Cocaine Withdrawal Signs And Symptoms

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Cocaine withdrawal happens when someone who has chronically abused cocaine suddenly cuts down on, or stops using the drug. It is possible for withdrawal symptoms to occur even if someone has not completely stopped using cocaine and still has some of the drug left in their system.

Often, cocaine withdrawal has no visible physical symptoms, like vomiting and shaking that accompany opioid or alcohol withdrawal. It is more common for cocaine withdrawal symptoms to be psychological and the opposite of the psychological effects of the drug.

Possible cocaine withdrawal symptoms include:

  • agitation and restless behavior
  • depressed mood
  • fatigue
  • general feelings of discomfort
  • increased appetite
  • vivid and unpleasant dreams
  • slowing of activity

Cravings for the drug and certain psychological symptoms can last for months after stopping long-term, heavy use. Cocaine withdrawal may also result in suicidal thoughts in some individuals.

Cocaine Withdrawal Signs And Symptoms_Suicidal Thoughts In Some People

During the withdrawal process, individuals can experience powerful and intense cravings for cocaine. Even if during their long-term abuse, when some individuals become sensitized (reverse tolerance) to cocaine, there can still be intense cravings for the drug. Someone who abused cocaine intravenously (IV), or by injection, is more likely to experience psychiatric withdrawal symptoms compared to those who abuse it by snorting or smoking.

Cocaine Withdrawal Timeline

Cocaine withdrawal can last for several days to a few weeks and, in some cases, for months after the last use. However, the general timeline for cocaine withdrawal lasts about a month. The initial mouth of cocaine withdrawal can consist of unpredictable and alternating states from low to high drug cravings, anxiety, paranoia and long periods of sleep.

The following are general symptoms that may or may not be experienced by someone going through the process of withdrawing from cocaine.

Symptoms felt 24-72 hours after the last dose may include:

  • confusion, depression and disorientation
  • intense cocaine cravings
  • fatigue
  • hunger
  • irritability, restlessness and remorse
  • insomnia

Possible symptoms four to seven days after the last dose include: anxiety, apathy, depression, decreased cocaine cravings, dysphoria (general dissatisfaction with life,) irritability and paranoia.

Symptoms that may occur a week after the last dose include: agitation, further decreased cocaine cravings, increase in appetite and vivid and unpleasant dreams.

Two weeks after the last dose, possible withdrawal symptoms may include: anger, the return of cocaine cravings, further depression and vivid dreams.

Three to four weeks after the last dose, people may experience increased depression, mood swings, trouble falling and staying asleep, increased stress and anxiety.

It is also possible for those who have abused cocaine for a long-time to experience post acute withdrawal symptoms (PAWS). These symptoms may occur three to six months after quitting cocaine and can include: anxiety, agitation, cravings, depression and mood swings.

Prolonged cocaine withdrawal can last between six months up to two years. The length of the withdrawal process will depend on the amount of time someone abused cocaine, the severity of their addiction and the purity of the cocaine abused.

It is recommended to seek professional, medical supervision during the withdrawal process in order to receive the proper emotional and psychological support, and prevent addiction relapse.

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Developing Tolerance To Cocaine

Each person who abuses cocaine will develop tolerance at a different rate. Some people may build up a classic tolerance to the drug, where they will require larger and more frequent doses in order to achieve the same high a smaller dose once produced.

Other people abusing cocaine may instead become more sensitive to the drug. This is a type of ‘reverse tolerance,’ also known as sensitization. When this happens, individuals may have more intense reactions to cocaine. Cocaine sensitization may also lead to negative and possibly life-threatening side effects including: cardiac arrest, cocaine overdose from very small doses of cocaine and respiratory failure.

The main symptom of cocaine tolerance is intense cravings for the drug. Once this occurs, many people will go on cocaine binges where they continually take the drug and remain in a ‘perminate high.’

Eventually, some people may experience a ceiling effect where, no matter how much cocaine they take, they are not capable of getting high because their system has been completely wiped of dopamine.

