Treating a Cocaine Addiction
Many people try to stop using cocaine without outside help. They may do this for a number of reasons, such as:
- Embarrassment over their cocaine use.
- Believing they cannot afford the cost of treatment.
- Believing that their cocaine use is not severe enough to qualify for help.
Unfortunately, most recovering addicts discover that there are pitfalls that occur when one tries to fight an addiction alone. Most often, individuals who have cocaine abuse or addiction issues have trouble when they attempt to quit on their own because:
- They lack structure in their approach.
- They don’t have an experienced support mechanism, such as a support group or a therapist, to rely on.
- They tend to retain their old habits or associate with the same people they associated with when using cocaine.
- They aren’t prepared to deal with the symptoms of withdrawal and/or strong cravings that result when quitting cocaine.
Types of Cocaine Addiction Treatment
Structured recovery programs allow you to benefit from both the professional training and treatment experience of others to assist them in their recovery. Structured treatment settings can include: 1
- Inpatient or residential rehab programs offer a safe, supportive place to live while completing a recovery program. Inpatient cocaine treatment programs design a treatment plan for you that may include initial detox, individual and group therapy, medical monitoring and aftercare planning.
- Outpatient rehab programs include many of the same services as inpatient programs but do not require you to live at the facility.
- Individual counseling/therapy gives you access to an addiction treatment professional who helps you structure a program of recovery and address the inevitable issues that will occur.
- Group counseling/therapy programs essentially perform the same functions as individual counseling/therapy programs do, but with the added benefit of interacting with others with varying levels of recovery to learn from, rely on and with whom to develop a positive support network. Group counseling programs can also consist of family counseling.
- Twelve-step programs are social support groups (not therapy or counseling groups), but also offer a structured program and boast very strong peer support during the recovery process.
Polysubstance abuse – using other drugs in addition to cocaine – can cause its own mental and medical health hazards. Treatment, in these instances, will need to address both addictions to maximize recovery.
What Is the Best Way to Quit Cocaine?
Inpatient therapies usually last from 30 days to 90 days depending on the situation. Most people enrolled in inpatient or residential rehabilitation programs continue their recovery with outpatient aftercare. Inpatient drug rehab programs often begin with a period of medical detoxification, where you are supervised while going through the withdrawal phase associated with quitting certain drugs.
Inpatient cocaine rehab may be useful if you need to remove yourself from a potentially hazardous environment that will increase the probability of relapse (e.g., a homeless person, someone who has a severely dysfunctional family, someone who associates mostly with individuals who use cocaine, etc.) or if you have a severe addiction.
Research indicates that individuals who begin their recovery in an inpatient program have a lower probability of relapse in the vulnerable early stages of recovery. 1
Most of the formal counseling/therapy programs that address substance abuse or addiction use cognitive behavioral therapy (CBT) techniques, which have scientific evidence to support their effectiveness. Twelve-step programs, such as Narcotics Anonymous (NA) or Alcoholics Anonymous (AA), do not directly use these techniques, though they may incorporate similar approaches. Twelve-step programs operate without required fees, whereas formal counseling/therapy programs require you to use your insurance or pay for the services out-of-pocket.
Cocaine Addiction Aftercare
Cocaine recovery can be a long-term or lifelong endeavor.
Because recovery from substance abuse or addiction is a long-term and, in many cases, a lifelong endeavor, it is important that you become engaged in some type of aftercare program to address the issues you will face when you leave a formal drug rehabilitation program. Social support groups, such as 12-step groups, are ongoing and can provide long-term aftercare.
Other options include sober living homes or halfway houses, regularly scheduled counseling visits and periodic “recovery maintenance” offered through more intensive outpatient program settings.
Cocaine Withdrawal Symptoms and Effects
Cocaine use produces an extreme sense of euphoria as a result of your brain releasing high amounts of several neurotransmitters, especially dopamine. When you stop using cocaine, you may experience “a crash” or immediate intensification of negative feelings, which are often later accompanied by strong cravings to use more cocaine.
- Severe fatigue or drowsiness.
- Increased appetite.
- Difficulty feeling pleasure.
- Severe restlessness.
- Being extremely suspicious or even paranoid.
- General feelings of malaise.
- Vivid dreams.
- An overall slowing of physical activity.
- Strong feelings of depression and even thoughts of hurting oneself. 3
For the most part, cocaine withdrawal does not produce the more unpleasant physical symptoms seen in people quitting substances such as alcohol and heroin – symptoms such as nausea, vomiting, trembling and cold sweats. However, the depression and craving for cocaine can be intense. Symptoms of severe clinical depression, including wanting to hurt yourself, as well as the onset of acute psychotic features, such as paranoia or hallucinations, are very serious and will require professional help. Even symptoms such as agitation and severe restlessness may require professional help.
Cocaine Withdrawal Timeline
The severity of the withdrawal symptoms will depend on how often you were using cocaine and the amount of cocaine you used, among other factors.
Phases of Cocaine Withdrawal
The cocaine withdrawal process often includes the following phases: 1, 3
- The crash. This phase can last from several hours to several days. These symptoms are the most severe and typically include depression, irritability, sleepiness, anxiety, fatigue, increased appetite and severe drug craving.
- Extreme craving. This phase of withdrawal may begin within several hours and may last for weeks. In this phase, you may continue to experience strong cravings to use cocaine and may begin to reflect on all of the positive feelings and experiences from cocaine use. You may be distractible, irritable, lethargic, depressed and/or anxious. For many people with severe cocaine problems, this phase may last from 8 to 12 weeks.
