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Cocaine Detox Centers

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Phillippe Greenough

Article Updated: 01/24/2021

Number of References: 3 Sources

Cocaine detox centers are a crucial first step in successfully detoxing from the drug and beginning long term recovery. The success rate of long term sobriety is greatly improved when people choose to attend a detox center as opposed to quitting cold turkey. In this article, we will look at when one of these centers may be recommended, what services these centers provide, and the unique benefits provided by attending a cocaine detox center.

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When Is A Cocaine Detox Center Recommended?

Cocaine detox can be beneficial for anyone who is attempting to recover from cocaine addiction. The medical and psychiatric care which is provided by detox centers can reduce the intensity of the symptoms experienced during detox, and possibly even the duration of the detox process. Additionally, the wealth of resources provided at these centers can give someone many more tools with which to use in their recovery. This includes further medical care for symptoms or co-occurring mental health issues, therapies and counseling, and referrals to continuing care providers.

Prior History of Relapse

If someone has tried to quit cocaine before and ended up relapsing, then detox is highly recommended. For all of the reasons mentioned above, entering a cocaine detox will greatly increase the chances of successful recovery compared to someone quitting on their own. The array of tools that these centers provide does not guarantee successful recovery, but they do provide more ways for someone to approach and participate in their own recovery.

IV Drug Users

For those who used cocaine by shooting up, then a cocaine detox is also highly recommended. Due to the intensity of the high during IV drug use, the brain undergoes much greater and longer-lasting changes. Because the drug has fewer intermediate steps when shooting it up, it reaches the brain in much higher concentrations, and this can make the detox process much more uncomfortable compared to detox from snorting or smoking cocaine. The array of therapies provided at cocaine detox centers will be able to help minimize these symptoms to reduce the discomfort of detox as much as possible.

People Experiencing Paranoia or Psychosis

Cocaine use is extremely disruptive to the brain and psyche, and psychotic states are fairly common among cocaine users. Having psychotic episodes or paranoid delusions is an unfortunate side effect of cocaine use, and extra care must be taken in these cases if the cocaine user is to recover. Cocaine detox centers have trained medical, psychiatric, and clinical staff to best help those who are suffering from cocaine-induced psychosis.

Beginning The Cocaine Detox Process

Since cocaine detox does not produce physical symptoms, the detox intake process will be fairly standard. This will entail an assessment with a caseworker along with some medical exams including:

  • Interview or questions about use habits
  • Vital sign measurements
  • Bloodwork
  • Questions about co-occurring mental or physical health issues

This will be a fairly standard process and is used to determine what kind of symptoms someone may expect to face. Additionally, this will act as a starting point in the assessment of which medications, and in what quantities, should be used to minimize the symptoms that are expected. With regard to cocaine psychological symptoms are the focus, and discussions with a doctor and psychiatrist will most likely take up the bulk of this process.

Medical Monitoring of Cocaine Detox Related Dangers

Medical monitoring during cocaine detox will mostly be in the form of psychiatric monitoring. While psychosis is common during chronic cocaine use, it is typically the first symptoms to resolve; usually in the first few days. This may require additional precautions or medications to protect the safety of both the patient as well as the detox staff themselves. In these cases, antipsychotics or major tranquilizers may be used for a short time until these symptoms resolve.

Other than psychosis, some persistent symptoms which will linger include:

  • Depression
  • Anxiety
  • Paranoia
  • Insomnia or Hypersomnia

These symptoms, while not directly dangerous, can certainly be uncomfortable or mentally painful early in the detox process. Medications may be used to reduce these symptoms, and monitoring their effects is the primary focus of medical supervision. Medication needs may be adjusted throughout the course of detox to find the right balance for each individual.

Cocaine Withdrawal Timeline

Medications Used By Cocaine Detox Centers

There are currently no FDA approved medications to treat cocaine addiction specifically. That being said, there are several medications that are used off label for this application which have proven effective and show promise. Since there is such great variability in cocaine detox symptoms between individuals, some medications may work better than others. Some of the most commonly used medications include:

  • Naltrexone: Commonly used to treat other drug or alcohol addiction, this medication is known to reduce cravings for both drugs and alcohol.
  • Antidepressants: Such as selective serotonin reuptake inhibitors (SSRIs), these medications may help reduce the depression and anxiety that typically accompany cocaine withdrawal.
  • Beta-Blockers: Such as propranolol, these medications may help reduce anxiety issues which result from cocaine withdrawal.
  • Anti-Anxiety Medications: Preferably of the non-benzodiazepine variety, an example of which is buspirone. These medications take some time to begin working but can relieve anxiety while having very little risk or potential for abuse.

