Cocaine Withdrawal & Detox

Cocaine is a powerful stimulant drug that has a strong addictive potential.¹ People who struggle with chronic cocaine misuse often experience brain adaptations that can lead to addiction as well as cocaine withdrawal symptoms if they stop using the drug.² An estimated 10-15% of people who use cocaine develop a substance use disorder.

If you or someone you know are struggling with cocaine addiction, you can seek help to start the road to recovery. This article will help you understand cocaine withdrawal and its symptoms, how long cocaine withdrawal lasts, how to cope with symptoms, and how to find treatment for a cocaine use disorder.

What Is Cocaine Withdrawal?

Cocaine withdrawal can occur when someone who regularly uses cocaine suddenly stops or cuts down their cocaine use.³ People who regularly use cocaine may use it daily, while others use it episodically, in binges where they stay awake for several days at a time. Withdrawal can occur after a binge or after long-term regular use. Withdrawal occurs as a result of physiological dependence, which means the body has adapted to the presence of the drug.

When someone who has developed cocaine dependence stops using or significantly reduces their dose, withdrawal symptoms emerge that can cause negative emotions and physical discomfort.⁴

What Are the Symptoms of Cocaine Withdrawal?

Cocaine withdrawal symptoms are not typically life-threatening or medically dangerous, but they can be distressing and lead to certain psychiatric concerns, such as severe depression or suicidal ideation.⁵ Paranoia, delusions, or other psychotic symptoms associated with sleeplessness or prolonged stimulant use may persist during withdrawal.  The greatest risk during cocaine withdrawal is doing harm to oneself.⁶

Signs and symptoms of cocaine withdrawal may include:⁵

• Depressed mood and anhedonia, or loss of interest in things that once brought a person pleasure.
• Hypersomnia (sleeping too much) or insomnia (being unable to fall asleep or stay asleep) followed by hypersomnia (excessive sleeping).
• Physical and mental fatigue.
• Slowed heart rate.
• Anxiety and irritability
• Poor concentration
• Impaired memory.
• Psychomotor retardation or agitation, meaning slowed or altered physical movement.
• Increased hunger, appetite, and weight gain.
• Cravings, or strong urges to use cocaine.

How Long Does Cocaine Withdrawal Last?

There isn’t a set timeframe for cocaine withdrawal, but stimulant withdrawal generally starts within a few hours of one’s last use and continues for 3–5 days, although some symptoms may persist as this substance works its way out of one’s system.⁷ However, it’s important to know that many factors influence the duration and severity of withdrawal, and the cocaine withdrawal timeline as well as the symptoms experienced and their intensity can vary greatly from person to person.⁶

Cocaine Withdrawal Timeline

Cocaine withdrawal can begin as soon as a few hours after your last use.⁷ Episodic use, where people binge on cocaine for several hours or days at a time, is typically followed by feelings of dysphoria and exhaustion and sleep may be excessive, sometimes as long as 24-48 hours. They  may experience negative emotions, fatigue, and cravings for food or drug cravings following this period.⁴

Chronic, regular use of cocaine, results in withdrawal symptoms that include problems with sleep and fatigue but also include low mood, anxiety, and irritability, at varying levels of severity but often last for several days once use has stopped.⁸ Cravings for continued cocaine use can wax and wane during this time, continuing for upwards of three weeks or longer.⁸ Moods and cravings gradually begin balancing out after several days to a month.⁸

Some individuals may develop protracted withdrawal symptoms that affect their energy levels and mood for several months. These symptoms can include fatigue, depressed mood, anxiety, and cravings.⁸  It is also possible to experience breakthrough psychotic symptoms during and even sometimes after withdrawal symptoms resolve.⁸

Factors That Influence Cocaine Withdrawal Timelines

Different factors can affect the duration and severity of cocaine withdrawal. Some of these can include:

• The amount of cocaine used. People who use large amounts of cocaine have an increased risk of protracted withdrawal symptoms and more severe symptoms, such as psychosis, during acute withdrawal.^7,8
• The duration of use. For example, people who have binged on cocaine for long periods (e.g., several days) may sleep for 24-48 hours during acute withdrawal. This period is sometimes referred to as a “crash.”⁸
• The overall duration of cocaine use. Prolonged cocaine use is associated with increased risks of experiencing protracted withdrawal.⁸
• If there is polysubstance use. Use of other substances along with cocaine can influence withdrawal symptoms and their severity.⁸
• The form of cocaine used. For example, smoking crack cocaine is associated with a more rapid withdrawal than snorting powdered cocaine.⁵

Does Medication Help With Cocaine Withdrawal?

