The detox process may vary depending on the type and severity of substance withdrawal being managed, as well as on the individual’s personal health. People with concerns about withdrawal and any associated health risks can find comfort in learning about the detox process for their individual circumstances
Unlike detox from opioids or central nervous system depressants like alcohol and benzodiazepines, detox from stimulants like cocaine is frequently associated with less pronounced physical symptoms and may take relatively less time to complete. More rarely, some of the symptoms of stimulant withdrawal may persist for months or even years after detox, which could make it more difficult to avoid relapse over time.1
Detox from Cocaine
Cocaine detox is a relatively fast process, compared to some other drugs. However, it can take longer if the drug has been used for a long time or if the individual has certain health issues.
According to the National Library of Medicine’s Medline Plus, withdrawal symptoms for cocaine may include:2
- Strong cocaine cravings.
- General discomfort.
- Depressed mood.
- Suicidal thoughts.
- Lethargy or slowing of activity.
- Increased appetite.
- Intense, unpleasant dreams.
Cravings for cocaine can be extremely intense during withdrawal, leading to a high risk of relapse. In some cases, these cravings may linger for months after the drug has left the person’s body, especially if there was heavy use for a long period of time. Another potentially long-lasting aspect of cocaine withdrawal can be anhedonia, which is a diminished ability to feel pleasure.2
The Journal of Analytical Toxicology describes how the body processes cocaine, referred to as the drug’s metabolism. This pharmacodynamic and pharmacokinetic properties of cocaine help to explain how the drug affects the body and also how quickly it leaves the body after use. These processes can vary somewhat depending on the way that cocaine is used because the drug is absorbed differently depending on how it enters the body.3
When cocaine is injected or smoked, drug levels rise relatively quickly in the bloodstream, resulting in an intense high. However, when the drug is snorted or absorbed through the mucous membranes, it takes a bit longer to have an effect; such routes provide a relatively less intense onset of the high over the course of about an hour. In all cases, the length of time it takes for the drug to peak in the body can vary depending on the individual as well.3
Once it is in the body, cocaine is processed and broken down into smaller components, called metabolites. Though inhaled cocaine takes somewhat longer than smoked or injected cocaine to metabolize, the major metabolite of cocaine, benzoylecgonine, is found in the blood within 15-30 minutes regardless of the method of use.3
Half-Life and Drug Elimination: Detox Timeline
Peak concentrations of cocaine begin to decline as it is cleared from the body through metabolic processes. How long it takes for half the dose to be eliminated from the body is known as the drug’s half-life, and this is a good way of measuring how long it takes for the drug to be fully eliminated. According to Mayo Medical Laboratories, the half-life of cocaine can be up to six hours and its primary metabolite—benzoylecgonine, with a half-life of 12 hours—may be detected via various testing assays for up to 4 days after use.4
In the case of cocaine, the metabolites take substantially longer to be eliminated. In fact, benzoylecgonine has a half-life of 6-12 hours, meaning that it can take a few days longer to eliminate this chemical from the body completely.
Drug elimination times have some influence on certain aspects of the cocaine detox/withdrawal timelines, such as these described by Mental Health Daily:1
- The crash phase: The initial drop from euphoria can last from a few hours to 3-4 days
- The craving phase: This stage of intense, sometimes debilitating cravings can range from one week to 10 weeks.
- The extinction phase: After 10-30 weeks, cravings for cocaine diminish, though they can continue on an intermittent basis and are easier to manage.
Chronic Cocaine Abuse and Duration of Withdrawal
While drug half-life a relatively fixed number, more chronic and intense levels of drug use may influence the character and duration of both acute and more protracted withdrawal. When cocaine has been used on a regular or continual basis for a long time, withdrawal symptoms and cravings can be much stronger over the course of detox and beyond. This can account for some of the longer durations of the craving and extinction phases.1
Cocaine is often mixed with other drugs, like heroin or marijuana, and its purity or potency may also be diluted by adulterant substances in some cases, either by the distributor for higher profits or by the person using it prior to injection or smoking. The more subjective experience of withdrawal and how long it lasts can also depend on factors such as these, in addition to just the severity or longstanding nature of the abuse.1
Managing Cocaine Detox
While the withdrawal symptoms of cocaine detox can be intimidating, it is reassuring to know that it is possible to recover from cocaine addiction. It is helpful to get support from loved ones, including friends and family who will encourage and understand what the individual is going through during detox. It is just as important to avoid people who might encourage relapse.1
Other supports during the cocaine detox process include healthy habits like eating good food and getting exercise, as well as keeping busy. These can strengthen the body’s ability to overcome the challenges of withdrawal and keep the individual distracted from cravings for the drug.
All of these areas can be supported through the assistance of a professional, research-based detox and treatment program. With treatment, the individual can develop needed skills and have access to more tools to prevent relapse than someone trying to detox from cocaine without help.
- Cocaine Withdrawal Symptoms + Timeline – Mental Health Daily. https://mentalhealthdaily.com/2014/04/22/cocaine-withdrawal-symptoms-timeline.
- Cocaine withdrawal: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/000947.htm. Accessed June 20, 2019.
- Cone EJ. Pharmacokinetics and Pharmacodynamics of Cocaine. J Anal Toxicol. 1995;19(6):459-478.
- Mayo Clinic Laboratories. Cocaine and Metabolite Confirmation, Urine. https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/9286. Accessed June 20, 2019.