How Cocaine Affects The Brain

Cocaine increases the levels of a naturally occuring chemical messenger, dopamine. Dopamine is involved in controlling pleasure and movement. Typically, the average brain releases dopamine within the brain circuits in response to potential rewards, like the smell of good food.

It then recycles back into the cell that released it, which turns off the signal between the nerve cells. When cocaine is introduced, is prevents dopamine from recycling which causes an excessive amount of dopamine to build up between the nerve cells. This disruption in the normal brain communication is what causes the high cocaine produces.

Risks Of Cocaine Abuse

Health risks associated with cocaine abuse may include increased stress on the heart and cardiovascular system. When someone abuses cocaine over a long-time period, (three or more weeks) they may also become malnourished or develop a movement disorder such as Parkinson’s disease later on in life.

Cocaine also holds a very high potential for addiction. This is due to the positive reinforcement caused by the flood of dopamine to the brain during use. This effect makes the brain believe that the body is doing something good and will trick the individual into wanting to repeat the process.

Cocaine Withdrawal Signs And Symptoms_Cocaine High Lasts Days To Weeks

Polydrug use, or using more than one drug at a time, while using cocaine also increases the risk of overdosing. Some people report becoming highly irritable and restless when they go on a cocaine binge. Other individuals may experience severe paranoia, where they become detached from reality and have auditory hallucinations (hear things that are not real).

Physical Effects Of Cocaine Addiction

Some short-term physical effects of cocaine abuse may include:

  • extreme boosts in energy and positive feelings
  • increased mental alertness
  • hypersensitivity to sights, sounds and touch
  • extreme mood swings including increased irritability
  • paranoia or extreme distrust of others

Although some people find that cocaine helps them perform simple physical and mental tasks more quickly than normal, others may experience the opposite effect. Effects of cocaine are felt almost immediately and may last for a few minutes to an hour.

Injecting or smoking cocaine produces a quicker and stronger, but shorter-lasting high than snorting the drug. The high from smoking cocaine may last five to 10 minutes. Some other physical effects of cocaine abuse include:

  • constricted blood vessels
  • dilated pupils
  • nausea
  • raised blood pressure and body temperature
  • increased heartbeat
  • tremors and muscle twitches
  • restlessness

Studies have shown that abusing cocaine can speed up HIV infection. Cocaine impairs immune cell function and promotes reproduction of the HIV virus. Research also indicates that individuals with HIV may have an increased risk for co-occurring infections, by contracting hepatitis C (a virus that affects liver function), even if they don’t inject the drug.

Effects Of Cocaine Abuse In Pregnant Women

Most women who suffer from cocaine addiction are of childbearing age. About five percent of pregnant women use one or more addictive substances, including cocaine. According to the National Institute on Drug Abuse, there are around 750,000 cocaine-exposed pregnancies every year.

Abusing cocaine during pregnancy can cause maternal migraines and seizures, premature membrane rupture and separation of the placental lining from the uterus before delivery. Pregnancy is associated with normal cardiovascular changes and cocaine can exacerbate these changes, causing serious problems with high blood pressure, spontaneous miscarriage, preterm labor and difficult delivery.

Treatment For Cocaine Addiction And Withdrawal

Treatment for cocaine addiction is typically addressed with behavioral therapies, which can help people deal with the psychological symptoms of withdrawal. Currently, there are no Food and Drug Administration (FDA) approved medications for treating the negative side effects of cocaine withdrawal.

In order to ensure the best care and comfort during the withdrawal process, it is best to enroll in an inpatient detox and/or treatment program. Doing so can provide the necessary support individuals need during the difficult withdrawal process and help to prevent relapse.

If you need more information on cocaine withdrawal and treatment, contact a specialist today.


University Of Maryland, Center for Substance Abuse Research—Cocaine (Powder)
U.S. National Library of Medicine, MedlinePlus—Cocaine Withdrawal

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