Cocaine is a highly addictive stimulant drug that produces a rush of euphoria and increased energy. The drug is made from the leaves of the coca plant and can be crushed and snorted, smoked, or injected into the bloodstream.[1] According to the 2020 National Survey on Drug Use and Health (NSDUH), an estimated 5.2 million Americans aged 12 and older used cocaine within the last year.[2]

Abusing cocaine can lead to physical and psychological dependence. People who become addicted to cocaine find it difficult to control how much and how often they use it and nearly impossible to quit. The main reason why quitting cocaine is so challenging is because withdrawal symptoms appear when people stop taking it.

This article will explore cocaine withdrawal. You will learn:

  • What causes cocaine withdrawal
  • Common withdrawal symptoms
  • How long cocaine withdrawal lasts
  • What to expect during the withdrawal timeline

If you or someone you love are struggling with cocaine addiction, please contact First Step Behavioral Health today to explore your treatment options.

Understanding Cocaine Dependence and Withdrawal

Cocaine dependence and withdrawal are two of the many risks of cocaine abuse. Cocaine works by increasing the levels of dopamine in the brain, which leads to feelings of euphoria and increased energy.[1] However, this surge in dopamine is temporary and can result in a crash once the effects wear off, causing individuals to binge on the drug.

With repeated use, the brain becomes desensitized to the effects of cocaine, requiring larger doses to achieve the same high. This process is known as tolerance. People with tolerance begin using larger amounts of cocaine and their bodies begin to rely on cocaine to function. As dependence develops, individuals may find it difficult to function without cocaine, experiencing strong cravings and unpleasant withdrawal symptoms when they try to quit or reduce their use.[3]

Symptoms of Cocaine Withdrawal

Cocaine withdrawal causes many unwanted physical and psychological symptoms, including:

  • Anxiety
  • Depression
  • Cravings for cocaine
  • Irritability
  • Low energy
  • Slow movements
  • Fatigue
  • Increased appetite
  • Sleep disturbances
  • Vivid dreams and nightmares
  • Memory problems
  • Difficulty concentrating
  • Paranoia
  • Suicidal thoughts

Without treatment, the intense cravings and withdrawal symptoms can be difficult to cope with. If you or someone you love wants to quit using cocaine, it’s important to seek help from a medical detox center where you can detox under the careful guidance of medical professionals.

How Long Does Cocaine Withdrawal Last?

The length of withdrawal can vary, but symptoms often begin within the first 24 hours after the last time cocaine was used. Symptoms should subside after a week or two, but some people experience more persistent, long-lasting withdrawal symptoms.

The cocaine withdrawal timeline can be broken down into three phases:

  1. Initial crash – When the effects of cocaine first wear off, users experience a “crash” characterized by anxiety, agitation, fatigue, and cravings for cocaine.[4]
  2. Acute withdrawal – As the crash progresses into acute withdrawal, symptoms become more intense. Mood changes, increased appetite, and intense cravings are common.
  3. Post-acute or protracted withdrawal – Some people may experience protracted withdrawal, also known as post-acute withdrawal syndrome (PAWS). Symptoms such as fatigue, anxiety, low energy, drug cravings, and depression may persist for several weeks or months, even after the physical symptoms of withdrawal subside. Protracted withdrawal can be managed with lifestyle changes and continued treatment.

Factors that Affect the Duration and Severity of Withdrawal

The cocaine withdrawal timeline can vary from one person to the next as several factors affect withdrawal, including:

  • How long cocaine was used
  • How often cocaine was used
  • The amount of cocaine regularly used
  • The person’s tolerance level
  • The method of administration (i.e. snorting, smoking, injecting)
  • Concurrent use of alcohol and/or other drugs
  • Age, weight, and metabolism
  • Co-occurring health conditions

People who have a history of heavy or long-term cocaine use are more likely to have severe and longer-lasting withdrawal symptoms. Similarly, people with slower metabolisms, such as those with certain co-occurring health issues or older individuals, will eliminate cocaine at a slower rate, leading to a longer withdrawal duration.

Research has found that withdrawal from crack cocaine may begin sooner than other forms of cocaine use. People who smoke crack cocaine may begin having withdrawal symptoms in just one hour after the last use, while intranasal cocaine users may not experience withdrawal symptoms for several hours or days.[1,5]

Medical Detox for Cocaine Addiction

Cocaine withdrawal is rarely life-threatening, but it can be difficult to accomplish without medical support. Due to the risk of severe depression and suicidal thoughts, inpatient treatment is encouraged. Additionally, people who suffer from cocaine-related cardiovascular issues, such as arrhythmias or a history of heart attacks, may be at an increased risk for potentially dangerous withdrawal symptoms.[5]

Medical detox programs provide close monitoring, medications, support groups, and other holistic services to ensure comfort and safety during the withdrawal process.

What medications are used to treat cocaine withdrawal?

Unfortunately, there are currently no medications approved by the FDA to treat cocaine use disorder. However, research has found that certain medications can help alleviate withdrawal symptoms like depression and insomnia.[5,6]

  • Propranolol – A beta-blocker that can control anxiety and agitation during withdrawal
  • Baclofen – A GABA B agonist and muscle relaxant that has been shown to reduce cravings for cocaine.
  • Topiramate – A medication that increases levels of GABA in the brain, relaxing the mind and body, and helping alleviate symptoms of withdrawal.

Medications prescribed are on a case-by-case basis depending on the symptoms a person is experiencing. An individually tailored approach such as this can promote a more successful detox.

How long does a cocaine detox program last?

How long people stay in detox depends on how severe their symptoms are and how long they last. Some people feel better in just a couple of days, while others need medical monitoring for a week or more. After detox is complete, individuals are encouraged to transition to an inpatient or outpatient treatment program to continue their recovery.

Cocaine Addiction Treatment at First Step Behavioral Health

First Step Behavioral Health’s cocaine rehab in Florida provides the drug addiction treatment and support that clients need to begin their journey to long-term recovery. Personalized cocaine addiction treatment plans allow clients to get the targeted help they need to create healthier routines, improve their mental health, and reduce the risk of relapse. To learn more about our treatment programs or to get started with a confidential, risk-free assessment, please contact us today


  1. National Institute on Drug Abuse (NIDA): Cocaine
  2. Substance Abuse and Mental Health Services Administration (SAMHSA): Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health
  3. National Institute of Health (NIH): The Neurobiology of Cocaine Addiction
  4. JAMA Network: The Physiology of Cocaine Craving and ‘Crashing’
  5. Substance Abuse and Mental Health Services Administration (SAMHSA): Detoxification and Substance Abuse Treatment
  6. National Institute of Health (NIH): New Medications for the Treatment of Cocaine Dependence

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