Cocaine withdrawal side effects

What happens to the body and mind when you stop taking cocaine? A review of primary and secondary side effects during cocaine withdrawal here.

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Cocaine withdrawal effects can occur even after one use of cocaine. This is because cocaine highly stimulates the brain and after-effects lead to a period during which the body physically “crashes”. So what can you expect during episodes of both mild and extreme cocaine withdrawal? We review here. Then, we invite your questions about side effects of cocaine use at the end.

Withdrawal effects of cocaine

Drug withdrawal usually occurs when a heavy drug user who has become physically dependent on a psychoactive substance cuts down or quits taking the drug. However, cocaine withdrawal can occur even after the first use; complete abstinence and a serum drug level of zero are not required. When cocaine use is stopped or when a binge ends, a crash follows almost immediately. Why?

Cocaine produces a sense of extreme joy (called euphoria) by causing the brain to release higher than normal amounts of chemicals, especially dopamine. Cocaine prevents the dopamine from being recycled in the central nervous system, causing excessive amounts to build up in the space between neurons. This amplifies the dopamine signal and ultimately disrupts normal brain communication. This is how cocaine can produce short-term euphoria, energy, and talkativeness. Cocaine’s effects on other parts of the body can be very serious or even deadly, causing physical effects like raised heart rate and blood pressure.

After cocaine effects wear off, users experience a crash that is opposite to the high. This crash is accompanied by a strong craving for more cocaine. Additional signals of cocaine withdrawal can include:

  • agitation, extreme suspicion, or paranoia (in some cases)
  • anxiety
  • cravings
  • depression
  • fatigue
  • increased appetite
  • insomnia
  • irritability
  • lack of pleasure
  • sleepiness
  • slowed psychomotor actions
  • vivid unpleasant dreams

Effects of cocaine withdrawal

Cocaine withdrawal after repeated use may not be accompanied by visible physical symptoms like the vomiting and shaking that accompanies the withdrawal from heroin or alcohol. Instead, cocaine affects energy levels and mood. Primary effects of cocaine withdrawal may include:

  • agitation and restless behavior
  • depressed mood
  • fatigue
  • generalized malaise
  • slowing of activity

The craving and depression associated with repeated cocaine use can last for months following cessation of long-term heavy use (particularly daily). So, how should you withdraw from cocaine? Seek medical supervision anytime you stop using cocaine, even if your body is not physically dependent on it. Withdrawal symptoms may also be associated with suicidal thoughts in some people. During withdrawal powerful, intense cravings for cocaine are often present. However, the “high” associated with ongoing use becomes less and less pleasant, and can produce fear and extreme suspicion rather than joy (euphoria). Just the same, the cravings may remain powerful for weeks or months after last use. So, getting help during cocaine withdrawal is critical to your mental health.

Side effects of cocaine withdrawal

There is a predictable sequence of events which occur during cocaine withdrawal. Withdrawal symptoms can typically last from 1-3 weeks and may consist of alternating low and high drug craving, low to high anxiety, paranoia, dysphoria, apathy, irritability, disorientation, hunger, fatigue, bradycardia, and long periods of sleep. At the moment, no medications exist to address the side effects of cocaine withdrawal, but possible points of pharmacological intervention are being discussed and new treatments proposed.

Additionally, cocaine can cause or exacerbate psychiatric symptoms indistinguishable from a classical psychiatric disorder. In fact, extreme anxiety, hostility, paranoia, and depression have been observed in those with a regular cocaine habit. Intravenous (IV) and freebase abuse is more likely to precipitate psychiatric symptoms. Systematic medical and psychiatric evaluation in addition to detoxification allows the detection and treatment of relapse-causing conditions. This permits more informed treatment decisions.

Cocaine withdrawal side effects

So why do such extreme side effects occur after you use cocaine? At this time, levels of the neurotransmitters norepinephrine and serotonin are thought to be significantly lowered due to the chronic depletion caused by cocaine use. The rapid reduction in the intensity of these withdrawal symptoms can constitute a major reason someone who is addicted to cocaine continues to use the drug. While there are no FDA-approved medications to treat cocaine addiction, behavioral therapies can help people significantly, and include:

  1. Cognitive-behavioral therapy (CBT)
  2. Community reinforcement approach (plus vouchers)
  3. Contingency management, or motivational incentives
  4. The Matrix Model
  5. 12-Step facilitation therapy

Questions about cocaine withdrawal effects

If you have been through cocaine withdrawal, please share your experience in the section below. Also, if there are any questions about cocaine’s side effects during withdrawal, feel free to ask. We will do our best to give you a personal and prompt answer.

Reference Sources: Medline Plus: Cocaine withdrawal
NCBI: Medical and psychiatric complications of cocaine abuse with possible points of pharmacological treatment
NHTSA: Cocaine
NCBI: Cocaine and Psychiatric Symptoms
NIDA: Drug Facts on Cocaine
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.


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  1. I do not do cocaine but a former friend does. He used about 3-4 days in a row and then asked me to stay with him while he was coming down…and then for no reason he brutally attacked me. Choked me, slammed my head repeatly into a cement wall, kicked me several times, grabbed my wrist so hard he broke my skin from the pressure of my bracelet gripping my skin… my point is to anyone helping a friend no matter how much you love and care for them….DON’T DO IT!!!!!!!!!!! He went into a rage and I was only saved by God’s grace but I will FORVER BE SCARRED EMOTIONALLY while the COCAINE ATTACKER IS SET FREE AND LAUGHING LIVING HIS LIFE WITH NO PAIN….and I will have pain and depression for years to come. THEY ARE SICK AND NEED TO BE LOCKED UP. I NEVER THOUGHT HE WOUKD EVER DO THIS……RUN RUN AND RUN AWAY BEFORE IT HAPPENS TO YOU. By all accounts of the brutal attack I should be dead

  2. My husband just had a 2week binge on cocaine. He last took it last Friday night. Is it normal for him to have the same withdrawal symptoms as a heavy user. He is sleeping a lot and is paranoid

    Thanks in advance

  3. I put AstroGlide on a gram of Coke and pushed it deep into my ass with my lubed middle finger, then I snorted the other 3/4 gram. The head high was almost instant, then the body high kicked in…. I do it once a week and can’t stop. I see no down side. Short recovery. No nasal probs. Amazing thoughts and submissive sex. Any help or suggestions???

    1. Hi Jimmy. Call the Cocaine Helpline listed here on 1-888-497-6879 to get in touch with dependable hotline professionals available 24/7. You will be talking to someone knowledgeable about cocaine abuse, rehab and recovery centers who can help you find a cocaine recovery program.

  4. my daughter has been very depressed for at least 9 months and after a failed suicide attempt landed in a locked facility. she is very very smart and knows exactly what the professional needed to hear to make her involuntary status change and eventually get discharged
    all in a 2 week period – she is now slated to have 12 ect treatments
    has had 5 and seems to be very very sad and dissassocciated with everything.
    I now have reason to believe she has been getting powdered coke off and on and that her addiction is the reason she has all these mood changes and anxiety and depression and not mental illness.- her dr is not aware of this – their are 2 children involved with her being out in society and I don’t know what to do – she isn’t having them on a regular basis due to ect treatments and not being able to care for them but I don’t really believe she has mental issues as much as drug withdrawal every few weeks – should I tell her dr what I think is behind this or not .

    1. Hi Sandy. Doctors should know everything about their patients in order to gave them a proper treatment. I suggest that you speak with your daughter’s doctor.

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