People who have substance use disorders (the diagnostic term that clinicians use to define substance abuse and addiction1) present with a number of different mental and physical symptoms. A core feature of a substance use disorder is the person’s inability to control his or her use of the drug or alcohol in spite of substantial problems resulting from the substance use.1 Very often this inability to moderate one’s drug or alcohol, given the obvious negative consequences, is puzzling to those who witness the behavior. Even more puzzling to friends and family members of these people is the common observation that they act as if everything is just fine.
Although the overall numbers of people with stimulant use disorders in connection with cocaine abuse are declining, cocaine still remains a very common drug of abuse. In fact, cocaine remains one of the most commonly implicated illicit drugs seen in association with emergency room visits in the United States.2 The National Institute on Drug Abuse’s most recent figures regarding drug-related emergency department visits indicate that cocaine is responsible for the most visits of all the illicit drugs.2
Signs and Symptoms That May Indicate a Problem
These are some of the signs and symptoms of a cocaine addiction (or stimulant use disorder):1,3
- Taking larger amounts of cocaine or using cocaine longer than originally intended.
- Strong urges/cravings to use cocaine.
- Inability to cut down or totally stop cocaine use, despite expressed intent or attempts to do so.
- Neglecting important obligations (job, family, school) as a result of cocaine use.
- Using cocaine in situations where it is dangerous to do so (driving a car, operating machinery, while watching children).
- Becoming isolated from others as a result of cocaine use.
- Giving up activities that were once important to use cocaine.
- Continuing to use cocaine despite obvious problems resulting from cocaine use (at work, in relationships, at school).
- Developing tolerance (needing more cocaine to get the same effect that was once achieved at lower amounts); experiencing both tolerance and withdrawal symptoms.
- Spending a lot of time using cocaine or trying to get cocaine.
- Exhibiting periods of elation, hyperactivity, inability to sleep, or extreme talkativeness followed by periods of lethargy, sleepiness, irritability, or depression.
- Displaying episodes of suspiciousness or seeing or hearing things that are not really there (psychosis).
- Disappearing for days at a time with no explanation.
- Displaying specific physical symptoms: frequent nosebleeds; frequent runny nose; sores around the mouth; needle tracks on the arms, legs, or other areas.
When someone exhibits two or more of these signs or symptoms, there may be reason to suspect that the person has a problem with cocaine.
Detoxing From Cocaine
Although the term detoxification or “detox” is often used to mean a formal program of medication-assisted withdrawal management, some clinicians no longer use this term in this way.4 The term detoxification technically describes a natural process the body uses to rid itself of waste materials and foreign substances, mostly via the liver. This process of detoxification occurs naturally whether you continue to use drugs or not.
If you stop using drugs after having developed a physical dependence to them, you are at risk for experiencing withdrawal symptoms. The concept of withdrawal management describes supervision and medical assistance to ease the withdrawal process in those who have developed physical or psychological dependence on a drug and are at risk of experiencing unpleasant withdrawal symptoms when they discontinue the drug.4 Professional detox programs can provide the best support, both medically and psychologically, for a recovering cocaine user. These programs tend to cost between $600 and $1,000 per day and will provide around-the-clock care to ensure the safest detox experience.7
Possible Withdrawal Symptoms
Some common cocaine withdrawal symptoms include:1
- Depression, apathy, uneasiness (and sometimes anxiety).
- Fatigue and sleepiness.
- Increased appetite.
- Insomnia or hypersomnia.
- Very lucid, often frightening dreams.
- Feeling or appearing as if you are moving in slow motion.
Other sources also report the following:4
- Severe mood issues: apathy; an inability to experience pleasure
- Psychotic symptoms: paranoia; hallucinations
- General feelings of malaise, such as mild flu-like symptoms
A decision to quit using cocaine and seek professional help can be life changing and must be taken seriously. It is important to understand that people who attempt to do this alone may have significantly higher relapse rates than people that choose formal cocaine addiction treatment programs.4 The withdrawal management program for people recovering from cocaine abuse will vary from person to person, depending on the severity of the person’s disorder, but often include medications to address the specific symptoms.
These are several things you should think about when you have decided to quit using cocaine:
- Find a Competent Program: Choosing a qualified treatment program to deal with your cocaine addiction is extremely important. Take a little time to look for programs that have licensed treatment providers, offer withdrawal management, and have long-term aftercare programs built into the overall program.
- Listen to Your Treatment Providers: Addiction medicine physicians and mental health care professionals have the training, experience, and desire to produce the best outcome for you. Listen to them. Follow their instructions. If you have questions, make sure to ask them. However, do not always expect to get the answer you want. Trust your treatment providers. It is also important to listen to others recovering from cocaine addiction and learn from their experiences.
- There Is No Time Like the Present: The quicker you can get involved in formalized treatment, the quicker you can address your issues and start to get back on track. If you think you have a problem with cocaine, the best time to do something about it is now.
