very intense and different from alcohol hangovers. People who experience serious symptoms from abusing cocaine are at risk of bingeing the drug because they may take a lot more of it to offset the comedown symptoms.
What Are the Effects of Cocaine?
In many cases, cocaine abuse occurs because people seek stimulating effects like:1
- Elevated mood.
- High physical energy.
- Mental alertness or feeling better able to pay attention.
However, other less desirable effects of cocaine abuse include:1
- Extreme irritability or intense mood swings.
- Violence toward others.
- Self-harming behaviors.
- Shakiness or loss of physical control.
- Sensitivity to sensation like light, touch, or sound.
Signs of a Cocaine Comedown
People who abuse cocaine are at risk of experiencing a comedown as the drug wears off. A cocaine comedown may involve intense effects that are somewhat opposite in character to those the drug causes during the euphoric phase. Comedowns are similar to alcohol hangovers for many people, but some symptoms may be very intense and different from alcohol hangovers. People who experience serious symptoms from abusing cocaine are at greater risk of bingeing the drug because they may take a lot more of it to offset the comedown symptoms.2
Cocaine use is accompanied by an increase in dopamine activity, which leads to the intensely euphoric effects often reported. As the drug wears off, there is relatively less dopamine active in the brain, and that can lead to the opposite of many of these effects: depression, physical slowness or sluggishness, foggy thinking, exhaustion but trouble sleeping, aches and pains, and more.2
It can be helpful to understand where comedown symptoms come from:1
- Runny nose: Cocaine is a vasoconstrictor, meaning it shrinks the blood vessels. When snorted, the vessels in the nose in particular shrink tight. When the drug wears off, the vessels open wider than they were before, which can lead to feeling congested, or cold or flu-like symptoms appearing.
- Depression: Serotonin and dopamine activity increase throughout the brain when cocaine is present, and when it goes away, these important, mood-related neurotransmitters are depleted.
- Foggy or slow thinking: Disruptions in normal neurotransmission can make thinking, remembering, and learning new things very hard.
- Physical shaking or tremors: This may also be related to specific neurotransmitter disruptions. Physical activity may feel somewhat painful, it may take more time because of slower movements, or it may require much more motivation to get up and moving. Physical shaking is also likely.
- Increased appetite: The desire for comfort food or high-fat foods often increases. Stimulants reduce appetite, so people high on cocaine may not eat for hours at a time until the drug wears off or the binge stops. Once appetite returns, it may return in force.
There is no reason you need to or should go through the pains of Cocaine withdrawal alone. At River Oaks Treatment Center, we offer a variety of Cocaine addiction and withdrawal treatment services including medical detox. Taking the client’s withdrawal symptoms into consideration, we closely monitor the client throughout the detox process, which lasts approximately five to seven days.
What Are the Symptoms of a Cocaine Binge?
Cocaine hits the brain very quickly, so effects begin soon after the first dose is consumed. Because the drug is metabolized rapidly, the effects wear off in about an hour, which may trigger immediate comedown symptoms. This, in turn, may trigger a binge as the person takes too much to avoid depression or feeling sluggish.3
A cocaine binge may include symptoms like:3
- Panic attacks.
- Lack of sleep.
- Increased irritability.
- Intense paranoia.
- Delusions and paranoia.
- Break from reality.
Cocaine Withdrawal Risks
Although some of the symptoms of a cocaine comedown are like those of cocaine withdrawal, these experiences are a little different. While a subjective comedown may be experienced even in first time users, the cocaine withdrawal syndrome may be more problematic. People who develop significant physiological dependence to cocain from consistent use are at risk of experiencing withdrawal.
Cocaine withdrawal may include:1
- Extreme depression.
- Agitation or restlessness.
- Fatigue or exhaustion.
- General physical discomfort.
- Increased appetite and binge eating.
- Unpleasant or vivid dreams, nightmares, or other sleep disturbances.
- Slowing of physical and mental activity.
Phase 1 of cocaine withdrawal: Intense comedown symptoms. Some symptoms will become more intense, some will be less intense, and some will change.4
Phase 2: Decreased cravings, increased inability to concentrate, emotional swings or irritability, and lethargy.4
Phase 3: Intermittent craving associated with addiction even after the drug has long been out of the body.4
Most people are able to detox from cocaine in two weeks with medical supervision. However, some people repeatedly attempt to stop abusing cocaine without medical supervision and relapse. They may develop post-acute withdrawal syndrome (PAWS), which can last for weeks or even months. Psychological symptoms, physical aches and pains, and drug cravings may increase or decrease in intensity over that time.5
Abusing cocaine even once can lead to a binge, which can trigger addiction or an overdose, so it is important to know how to take care of oneself when the depression and flu-like symptoms of withdrawal hit.
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Long-Term Harm from Cocaine Binges: Addiction and Physical Harm
If a person who abuses cocaine goes on a binge, they may experience significant changes in brain chemistry. Psychotic symptoms may arise, or they may experience depression when they eventually detox from the drug. Cardiovascular risks are high. Blood clots, weakened heart muscle, and chronic high blood pressure can all develop in the context of certain types of cocaine abuse.3 Cocaine also reduces blood flow by constricting blood vessels throughout the body, which can result in ischemic injury to various organ systems such as in the gastrointestinal tract. Malnutrition from failing to eat healthy meals is also a risk.
Quitting cocaine is not easy, so it can be helpful to find medical supervision for a safe, supervised detox and then enter a rehabilitation program that provides evidence-based therapy to change behaviors around drugs or alcohol.
- DrugFacts: Cocaine | National Institute on Drug Abuse (NIDA). https://www.drugabuse.gov/publications/drugfacts/cocaine. Accessed June 17, 2019.
- Hartney E. The Term Comedown in Drug Addiction. https://www.verywellmind.com/what-is-a-comedown-22268. Accessed June 24, 2019.
- What are the long-term effects of cocaine use? | National Institute on Drug Abuse (NIDA). https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-long-term-effects-cocaine-use. Accessed June 17, 2019.
- Department of Health | The cocaine withdrawal syndrome. https://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-modpsy-toc~drugtreat-pubs-modpsy-3~drugtreat-pubs-modpsy-3-7~drugtreat-pubs-modpsy-3-7-cws. Accessed June 24, 2019.
- Post-Acute-Withdrawal Syndrome (PAWS): An In-Depth Guide. https://americanaddictioncenters.org/withdrawal-timelines-treatments/post-acute-withdrawal-syndrome. Accessed June 17, 2019.
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