Since cocaine withdrawal does not produce physical symptoms, the exact timeline is difficult to describe in a concrete manner. That being said, there are intense and potentially serious psychological symptoms that are common among cocaine users in the period immediately after cocaine use has ceased. This varies between people, and some people may experience mild symptoms while others experience very intense symptoms. Additionally, the timeline for cocaine withdrawal will vary, sometimes greatly, between people depending on a variety of different criteria.
Here we will take a look at the average timeline for cocaine withdrawal to get a clearer picture of what someone could expect:
The immediate stage of cocaine withdrawal is known as the “crash” and this may be most intense in the day or two immediately after cocaine use has stopped and will decrease gradually over the first week. Sleep disturbances are common as it typically takes a very long time to get to sleep. Depression will typically begin within a day of the last time cocaine was used and may intensify over the first week. Fatigue and lethargy will grow alongside depression and anhedonia, or an inability to feel pleasure or joy will become apparent during the first week. Early in the second week appetite may begin to return somewhat, and eating more may help the other symptoms resolve a little quicker.
By the beginning of the third week, cocaine cravings may begin to come and go and are no longer a constant presence. Getting to sleep may still be more difficult than normal, but the quality of sleep should begin to improve somewhat. Depression may be reduced in the third week, but is usually still disruptive to someone’s life. Appetite should be near normal levels now, and fatigue and lethargy may be mostly resolved by the end of week three. Cognitive problems such as clouded thinking and poor memory may begin to lessen during the third week as well. The fourth week usually marks a substantial improvement, and cognitive issues are normally much improved by the fourth week, although they may remain for another few months to some degree. Sleep may have returned to normal week four, as getting to sleep becomes easier and the quality of sleep that is achieved improves. Fatigue and lethargy may be almost completely absent by the fourth week as well.
Some of the most common symptoms during the third and fourth weeks of cocaine withdrawal may include:
While these symptoms may still be present at the end of the first month, they should be greatly improved. They should continue to resolve as time passes, but this can happen at different rates for different people.
Post-acute withdrawal symptoms may persist for many months after cocaine use has been stopped and is characterized by depressive symptoms and intermittent cravings for cocaine. The symptoms are much less severe than during acute withdrawal but are still present nonetheless. This phase is different for everyone, and the length is dependent upon many variables and contributing factors.
Some of the most common symptoms of post-acute withdrawal syndrome include:
Post-acute withdrawal from cocaine can last around 6-7 months on average but has been known to persist for years in rare cases. The length of time as well as the amounts of cocaine that someone used will certainly play a role in the duration of post-acute withdrawal symptoms. This means that the more and longer someone uses, the longer the withdrawal symptoms will persist. That being said, the symptoms will not disappear all at once. There is a tendency for the symptoms to lessen over months until they have completely resolved.
There is a great deal of uncertainty in the exact duration of cocaine withdrawal experienced between individuals. In part, this is due to the lack of a clear cut and distinct transition between the two phases as well as the great variation of cocaine withdrawal experiences between people. For some people, the experience is over in a month, whereas other people may experience intense symptoms for a year or more. While the exact reason for this is unknown, there are several factors that are known to play large roles in the intensity and duration of withdrawal symptoms.
Several factors which may impact the cocaine withdrawal intensity and timeline between individuals include:
The genetic predisposition for addiction is not well understood, but it certainly plays a role in how quickly someone may become addicted to a drug. It may also affect the intensity of their addictive behavior to some extent. The amounts of cocaine that someone used will directly impact the withdrawal intensity and timeline, as larger quantities of cocaine produce a greater amount of downregulation. This in turn requires longer for the brain to restore balance after cocaine use has ceased. This is the same reason that the length of time someone used cocaine will extend the cocaine withdrawal timeline.
Co-occurring mental health issues play some role as well, although the exact interplay between pre-existing mental health issues and cocaine use is not clear. What is known is that the depressive symptoms of cocaine withdrawal will be more intense if someone were to suffer from depression previously. The neurotransmitter deficiencies produced through cocaine withdrawal are in a way very similar to some of the causes of depression. In this manner, these separate issues can compound and amplify each other, leading to a more unpleasant experience. The same could be said for anxiety, and possibly even psychosis or paranoia.
Cocaine produces its effects primarily through increasing levels of dopamine in the brain. The neurotransmitters serotonin, norepinephrine, glutamate, and others are also affected, but dopamine is the major player regarding cocaine highs and cocaine withdrawal. Dopamine is an excitatory neurotransmitter and is in part responsible for mood, memory, concentration, learning, sleep, motor control, and feeling of reward and pleasure. When cocaine is used for long periods the brain adapts to these increased levels of dopamine through a process called downregulation. This means that the brain reduces its sensitivity to dopamine to compensate for the increased levels.
The process of downregulation is initially responsible for tolerance, and once cocaine use is suddenly stopped, it is the cause of the withdrawal symptoms that someone experiences. The cessation of cocaine use coupled with the brain’s reduced sensitivity to dopamine means that dopamine is present in much lower levels as well as having a reduced effect. The brain is capable of increasing dopamine sensitivity again, but this process takes time. During this process is where the experience of cocaine withdrawal lives.
Cocaine withdrawal can be a protracted experience but is commonly divided into 2 phases: acute and post-acute. While the symptoms during each phase are very similar, the distinction is mainly related to the intensity of the symptoms. To get the most well-rounded picture possible, let’s take a look at each phase in turn:
The symptoms of cocaine withdrawal can be very emotionally uncomfortable, and getting help to manage them is critical. Entering a cocaine detox center can provide medical supervision, medications, and therapies that may both reduce the discomfort and improve someone’s chances of successful recovery from cocaine addiction. In addition to direct benefits, these centers may provide resources for continuing care after detox and help someone build a comprehensive foundation in recovery.
There are several other stimulant drugs that can produce uncomfortable or even dangerous withdrawal symptoms. We have more in-depth withdrawal guides for drugs such as:
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