Some medications which have only recently been applied to treat cocaine addiction are very promising, but are currently experimental and require further trials and studies before they will be approved by the FDA for this use. A healthcare professional should be consulted before attempting to use any of these medications. Some of these include:

  • Baclofen: A skeletal muscle relaxant and GABA promoter, this medication may reduce cravings or dull the cravings that are experienced. It works by reducing the levels of dopamine released in certain areas of the brain such as the nucleus accumbens, a key area which is affected through cocaine use.
  • Topiramate: Another GABA agent, this medication has shown promise in several studies of recovering cocaine addicts. Through a complicated mechanism of action, it is able to reduce cravings and has led to lower rates of relapse in patients who received topiramate during withdrawal treatment.
  • Disulfiram: Commonly used to treat alcoholism, this medication holds promise in aiding recovery from cocaine addiction as well. It acts to change the way the body metabolizes cocaine and results in very high levels of dopamine after cocaine is used. Instead of increasing the high from cocaine, the result is that the anxiety and nervousness are increased, but not the euphoria. This has shown some potential as a relapse prevention medication, as using cocaine while taking it can be very uncomfortable.
  • Modafinil: Originally a medication used to treat narcolepsy, this medication has shown potential for treating cocaine addiction as well. It increases levels of glutamate, an excitatory neurotransmitter, in the nucleus accumbens and subsequently reduces cocaine cravings. Additionally, when taken consistently it is somehow able to block the euphoria produced through cocaine use, resulting in a much less pleasurable experience when using cocaine.
  • TA-CD: While technically not a medication in the usual sense, this is actually a vaccine that causes the body to produce antibodies that will attack cocaine molecules when they enter the blood. This can prevent someone from feeling any effect at all when using cocaine, as the body’s immune system will bind to cocaine before it can cross the blood-brain barrier. Someone may still crave cocaine, but they will feel no effect when they do the drug. This is still in development and is still a ways off from common use.

Therapy During Cocaine Detox

Alongside medications during cocaine detox, a variety of therapeutic techniques have shown to be very helpful as well. Cocaine addiction can be characterized by isolation, deceit, and suspicion of others and the world at large. Working to break down these barriers is the main goal of the therapies which are utilized during cocaine detox.

Some common therapies used during the cocaine detox process may include:

Talk Therapies

These may take the form of group therapy sessions or individual counseling sessions. The main goal is to help the recovering cocaine addict open up to themselves and others. Helping someone to articulate their own desire to recover can be extremely helpful regarding their chances of long term recovery. Additionally, having others who are currently in, or have been in, the same situation can go a long way towards building connections with others. The isolation of addiction will commonly cause people to feel alone, misunderstood, and hopeless. Having others who can relate can be an extremely helpful source of hope and encouragement.

Behavioral Therapies

Specifically cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), these methods are very effective at helping someone to identify, and then change, thought patterns that promote isolation and addiction. CBT is geared towards identifying ways of thinking which may lead to unhealthy reactions and the interplay between thoughts, feelings, and behaviors. DBT is mostly aimed at interrupting these unhealthy patterns and developing new ways to cope with thoughts and emotions. Joined together, these therapies can be a very effective tool for developing new ways of interacting with oneself and the world.

Aftercare Planning

Cocaine detox is not the end of the road as far as recovery is concerned. Continuing care and treatment is needed to give someone the best possible chances to achieve long term recovery. This is where aftercare planning comes in; developing a long term roadmap for continuing treatment after detox. During detox, someone will work with a caseworker to have a plan and strategies for how they will protect and nurture their recovery after they have completed the detox program. This aftercare plan includes attending support groups, 12 step meetings, getting a sponsor, finding a sober living program, and many other aspects of continuing their recovery out in the world.

Continuing Cocaine Addiction Treatment

While we have mentioned several ways to continue cocaine addiction treatment after detox, there are some ways that produce higher success rates than others. One of the more effective treatment modalities is cocaine outpatient treatment. These programs can vary between 3-8 hours per day depending on if they are outpatient or intensive outpatient and are typically 30 days long but may last longer as someone’s individual needs dictate.

Cocaine outpatient treatment programs provide individual and group therapy, addiction education classes, coping skill development classes, and aid a recovering addict to form connections with others who are likewise trying to recover from cocaine addiction. There is hope to recover from cocaine addiction and the more tools available, the better someone’s chances will be to achieve long term recovery.

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