If you regularly abuse cocaine for a significant period of time and then stop, you may experience withdrawal symptoms and cravings. Cravings are a normal part of the recovery process, but it’s important to understand them and have a plan to deal with them.
Cravings Signs and Symptoms
Cravings often represent programmed responses to signals from the environment that have been connected to your use of a drug.1
For example, imagine that you were able to return to a place of your childhood where you had many satisfying experiences. You would walk around that place, and you would be reminded of certain feelings, experiences and other associations that would trigger vivid memories.
Cocaine cravings are similar to this. They are vivid memories of the effects that the drug had on your brain that are triggered by events in your surroundings or by fleeting thoughts and feelings.
These triggers or reminders can be anything. Triggers can be very specific to you or can consist of rather general cues that elicit these memories in other addicts. Because there is a very strong neurochemical bond related to these triggers and memories of the experiences of drug use, cravings are experienced as extremely strong urges to engage in drug use.
Physical and Mental Symptoms Associated With Triggers
Some of the general physical and mental characteristics associated with cocaine triggers include:1
- Increases in heart rate.
- Increases in blood pressure.
- Increases in sweat gland activities.
- Stomach cramps.
- General sensations of invigoration.
- Increased anticipation.
- Heightened awareness.
Onset of Urges
For many individuals, cravings can occur after only a few hours following discontinuation of cocaine. Other individuals may not experience cravings for several days or even weeks.
However, both experiencing and enduring cravings are normal parts of the recovery process. Most individuals with a substance use problem will encounter them at one time or another.
Treatments and Medications to Help Stop Cravings
The standard forms of treatment for dealing with cravings include various forms of psychotherapy and medications.2
Psychotherapy programs directed at addiction recovery most often use approaches that incorporate principles of cognitive behavioral therapy (CBT). This approach to preventing relapse is designed to help you:
- Understand that cravings are normal experiences and not signs of failures or weakness.
- Recognize your own triggers.
- Recognize general triggers.
- Develop coping strategies, such as avoiding triggers or anticipating them.
- Develop a plan of action to deal with triggers when they arise.3
These tools allow you to develop skills, self-confidence, and social networks that help you recognize environmental cues, negative emotional states and peer pressure that either trigger cravings or are the result of cravings. Other self-help programs, such as 12-step programs, promote the use of these principles and similar methods of coping.
Several different drugs are now used to reduce cravings for cocaine:2
- Gabapentin (Neurontin), topiramate (Topamax), and vigabatrin (Sabril) are anticonvulsants—all may reduce cravings for cocaine.
- Baclofen (Gablofen) is a muscle relaxant shown to reduce cocaine cravings in past heavy users.
- Modafinil (Provogil) is a eugeroic medication or wakefulness-promoting agent that may help reduce cravings by reducing daytime sleepiness in cocaine users trying to remain abstinent.
- Several other medications such as naloxone and even carefully monitored doses of the prescription stimulant methylphenidate (Ritalin) may help reduce cravings.
Can You Stop Cravings Naturally?
Some other strategies to reduce cocaine cravings that may be useful include:2
- Diet: Paying attention to your diet and eating healthy may reduce certain internal triggers such as fatigue and frustration that could trigger cravings.
- Exercise: Some people find that exercise helps to distract them from their cocaine cravings. Exercise also results in stimulation of many of the neurotransmitters that cocaine use affects, thus reducing craving for cocaine in some people.
- Meditation: Some research has shown that using meditation may reduce drug cravings to some extent.
- Distraction: Many people find that keeping busy reduces cravings by occupying their thoughts and minds with goal-directed behaviors.
- Vitamins: Evidence for megavitamin therapy and other natural substances such as herbs is limited. But research has supported the use of the amino acid N-Acetylcysteine (NAC) in reducing cravings for cocaine. The substance can be purchased without a prescription.
Detox and Withdrawal Risks
Cocaine withdrawal is emotionally and psychologically demanding.
People attempting to begin recovery from cocaine abuse/addiction will experience a withdrawal syndrome that is composed of:
- Strong cravings.
- Some minor discomfort in the form of flu-like symptoms (although this is not as common as the emotional and psychological symptoms).2,3
Unlike withdrawal from alcohol or opiates, cocaine withdrawal does not appear to be as physically demanding. However, it is extremely psychologically and emotionally demanding. Many people experience very strong cravings, periods of depression, and irritability for 24 to 72 hours following discontinuation.
