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Beach House Recovery Center » Blog » Cocaine Detox Guide
Leaves of the coca plant, native to Central and South America, release a stimulant and are chewed by rural laborers to keep their energy up. Pure cocaine powder was first extracted in 1860, providing opportunities for more intense stimulation. It is approved for some medical uses, notably local anesthesia, but the majority of users are seeking illegal pleasure or stress relief.
Made into a paste, cocaine is typically snorted or injected. It stimulates the central nervous system to produce and retain more pleasure-enhancing dopamine, resulting in intense, long-lasting euphoria. A crystallized, smokable derivative called “crack” is popular in poorer demographics: crack provides a quicker (though shorter-lived) rush at one-sixth to one-tenth the cost.
Over 4.7 million Americans abuse cocaine, and over 900,000 have cocaine addiction disorders. About 13 percent of people in addiction treatment name cocaine as their drug of choice. Over a long-term period, ongoing use can result in chronic muscle tremors, psychosis, liver dysfunction and heart failure.
Withdrawal from cocaine can be characterized by intense “stress” symptoms:
While cocaine withdrawal rarely causes life-threatening physical symptoms, its mental–emotional effects can drive people to dangerous behavior or even suicide.
Withdrawal duration and intensity can be affected by how long a person has been addicted, the size of regular doses, the setting of the detox attempt, and co-occurring mental disorders such as clinical depression.
Cocaine is noted for its short half-life: discernible withdrawal symptoms can manifest as soon as 90 minutes after the most recent dose. Unfortunately, perhaps because cocaine exerts particularly strong psychological influence, the time it takes symptoms to disappear completely is often as long as ten days. Many experts consider this only the first phase of withdrawal—the initial “crash”—and propose a three-phase timeline that may last for months:
The “crash” period is effectively synonymous with detox, the initial phase of treatment for all chemical addictions. After this stage—which should be undertaken in a hospital with medical supervision—the patient requires additional treatment during “withdrawal” and the early weeks of “extinction.”
For this longer-term treatment, the first important decision is: inpatient or outpatient treatment? Both last up to three months, involve clinical and medical therapy, and cover:
With inpatient, or “residential,” care, the patient stays in medically supervised facilities for up to three months. Inpatient care is highly recommended if:
The advantage of inpatient care is that it keeps the patient in a supportive environment with relapse temptations and triggers a safe distance away, and professionally trained staff on hand to tend to emotional or physical needs.
Learn more about Inpatient Drug Rehab
With outpatient care, a patient lives offsite and reports to detox facilities for ongoing therapy. Specific approaches vary, from sending clients back to their regular homes and having them return for three-hour appointments three days each week, to providing open housing on the detox center’s campus with lengthy therapy sessions five to seven days a week. Some centers start newly detoxed patients in shorter inpatient programs (up to 35 days) and transition them into outpatient programs.
Outpatient care may be preferable for someone who:
Learn more about Outpatient Drug Rehab
While outpatient care has advantages after physical detox, the detox itself should always be undertaken in an inpatient setting. Although people have successfully detoxed at home, it’s a serious risk, especially for anyone who has co-occurring depression issues or has previously considered or attempted suicide.
Even in the best-case scenario—a person has used cocaine for a relatively short time, is in overall good health and has access to trustworthy support—medically supervised inpatient treatment is preferable because:
Detox centers also have access to licensed M.D.s who can recommend higher-tech treatment approaches, including prescription medications. This is a less likely scenario with cocaine than with substances where withdrawal manifests intense physical symptoms, and currently there are no FDA-approved medications for treating cocaine addiction. However, some medications show potential to reduce intensity of withdrawal symptoms and risk of relapse:
With some substances (particularly benzodiazepines and methadone), detox providers frequently use the “tapered” approach, administering gradually reduced doses of the addictive substance rather than abruptly cutting off the supply. Most often recommended for people at risk for severe withdrawal symptoms, “tapering” can spare the body and brain some “cold turkey” shock. It is rarely used with cocaine addiction.
Besides inpatient/outpatient options and medical treatment approaches, factors to consider in choosing a treatment program include:
Depending on treatment methods, additional facilities provided and individual patient needs, cocaine detox and rehab can be expensive. Fortunately, most health insurance policies, including Veterans Affairs, cover at least part of addiction-treatment expenses. Some healthcare costs are even tax deductible.
Relapse rates for cocaine (around 40 percent) are comparable to those for other addiction disorders. As many as one in four people who complete detox may return to full addiction— especially if they rushed back into normal life without adequate time in treatment. So it’s vital to implement alternate techniques for managing stress and finding pleasure.
These techniques include ongoing therapy, treatment for co-occurring illnesses, and support-group attendance. (Over 80 percent of support-group participants report that empathy and accountability reduce relapse temptations.) Other elements of effective aftercare include:
Learn more about Cocaine Aftercare
Australian Government Department of Health (2004, April). “The Cocaine Withdrawal Syndrome.” Retrieved from http://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-modpsy-toc~drugtreat-pubs-modpsy-3~drugtreat-pubs-modpsy-3-7~drugtreat-pubs-modpsy-3-7-cws
National Institute on Drug Abuse (2016, May). “Cocaine: How Is Cocaine Addiction Treated?” Retrieved from https://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers
National Institute on Drug Abuse (2016, May). “What Are the Long-Term Effects of Cocaine Use?” Retrieved from https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-long-term-effects-cocaine-use
National Institute on Drug Abuse (2016, June). “What Is Cocaine?” Retrieved from https://www.drugabuse.gov/publications/drugfacts/cocaine
Tracy, Kathlene, and Samantha P. Wallace (2016, September 29). “Benefits of Peer Support Groups in the Treatment of Addiction.” Substance Abuse and Rehabilitation (2016, No. 7, pp. 143–154). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047716/
Whether you’re researching for yourself or a loved one, Beach House can help. We understand that this is a serious time in your life and that the treatment center you choose matters. We want you to feel comfortable and empowered to make the right decision for yourself, a friend, or a family member. This is why a counselor is waiting and available to answer your questions and help put your mind at ease regarding the next steps. Many of the staff at Beach House have walked in your shoes. If you feel you’re ready or want more information about how to help a loved one, we can help today. You can also learn why we are voted the #1 rehab for addiction treatment in Florida.
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