Cocaine Detox Guide: Symptoms, Timeline, and Effects

Cocaine is a substance derived from the leaves of the coca plant. Illicit forms of the substance include a white powder as well as a processed crystal called crack cocaine ^1,2. The various forms of the drug can be smoked, snorted, and injected ^1,2. A legal, pharmaceutical form (cocaine hydrochloride solution) of the drug is used as a local anesthetic and vasoconstrictor during certain head and neck procedures ¹. Since cocaine has a high abuse potential but some medical use, the substance is listed as a Schedule II controlled substance ¹.

As a central nervous system (CNS) stimulant, the powerful drug results in a euphoric feeling that makes cocaine abuse common for adults and teens alike ^1,2. The Drug Enforcement Administration (DEA) reports that about 4.7 million people abused cocaine in the last year ¹. The National Institute on Drug Abuse reports that 3.7% of 12^th graders have abused cocaine at some point in their lives ².

Abuse of this substance often results in cocaine addiction and dependence.

Abuse of this substance often results in cocaine addiction and dependence. Someone addicted to cocaine is at risk of many unwanted effects to their health and well-being ^1,2. As the negative health effects accumulate, the person may wish to quit using; however, the associated physiological cocaine dependence can make this process challenging. Not only will the individual encounter strong cravings for more cocaine, but they will also endure a period of discomfort and distress ^3,4. Called cocaine withdrawal symptoms, the effects associated with abruptly quitting cocaine, though different for each person, can be quite unpleasant, especially without proper care.

What Are the Signs and Symptoms of Cocaine Abuse?

Knowing the signs and symptoms of cocaine abuse can help you get your loved one quality detox and treatment. The following are potential, observable signs ⁵:

• Dilated pupils
• Euphoria
• Grandiosity
• Anxiety
• Tension
• Inappropriate anger
• Impaired judgment
• Changes in sociability
• Excessive sweating
• Chills
• Nausea or vomiting
• Marked weight loss
• Psychomotor agitation (purposeless, repetitive movements)
• Psychomotor retardation (slowed movement or thought)
• Muscular weakness
• Respiratory depression
• Confusion
• Seizures
• Involuntary muscle contractions
• Coma

Bursts of energy followed by “crashes” that include depression, anxiety, irritability, and other negative emotions may indicate cocaine abuse, especially when they occur together with the other symptoms. When coming down from a cocaine high, users may experience suicidal thoughts or exhibit suicidal behaviors ⁵.

Cocaine Detox Symptoms

Symptoms will vary due to the unique differences of the individual, but some expected cocaine withdrawal symptoms include ^3,4,5,6,7:

• Exhaustion and lethargy.
• Low mood/depression.
• Anhedonia (diminished ability to derive pleasure from previously enjoyable activities).
• Increased appetite.
• Dehydration.
• Chills.
• Restlessness/agitation.
• Anxiety.
• Irritability.
• Insomnia.
• Vivid dreams.
• Poor attention and concentration.
• Slowed movements and thoughts.
• Impaired memory.
• Strong cocaine cravings.
• Paranoia and confusion.
• Hallucinations.

How Long Does Detox Last?

The body’s ability to process and remove toxins from the system is referred to as detoxification (detox) ⁶. Like withdrawal symptoms, the length of detox is unpredictable and affected by many individual differences related to cocaine abuse ⁵. Over all, cocaine detox symptoms will emerge within 24 hours after last use and continue for between 3 and 5 days, although some symptoms may persist for weeks ^6,7.

Another model of cocaine detox separates the process into three phases ³:

• The crash: This first part of drug detox will begin soon after heavy cocaine use with symptoms of exhaustion, increased hunger, depression, anxiety, and irritability. This can last for a few days.
• Withdrawal: Following the crash, the withdrawal phase can last for 10 weeks and include symptoms like lethargy, cocaine cravings, poor concentration, mood swings, and irritability.
• Extinction: The final phase, extinction can last for 6 months after last use with low mood and some cravings.

Additionally, cocaine addiction is linked to post-acute withdrawal syndrome (PAWS). This condition produces protracted withdrawal symptoms like poor impulse control and difficulty regulating emotions ⁸.

What Are the Effects of Cocaine Withdrawal?

Cocaine withdrawal does not pose the same risks as detoxing from alcohol or sedatives, but serious dangers may present. The most serious hazards of cocaine detox include ^4,6,7:

• Cardiovascular issues: Any stimulant abuse puts additional strain on the heart. With heavy use, problems may arise during detox like heart attack, stroke, or irregular heartbeat.
• Seizures.
• Mental health risks: Perhaps the most significant health effects of cocaine detox involve the individual’s mental health.
  • Depression: The level of negative thoughts can be profound. Depression may lead to suicide, especially in an individual with established depressive disorders.
  • Violence: During the period of agitation, confusion, paranoia, and hallucinations, a person can lash out violently against strangers or loved ones.
• Cravings: The strength of cocaine cravings throughout detox can result in relapse.

What Are the Different Types of Detox?

Treatment will focus on monitoring symptoms and providing a safe environment…To safely and comfortably detox and avoid the unwanted effects of cocaine withdrawal, professional detox options will be valuable tools. There are no medications used specifically in the treatment of cocaine withdrawal, so treatment will focus on monitoring symptoms and providing a safe environment to limit harm to self and others. Detox options are available in ^6,9:

• Outpatient settings: For people with strong supports and limited risks, outpatient treatment allows the individual to maintain their usual lifestyle, attend some treatment, and return home. Outpatient treatment is available at doctor’s offices or community addiction treatment centers.
• Inpatient settings: The best fit for people with high risk and low supports, inpatient options offer 24-hour care while requiring the individual to live at the treatment center. This treatment is available in hospitalized and residential treatment settings. Inpatient treatments can last days, weeks, or months based on the needs of the person and the level of their withdrawal symptoms.

Detox provides a solid foundation for recovery, but it is not a substitute for substance abuse treatment ^6,9. Those interested in long-term recovery and abstinence from cocaine abuse will need to attend some form of professional addiction treatment, whether it be an inpatient, luxury, executive, or outpatient program ⁹.

Sources

1. Drug Enforcement Administration. (2013). Cocaine.
2. The National Institute on Drug Abuse for Teens. (2017). Cocaine.
3. Australian Government: The Department of Health. (2004). Models of Intervention and Care for Psychostimulant Users, 2nd edition: The Cocaine Withdrawal Syndrome.
4. Substance Abuse and Mental Health Services Administration. (2001). Treatment for Stimulant Use Disorders: Quick Guide for Clinicians.
5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
6. World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Setting.
7. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal.
8. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.
9. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.