Cocaine withdrawal runs through several stages. Immediately after using cocaine, the user undergoes a “crash,” which begins with a rapid drop in mood, fatigue, and intense craving for cocaine. This craving usually subsides within a few hours, followed by increased fatigue and need for sleep. At this point, people who are not in treatment often use alcohol, anti-anxiety drugs, sedatives, opiates, or marijuana—just to get some sleep.
In treatment, these symptoms can be managed with electro-chemically balanced nutrition, certain natural supplements, exercise, and the occasional use of nonaddicting, mildly sedating medications, such as sedating mood-stabilizing antidepressants.
After the Crash
Once the cocaine user gets past the acute fatigue and need for sleep, most of the “crash” symptoms disappear. The short- and long-term effects of cocaine usually depend on whether the drug was snorted, smoked, injected, or swallowed (i.e., snorting damages nasal passages, smoking affects the lungs, etc).
Crack, because of the severity and intensity of its abuse, often causes extreme side effects. It has been estimated that an alarming 24 percent of female crack users and 9 percent of male users had experienced side effects severe enough to require a trip to a hospital’s emergency room. The reasons given for these hospital visits include “my heart stopped,” “I thought I was going to die,” and “my lungs filled up with blood.”
The most notable after-crash symptom for cocaine users is a chaotic emotional state. Users can experience rapid mood shifts, emotional instability, and an overall heightened emotional range. Basically, a cocaine-user will experience their emotions as being all over the place.
A pronounced cognitive issue in cocaine withdrawal is anhedonia—an inability to feel pleasure or enjoyment. Experts say that the most common complaint of chronic cocaine users is boredom, because they don’t know the word anhedonia. The state can be described as an empty subjective existence, and during anhedonia the cocaine user may feel the pull toward cocaine-induced euphoria most strongly.
This is a major danger period during which many cocaine users return to the old cycle: high-crash-anhedonia-craving-use-high, and so on. But during treatment, with abstinence and with medical and psychological support, the anhedonia disappears—usually within two to ten weeks.
Quality treatment programs also have the great advantage of protecting the cocaine user against “cues” or reminders of past euphoria that make return to cocaine so tempting during the period of boredom.
Triggers and Cravings
Even after the worst is over, there can be moments of intense craving. Cocaine users seem to have remarkably poor memories of the bad effects of their habit—physical, emotional, and social—and remarkably strong memories of the “highs.” The bad memories, which make returning to cocaine less appealing, do seem to return after the craving period is over. Part of addiction treatment is helping you learn to survive the craving and reinforce the reasons you needed to quit.
Compared to cravings for other chemicals, craving for cocaine seems more strongly linked to such influences as your mood, scenes, particular people or events, times of the year, problems with other people, or various objects associated with drug use. These associations can be part of the so-called “glamor appeal” of cocaine. For the majority of users, these associations are not glamorous: driving past an old nightspot, bumping into the neighborhood dealer, even watching an actor use cocaine in a movie can trigger powerful craving. For this reason, therapy for cocaine dependence deals intensely with techniques to reduce the power of these triggering factors.