Cocaine is considered an ego and performance drug, has a stimulating effect, makes you eloquent and gives you a sense of omnipotence. The stress of everyday life and the challenges of the job take a back seat; after all, everything seems to be feasible with the drug and success within reach. So it is quite understandable that many consumers do not want to miss the feeling of elation and energy immediately after consumption. And it is precisely this constellation that makes cocaine withdrawal from the substance so extremely difficult.
How does cocaine withdrawal feel?
The consequences of cocaine addiction mean that the non-consuming patient usually has to struggle with severe depression, lack of energy and a feeling of absolute emptiness. And that can also happen during detox and weaning treatments. Ultimately, the stop to consumption results in a gap that only has to be filled in gradually through healthier activities. Those affected miss the euphoria of intoxication and the self-esteem associated with it. In contrast to other drugs, cocaine craving is particularly pronounced, so that cocaine addicts find it very difficult to let go of the substance. This also applies during cocaine withdrawal.
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In addition, there is massive self-doubt as to whether withdrawal and life without the drug can even be achieved. Basically, cocaine withdrawal symptoms are more psychological than physical in nature. Typically, the worst craving, especially with psychologically addictive drugs such as cocaine and cannabis, often only begins in weeks 2 to 3 of the inpatient weaning phase. Many of those affected initially take a certain parental leave, but not continuously. Stopping treatment at this stage leads to relapse in almost all patients.
Why is home cold cocaine withdrawal not recommended?
In addition to the symptoms already described, cocaine massively imbalances the dopaminergic system by blocking the dopamine transporter. The synaptic gap is literally flooded with dopamine, which leads to extreme feelings of happiness with the simultaneous increased serotonin and noradrenaline concentration. For this reason, only insufficient dopamine, serotonin and norepinephrine are formed in the patient’s central nervous system. Ultimately, the brain has got used to the fact that the drug itself no longer had to produce any endorphins. This is also the reason why serious depressive symptoms can develop if consumption is stopped. Until normal is restored, the body lacks important messenger substances, which explains the deep depression during withdrawal.
Due to the strong activation of the cannabinoid receptor 1, the addict hardly has the strength to carry out cocaine withdrawal without professional medical support. The receptor is particularly stimulated during and after the consumption of cocaine in order to alleviate the drug-induced hyperactivity of the brain but is active for significantly longer than cocaine. The stimulating effect of the drug is already waning, while CB1 continues to slow down the body and thus cause a lack of energy.
If the detox takes place as a cold withdrawal, those affected are completely exposed to the withdrawal symptoms without relieving medication, which leads to many relapses and reduces the motivation for any further cocaine withdrawal.
In order to end the psychological cocaine addiction, it is important to work out the causes and triggers of the consumption, to treat them and replace them with alternative solution strategies. This usually happens during weaning therapy that follows detoxification. If the cocaine withdrawal is carried out on your own, there is no treatment of psychological dependence, so that a relapse is inevitable.
What drugs help with cocaine withdrawal?
In order to finally leave the white powder behind, cocaine withdrawal should only be carried out with medical and therapeutic assistance and the withdrawal symptoms should be reduced with suitable medication. Tricyclic antidepressants or benzodiazepines can alleviate depressive moods and, depending on the active ingredient, also increase the drive. Antipsychotics can be given against paranoid delusions and psychoses.
What happens during cocaine withdrawal?
In general, withdrawal from cocaine takes place in three phases, each of which is characterized by depression or even suicidal thoughts to different degrees.
Crash phase
The crash phase is the first phase of withdrawal after stopping cocaine use. It is mainly characterized by withdrawal symptoms such as difficulty sleeping, tiredness, self-doubt, and anxiety.
Withdrawal phase
The actual withdrawal phase follows the crash phase and can last up to several weeks. Depression, exhaustion and an immense desire for cocaine (craving) occur. In the mind, everything revolves around drug addiction and how it can best be obtained. This makes the withdrawal phase the phase with the highest risk of relapse.
Quenching or extinction phase
In the deletion phase, the psychological dependence is already weakened and the addictive pressure only occurs in spurts. Former intoxicating experiences are relived in nightmares. Comprehensive psychological support is still necessary to avoid relapses.
How does cocaine withdrawal work?
The structure of cocaine addiction withdrawal does not differ significantly from other withdrawal therapies. Together with the doctors and therapists, the patients go through a treatment program which is divided into three consecutive steps: detoxification, weaning and outpatient follow-up care.
Detoxification
Detoxification is about ridding the patient of the addictive substance and its breakdown products. During withdrawal, the vital functions are closely monitored so that complications can be treated at an early stage.
Weaning
During weaning, the addiction triggers are dealt with psychologically and alternative solution strategies are developed together with the person affected in order to prevent them from resorting to drugs again when problems arise. Possible concomitant diseases and existing mixed consumption are also treated. Cocaine is often consumed together with alcohol, so that cocaine withdrawal must be combined with alcohol withdrawal.
Aftercare
In order to ensure lasting abstinence, follow-up care should be carried out with outpatient therapeutic discussions and a visit to a self-help group.
How long does cocaine withdrawal take?
Although cocaine has a relatively short half-life of 2 to 5 hours, due to the dysfunctional dopamine metabolism it can take up to 10 weeks until the natural balance of messenger substances is restored. Thus, cocaine withdrawal usually takes significantly longer than alcohol withdrawal. Decisive for the length of the withdrawal are the duration and amount of ingestion, any concomitant diseases and the general physical condition of the person concerned. Basically, it can be assumed the greater the amount of drug consumed greater the withdrawal treatment takes. However, a relatively precise assessment is only possible after a medical examination and anamnesis discussion.
Which rehab clinics are available to treat addiction?
There is a difference in the treatment methods of the drug rehabilitation centers.
Cocaine withdrawal in public hospitals, psychiatric hospitals, and rehabilitation clinics
Cocaine addiction is a recognized disease so that the people affected are entitled to adequate treatment, which is covered by the public payers. Detoxification is part of the health insurance scheme and takes place in a hospital or psychiatric ward.
Weaning, on the other hand, is a matter for the pension insurance and is carried out in a rehabilitation center that specializes in addiction, hence the term addiction rehabilitation. The disadvantage of this dichotomy is that it usually takes several weeks between detoxification and weaning. During this time, the strong psychological desire remains and the risk of relapse is high.
Addiction rehabilitation: what’s the best way to go about it?
Detoxification and withdrawal are usually possible in rehab clinics, so that withdrawal in these clinics is usually more successful. This is especially true for the treatment of cocaine addiction, in which the main focus of the therapy is on overcoming psychological dependence. Because of the strong depression, it is very uncomfortable and sometimes almost unbearable for the addicts to “hang in the void”. In addition, psychotherapy in a private addiction clinic is much more intensive and more productive than in public institutions due to one-on-one interviews. Our cocaine withdrawal tip is therefore to choose a private clinic where the family work is actively lived.