- Extinction. Generally, when you have been clean from cocaine for about 10 weeks, you enter an extinction phase that consists of less frequent and often less severe cravings for cocaine. If you do have cravings, they are often triggered by events in your surroundings, such as friends that you used to do cocaine with, stressful events and revisiting places where you may have used cocaine.
- Post-acute withdrawal syndrome. Some sources have discussed a more extended period of withdrawal known as post-acute withdrawal syndrome (PAWS). 1 During PAWS, you may experience psychological and emotional symptoms believed to be related to a more long-term withdrawal process that include:
- Mood swings.
- Fatigue or variable energy levels.
- Problems with concentration.
- Problems with sleep that can include insomnia or hypersomnia (excessive sleeping).
These symptoms may even persist for a few years after the last instance of cocaine use. Some researchers believe that PAWS symptoms can contribute to relapse because once the person begins to take the drug again, these symptoms will tend to go away. This is another reason why a long-term aftercare program can be an essential component of long-term recovery, relapse avoidance and quitting cocaine for good.
Can You Quit Cocaine Cold Turkey?
Cocaine withdrawal can lead to depression and suicidal thoughts.
Quitting cocaine without professional help can be very difficult. Someone who stops using cocaine under medical supervision can benefit from medication(s) that may help reduce their cravings, mood swings, irritability and so forth. This approach may reduce the risk of relapse. 1, 3
Cocaine withdrawal can also lead to depression and suicidal thoughts, and these feelings can be difficult if not dangerous to manage on your own.
Benefits of Quitting Cocaine
The following benefits can be expected when quitting cocaine: 2
- Reduced risk of health problems. The risks will almost immediately diminish for experiencing cardiovascular problems (stroke or heart attack), seizures, problems with your nasal passages or with your respiratory system, as well as various problems associated with intravenous drug use – contracting hepatitis, HIV or other serious infections.
- Better sleep. Many people who quit using cocaine experience an increase in the quantity and quality of their sleep.
- Reduction of many behavioral consequences associated with cocaine use. These include the reduction of potential criminal consequences associated with cocaine use and cocaine possession, and an increase in self-control and goal-directed behavior.
- Improved mental health. Many people experience the elimination of stress and an end to the cycle of ups and downs that most people who use cocaine routinely experience.
- Lowered risk of developing mental illness. Long-term cocaine use can lead to developing symptoms of mental illnesses, such as anxiety, psychosis, depression and associated thoughts of hurting oneself or hurting others.
- Improved finances due to the expense of cocaine use. When you kick a cocaine addiction, you will not be spending money on a cocaine habit anymore.
- More opportunities for employment. Most people who quit using cocaine are able to focus more on earning a living and building their career.
- Increased cognitive abilities. Many people see improvements in their attention, memory and other thinking abilities, such as abstract thinking.
- Increased self-confidence and self-control. You may feel more confident as you start to see other positive changes in your life.
Factors That Affect Benefits
The benefits from quitting are based on several factors, such as:
- How long you’ve been using the drug.
- The amount you used.
- The regularity of use and whether you took cocaine in combination with other drugs, such as alcohol, other stimulants and benzodiazepines.
Quitting cocaine will not make all of your problems disappear. It will not change situations that you have no control over or result in a stress-free life. What will change is your ability to better control and determine how you respond to the hurdles that occur as a result of living in the world.
Tips for Quitting Cocaine
There are several suggestions that individuals can follow to help them quit using cocaine:
- Prepare in advance to deal with cravings for cocaine. Develop a plan to deal with stress – such as exercise or meditation – and become aware of social support networks that you can count on when you need it.
- Find alternative interests or hobbies that you can use to fill your time. The important thing is to do something that you enjoy doing.
- Avoid people and places you associated with when you used cocaine. These can serve as triggers for a relapse.
- Consider a structured treatment program. The program can be inpatient or outpatient. An inpatient cocaine rehab program will provide structure and education and isolate you from negative influences during the most crucial part of your recovery. Eventually you will need a long-term outpatient aftercare plan.
- Try a social support group such as Narcotics Anonymous. Twelve-step programs or other support groups such as SMART Recovery can allow you to get encouragement and support from your peers in recovery, as well as provide a program to follow.
Helping a Loved One Quit Cocaine
If you know someone who has a cocaine abuse issue or addiction problem and you want to help them, there are several things to consider:
- Be thoughtful in your approach.
- Avoid accusing the person.
- Avoid being extremely confrontational or argumentative.
- Stay calm; do not get angry or emotional.
- Ask questions regarding the person’s behavior.
- Never threaten the person with treatment – make suggestions instead.
- Expect the person to be resistant.
- Stay in control of yourself no matter how the other person acts.
- Communicate concern.
- Point out inconsistencies in the individual’s behavior.
- Encourage the person to talk to a treatment professional.
Be aware that it can sometimes take several attempts to get someone with a cocaine addiction to accept that they need help.
Finding a Cocaine Addiction Treatment Program
Before you call a treatment center or admissions consultant, have some information ready, such as your insurance info, you or your loved one’s age, where you live, how long you’ve been using cocaine, how much, whether you’ve been abusing other drugs, and whether you have any health or psychological problems.
. Ries, R. K., Fiellin, D. A., Miller, S. C., & Saitz, R. (2014). The ASAM Principles of Addiction Medicine. Lippincott Williams & Wilkins.
. Waldorf, D., Reinarman, C., & Murphy, S. (1992). Cocaine changes: The experience of using and quitting. Temple University Press.
. Wax, P. M. & Barrera, R. (2009). Drug Withdrawal. In Wolfson, A. B., Hendey, G. W., Ling, L. J. et al., (Eds.) Harwood-Nuss’ Clinical Practice of Emergency Medicine (5th edition). Lippincott Williams & Wilkins.