- Stick with It: Recovery from a substance use disorder is a complex and difficult process for anyone. There will always be bumps in the road and there will always be situations that are frustrating and discouraging. Recovery is a process and represents an ongoing and evolving route of self-improvement. The only guarantee you have is that if you stay focused, refuse to give up, and endure despite everything that happens, you will eventually move toward recovery.
Rehab Options to Get and Stay Clean
People with cocaine addictions also often have psychological/psychiatric conditions—known as co-occurring conditions, or a dual diagnosis—that may complicate the treatment process.1,4 Fortunately, decades of research, successful outcomes in treatment, and the development of formalized approaches to treatment can help someone recovering from cocaine addiction in the most-efficient and least-stressful manner.4,5,6
Primary principles directing any form of treatment include:
- An effective treatment program addresses both the general principles of recovery (e.g., the notion that a person in recovery should remain abstinent from alcohol and drugs) and a person’s specific needs.
- Medication-assisted treatments are often extremely useful for people in recovery and should be used when deemed necessary by a medical professional.
- Co-occurring psychological and medical conditions should be addressed along with the substance use disorder.
- People with co-occurring psychological and medical conditions should have these treated alongside their substance use disorder. For example, if a person has clinical depression and a cocaine addiction, just treating the cocaine use disorder may not be as successful in the overall progress of recovery.
- Lapses and relapses are common in people recovering from substance use disorders. While people in treatment should work hard to avoid these, they should also not catastrophize the situation if a lesser relapse occurs. Instead, lapses and relapses should be viewed as an opportunity to learn and improve.
- Therapy, particularly cognitive behavioral therapy, is extremely important in helping a person understand the reasons that drove his or her substance use, to teach coping strategies, to learn new skills, and to avoid relapse in the future.
In the initial stages of recovery, people may choose between starting treatment on an inpatient or outpatient basis. Whether inpatient or outpatient treatment is better depends on a number of factors, including the severity of the person’s substance use disorder, the presence of any co-occurring conditions, and the need for the person to be isolated from potentially toxic environmental conditions (e.g., cocaine abusing friends and other triggers) that can increase the probability of relapse.
People who have complicated co-occurring disorders (e.g., severe depression, trauma- or stress-related disorders, personality disorders), have complicated living situations (e.g., are homeless, have an abusive relationship), or have very severe addictions that require close supervision during the withdrawal management process are often better off beginning in an inpatient treatment program.
Inpatient treatment programs are time-limited, at the end of which a person has the option to transition to an outpatient program. Inpatient programs can cost between $200 and $900 per day, depending on the length of the program, with longer treatment duration costing less per day.7 Following the withdrawal management process, most people will continue long-term aftercare treatment in an outpatient or in a partial hospitalization program (where a person spends several hours a day in treatment and then goes home).4 It is important for those entering treatment for a cocaine addiction to discuss these options with their physicians and therapists.
You can expect to receive both individual and group therapy in an inpatient program, and also may be required to participate in social support groups such as 12-step groups.
Outpatient treatment allows the recovering individual to live at home throughout treatment. These tend to cost between $100 and $500 per treatment session, with longer treatment plans costing less per day.7 In some outpatient programs, people may choose between individual or group therapy. The research indicates that both are equally effective,4, 5, 6 however, some may prefer individual therapy since it is more confidential, focused on the person, and allows for the development of a more personalized therapeutic relationship. And still others may prefer group therapy because they find that they learn better from the other group members.
Getting involved in social support groups such as 12-step groups (e.g., Cocaine Anonymous, Alcoholics Anonymous, Narcotics Anonymous, etc.) should always be considered for people recovering from substance use disorders. These groups are not formally therapy groups because they are not run by professional therapists, however, they offer a number of advantages that include:
- Running indefinitely (therapy eventually terminates).
- Extremely accessible (meetings offered nearly every day at different times).
- Offer the development for positive social support focused in one’s recovery.
Finally, it is important to remember that just going through rehab does not automatically result in a successful recovery process.4 People in recovery from cocaine abuse or addiction need to follow up with targeted therapy that addresses the root causes of their substance abuse, teaches them new living skills, and prepares them to confront potential issues in the road that can result in relapse.
*This information is provided to educate only, and should not be used make a diagnosis; consult a licensed mental health care professional to diagnose any mental health or substance abuse disorder.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth Ed.). Arlington, VA: American Psychiatric Publications.
- National Institute on Drug Abuse. (2011). DrugFacts: Drug-Related Hospital Emergency Room Visits.
- Vanderschuren, L. J. & Ahmed, S. H. (2013). Animal Studies of Addictive Behavior. Cold Spring Harbor Perspectives in Medicine, 3(4), a011932.
- Ries, R. K., Fiellin, D. A., Miller, S. C. & Saitz, R. (2014). The ASAM Principles of Addiction Medicine. New York: Lippincott Williams & Wilkins.
- Doweiko, H. (2011). Concepts of Chemical Dependency. Stanford, CT: Nelson Education.
- National Institute on Drug Abuse. (2014). Drugs, Brain, and Behavior: The Science of Addiction.
- American Addiction Centers. (2017).