There are no medications that are specifically FDA-approved for cocaine withdrawal. Supportive medications may be used to alleviate certain symptoms associated with cocaine withdrawal or as a result of complications during withdrawal.⁸

For example, people struggling with insomnia may receive diphenhydramine, trazodone, or hydroxyzine to alleviate sleep difficulties.⁵ Others may receive benzodiazepines, such as diazepam, to control agitation, tachycardia (rapid heartbeat), and other related effects.⁸

Detoxing from Cocaine

Medical detox involves a set of interventions designed to manage acute intoxication and withdrawal. It supports your body as it removes toxins and minimizes the physical harm caused by the substance.⁵

Medical detox can provide patients with monitoring, support, and medication as needed, as well as immediate medical attention in case of complications.⁸ For those at increased risk of complications and dangers that could occur, such as chest pain, seizures, paranoid reactions, and suicidal thoughts, medical detox can provide prompt attention and treatment.⁸

Medical detox can take place on an inpatient basis, meaning you live onsite for the duration of detox treatment, or outpatient basis, meaning you live at home but travel to a detox facility on a set schedule. Inpatient medical detox provides 24/7 care and attention, which can be beneficial for people with severe symptoms or at risk of complications, as mentioned above, or who may be at risk of withdrawal from multiple substances (e.g., cocaine and alcohol).⁵  Inpatient detox settings can include hospitals or freestanding inpatient detox centers, while outpatient detox settings can include day hospital settings, freestanding detox outpatient centers, a physician’s office, or home health care services.⁵

After Cocaine Withdrawal: Continuing with Treatment

Getting through withdrawal is only the first stage in recovering from cocaine addiction.¹¹ There are multiple levels of care after detox that can help to address the underlying issues that may have led or contributed to the addiction.^10,11  Rehab settings can include:¹¹

• Inpatient rehab. At inpatient rehab, you live at a treatment facility and receive round-the-clock care and supervision. You participate in different forms of individual and group therapy, health and wellness groups, educational groups, and mutual support groups, such as Cocaine Anonymous, as well as learn relapse prevention skills, attend family therapy, and obtain treatment for co-occurring mental health disorders if necessary.
• Outpatient rehab. During outpatient rehab, you live at home and travel to the facility on a regular schedule. Outpatient treatment can take place on different levels of intensity, such as highly supportive intensive outpatient programs that require frequent attendance, or less supportive standard outpatient programs that may require attendance 1-3 times per week. Services provided include the same as those in inpatient settings, including individual and group counseling, focused education sessions, skills groups, and mutual support groups.

The length of addiction treatment can vary depending on your needs and treatment goals. For example, some people may benefit from a short stay in rehab and then transition to an outpatient program, while others can benefit from longer lengths of inpatient treatment, such as 30 days of inpatient or a 2–3 month rehab. During your evaluation, the medical team will help determine the appropriate placement and length of stay that’s right for you, and this will be revisited along with your treatment plan as you make progress in your treatment goals.

How to Get Help for Cocaine Addiction

If you are struggling with cocaine misuse or addiction, you should know that cocaine detox and treatment can help you get your life back on track. No matter how bad things might seem right now, there is always hope, and people can and do recover from substance misuse and addiction and go on to live satisfying and productive lives.

Helping a loved one with addiction isn’t always easy, but you can provide support and encouragement, which may motivate them to seek help. You might first talk to them about your concerns and encourage them to visit their doctor. A physician can evaluate their condition and help determine the appropriate course of action, and perhaps refer your loved one to treatment.¹²

Getting admitted to treatment is simple. You can start the admissions process today by calling our free, confidential helpline at to gather more information. You’ll speak to one of our caring admissions navigators, who can help you understand the admissions and treatment process as well as answer all of your questions. You can also learn more about insurance plans that cover treatment, payment options, and easily online.