Cocaine Comedown

Cocaine is a stimulant drug that increases the speed at which messages travel between the brain and the rest of the body. When long-term, heavy users try to stop or reduce their cocaine consumption, there is a corresponding crash or comedown: fatigue, agitation, trouble sleeping, depression, and vivid but unpleasant dreams. Manage it with hydration, a healthy diet, exercise, and cognitive-behavioral therapy.

Cocaine belongs to a group of drug known as stimulants. Stimulants speed up the messages traveling between the brain and the rest of a person’s body. Cocaine is highly addictive and many people become dependent on it. A study published in the Journal of Addiction Disorders stated that 5 to 6 percent of people who try cocaine become dependent on it within the first year. Also, 15 to 16 percent of cocaine users become dependent on it after 10 years. A cocaine comedown happens when someone who used a lot of cocaine cuts down on their use or suddenly stops taking the substance. Symptoms are sometimes seen in people who are not even completely off the drug yet.

Cocaine Comedown Symptoms

Cocaine comedown symptoms include fatigue, general feelings of discomfort, increased appetite, agitation, restless behaviors, sleep disturbances, depressed mood, unpleasant and vivid dreams, and slowing of activity. If a person used cocaine heavily, the craving and depression can last for months after taking the last dose of cocaine. Some people even experience delusions and suicidal thoughts. Also, a person can experience powerful cravings for cocaine which makes it extremely difficult to quit the drug.

Cocaine Binge and Crash

A cocaine binge happens usually sometime after the initial high fades and a person may continue to use cocaine every couple hours in order to maintain euphoric feelings. The crash is the last stage before a person goes through withdrawal. A crash can start within hours after a person takes their last dose of cocaine or it could take a few days.

Managing a Cocaine Comedown

People who engage in cocaine use experience a reduction in their appetite which can lead to weight loss and poor nutrition. Therefore, people who are detoxing from cocaine need to increase their fluid intake, especially water, in order to stay well hydrated and prevent dehydration. Other things people can do to manage their cocaine comedown is to talk with a doctor, get exercise, eat a balanced diet, get plenty of sleep, keep busy, relax, meditate and try to learn some basic stress management techniques.

Giving up cocaine after prolonged use can be extremely difficult because the body is so used to functioning with the substance. According to the Substance Use Disorder and Mental Health Services Administration (SAMHSA), in 2011 about 24 percent of emergency room visits involving people seeking detox or substance use disorder used cocaine. Additionally, in 2011 about 6 percent of emergency room visits involving cocaine were for suicide attempts. Therefore, before coming off cocaine it is important to seek medical advice and treatment to ensure a safe detox.

Withdrawal from Cocaine/Detox

Cocaine withdrawal symptoms vary from person to person. Typically, they start about 1 to 2 days after the last dose of the substance was taken. They can last about 10 weeks, but the first 4 to 7 days are the worst. Withdrawal usually happens in 3 phases. The first phase is the crash and lasts for the first few days. This period is characterized with symptoms of agitation, depression or anxiety, hunger, cravings for cocaine, insomnia, and extreme fatigue. A few people may even experience suicidal thoughts. After this phase comes withdrawal which can last about 10 weeks. Withdrawal is characterized with intense cocaine cravings, lack of energy, anxiety, angry outbursts, and an inability to feel pleasure. The risk of relapse is very high during this phase. The final phase is extinction which is characterized with intense cravings for cocaine that come and go. This phase is ongoing so seeking support groups or other forms of treatment is necessary to ensure lifelong abstinence.

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Medications to Assist in the Withdrawal Process

The symptoms associated with coming down from cocaine make it difficult to attain an initial period of abstinence. Medications are used to help people attain an initial period of abstinence as well as avoid relapse. According to the National Institute on Drug Abuse, currently there are no FDA approved medications available to treat cocaine addiction. However, there are a few medications that are used to treat other diseases that can be used to help reduce cocaine use. One of these medications is known as disulfiram which is currently being used to treat alcoholism. However, this drug does not work for everyone and scientists do not really know how it reduces cocaine use. When used along with alcohol it cause adverse reaction leading to nausea,vomiting,severe throbbing headache, chest pain and palpitations.These adverse effects prevent the person from taking alcohol .Another medication known as propranolol was found to be promising for people who are experiencing extreme cocaine comedown symptoms. Since propranolol is a beta-blocker it may be able to reduce the anxiety that is caused by cocaine withdrawal as it reduces some of the uncomfortable symptoms of cocaine-like cravings.

After individuals recovering from cocaine addiction attain an initial period of abstinence, then the more difficult part of treatment can begin. This is relapse prevention. A few medications that are promising for relapse prevention include baclofen, tiagabine, topiramate, modafinil, and TA-CD.

In terms of relapse, researchers have created and are in the early testing phases of a cocaine vaccine that could help reduce the chances of relapse. The vaccine works by stimulating the immune system to develop cocaine specific antibodies that bind to cocaine. This prevents cocaine from making its way into the brain. The downfall of this potential cocaine vaccine is that it does not work for everyone. In the clinical trials, only 38 percent of vaccinated people’s bodies created enough antibodies to prevent cocaine from getting into the brain and the antibodies only lasted 2 months.

Finding a Treatment Center

If using cocaine is impacting your health, family, relationships, work, school, finances, or any other life situation finding a high-quality rehabilitation clinic can help. The most successful treatment programs for cocaine addiction use behavioral therapies and aftercare to help prevent relapse.

One form of behavioral therapy that has been proven to help a person overcome their cocaine addiction is cognitive-behavioral therapy. This is used to help individuals impede relapse and aids in continual abstinence from using cocaine. Another form of behavior therapy is contingency management. This is a program that uses a prize-based system that rewards individuals who are recovering from their cocaine addiction for refraining from cocaine use. This provides an encouragement to them. Another treatment option is a 12-step program that can help individuals who are addicted to cocaine overcome their affliction and maintain abstinence.


Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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