Afterward, these people will still experience these feelings, but their intensity will diminish over time. Anyone going through a detoxification period from cocaine abuse would be wise to enlist the help of an addiction specialist to monitor their recovery, to manage any severe symptoms of depression, and to minimize the risk of relapse in response to unpleasant withdrawal effects.
Cravings and Relapse
Relapse rates for recovering cocaine abusers are as high as they are for other drugs of abuse.
For most people, a relapse doesn’t just happen. It is associated with certain signs that the person is beginning to move in the wrong direction.
Relapse Warning Signs
Some signs of an impending or possible relapse include: 3
- Romanticizing past drug use. You only think about the good times or the positive aspects of using cocaine.
- Stopping attendance of therapy or support groups. Perhaps the most common sign that a relapse is dangerously near is when you stop doing all of the positive behaviors that helped to keep you abstinent.
- Thinking that using one time would be OK. Any relapse begins with that first return to use. If you don’t engage in the first use, then you cannot relapse on cocaine.
- Continuing to engage in behaviors that other substance users engage in. This includes accusing other people of causing your problems, getting moody and selfish, and hanging out with people you socialized with when using or in places where you used the drug. Many successful recovery cocaine abusers find that they need to separate themselves from the people, places and activities they used to perform when engaging in their cocaine use.
- Moving away from activities, people, and other things from your sober lifestyle. For example, you return to lying to loved ones, not being honest with others, and so forth.
- Becoming upset or extremely defensive when someone points out inconsistencies in your behavior. Many people find that an inability to accept criticism is a sign that a person may be headed toward a relapse.
What to Do
- Know your triggers and have a plan to deal with them.
- Understand that things in life will not always go the way you want them to and accept your ability to only control how you react to the things you experience.
- Maintain a positive support group and listen to the people in that group.
- Know the signs of relapse and be prepared to spot them.
- Have a backup plan in place if you feel that you are headed toward a relapse.
- Be honest and open with yourself and others.
- Maintain a daily commitment to recovery.
How Long Do Urges Last?
Many people begin to experience cravings for cocaine within a few days to a few weeks after quitting. Some people may even begin to experience cravings within several hours of their last drug use. Several aspects of your past use may predict how strong your cravings may be and how long they may last:3
- The length of time you used cocaine.
- The amount of cocaine you used in the past.
- The regularity of cocaine use in the past (e.g., every day, once a week, etc.).
- If you have any cross addictions, such as alcohol.
- If you have a family history of serious addictive behaviors.
Research on Craving Duration
Research using animal models of cocaine addiction has suggested that those with severe cocaine abuse problems may experience recurrences of cravings long after they have discontinued using the drug. Some may experience especially protracted cravings—even years after stopping.
Typically, the cravings that occur months or years following discontinuation are not nearly as strong as those experienced only a few days after stopping. But many addicts report experiencing occasional cravings in the years following discontinuation.
This is why it is important to have knowledge of the recovery process, knowledge of your triggers and a plan to deal with cravings even after you have been abstinent for some time.
Frequently Asked Questions
Why Do I Crave Cocaine After I’ve Stopped Using?
Some cravings represent learned associations your brain made when you were abusing cocaine. Reminders of these experiences, particularly the pleasant or reinforcing experiences of the drug, trigger cravings.
When these triggers cue these feelings, you automatically associate them with the drug use and have a desire to use the drug.
Why Do I Crave Cocaine While I’m Using Other Drugs, Like Alcohol?
The use of a drug serves as a trigger for other drugs you’ve used.
The use of any drug serves as a trigger for any other drugs that you may have used in the past. Most people find that if they are trying to stop using cocaine they must also stop doing many of the things that they did when they were abusing cocaine, such as:
- Quitting other drugs of abuse.
- Not hanging around with the people they used cocaine with.
- Not going to the places where they used cocaine.
- Welberg, L. (2013). Addiction: Craving: A core issue. Nature Reviews Neuroscience, 14(5), 307–307.
- O’Brien, C. P. (2014). Anticraving medications for relapse prevention: A possible new class of psychoactive medications. American Journal of Psychiatry. http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.162.8.1423
- Marlatt, G. A. & Donovan, D. M. (Eds.). (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. Guilford Press.