Author: James Anderson

Your Guide to Cocaine Withdrawal Symptoms and Recovery

This seemed to imply that 5 months without cocaine would restore much of what was lost in terms of brain function. In-patient treatment programs can help people go through cocaine withdrawal in a safe and medically monitored setting. Medical and mental health professionals can provide guidance and can treat any symptoms as needed. Sometimes, people experience symptoms for longer than the initial 1- to 2-week period. This is called chronic withdrawal, long-term withdrawal, postacute withdrawal, or subacute withdrawal, and it can last for up to 2 months.

There are different treatment options available for people who need help stopping cocaine use. The impact of cocaine on your brain cells becomes even more significant as you age. That can cause the neurons in your brain to work more slowly or begin to die off. Keep reading to understand how cocaine can trigger brain damage and its other serious side effects.

Neurobiological Processes That Predict Adolescent Recovery

It can also starve your brain of the blood it needs, which kills brain cells. Since cocaine causes your blood vessels to narrow, your heart has to work harder to pump blood to your brain. They might need intravenous (IV) fluids to help address dehydration from vomiting or diarrhea. This can be life threatening, and people can benefit from medical supervision. Medical professionals can supervise, help manage symptoms, and monitor for any complications. Cocaine withdrawal can cause intensive depressive symptoms, along with negative thoughts and suicidal ideation.

Although we cannot say with certainty that reducing/stopping cocaine use entirely accounts for the observed changes, this study does suggest that individuals recovering from substance use disorders can show neural and cognitive improvement. This study further demonstrated that neural recovery can occur even without complete abstinence, suggesting that positive recovery outcomes are also possible for individuals who struggle to maintain continuous sobriety, but who substantially reduce drug exposure. With regard to the brain regions and respective executive functions that showed remission-related changes in this study, complementary treatments that aim to improve decision making skills and cognitive flexibility might aid implementation of newly learned skills important for maintaining sobriety. For example, encouraging the use of cognitive retraining games that target decision making skills could potentially accelerate their improvement, thereby making this skill set more readily available for treatment-seekers to select newly learned recovery-driven choices, and avoid harmful options, when making decisions. Indeed, the inferior frontal gyrus and ventromedial prefrontal cortex are prefrontal structures that are important for a variety of executive functions and their impairment might contribute to the maintenance of addictive behaviors. Thus, supporting the recovery of these structures and their functions with respect to cocaine use disorder might benefit addiction treatment outcomes.

This challenge results in most of the studies of individuals abstaining from cocaine to be limited to the scope of the typical 1–4 week timeframe of a treatment programs. Brain imaging studies have repeatedly revealed altered brain structure among individuals with substance use disorder. Some structural abnormalities are seen across multiple substance use disorders (e.g., alcohol, cocaine, methamphetamine), including abnormalities of the prefrontal cortex. The prefrontal cortex is a structure composed of several sub-regions, all of which are implicated in various executive functions – a set of skills important for behavioral control and essential for addiction recovery (e.g., inhibiting behavioral responses to drug cues, implementing newly learned coping skills). Several early MRS studies demonstrated that cocaine users have 30% less GABA in the prefrontal cortex (Ke et al., 2004) and 23% less GABA in the occipital cortex than controls (Hetherington et al., 2000).

If you are going through cocaine withdrawal symptoms, or know someone who is, never hesitate to reach out for support. The withdrawal symptoms of cocaine use can vary depending on the person and on the length and severity of their cocaine use. A newborn baby may also develop cocaine dependence if exposed to it in utero. “NAS” is the term for the symptoms a newborn may develop due to withdrawal when they stop receiving the substance after birth. SMART Recovery is an organization that provides resources for people with substance use disorders. Narcotics Anonymous (NA) is a global, community-based organization that provides a range of services to people with substance use disorders.

While human neuroimaging studies provide us with a lens that can only assess activity in relatively large areas of the brain, preclinical studies focus on transmitter systems that elegantly resolve alterations that occur in pre and postsynaptic densities at the synaptic level. While clinical research on abstinence frequently uses “time to relapse” as a dependent measure, preclinical research typically reintroduces cocaine at a predetermined time point and uses behavior as the dependent measure. Other studies have attempted to examine the persistence of some cellular and molecular processes and how these change with time.

Without a more complete picture of these structural and functional neuroadaptations, it is difficult to direct effective strategies towards targets with the greatest potential for promoting abstinence and reducing harm. The first group was made up of 19 individuals (68% male; ~43 years old) diagnosed with cocaine use disorder (i.e. dependence; using the diagnostic and statistical manual of mental disorders, or DSM, 4th edition). All had recently attended or were currently attending one of three addiction treatment facilities and had at least 3 weeks of abstinence from all drugs. The second group consisted of 12 healthy controls (92% male; ~39 years old) who had no history of substance use disorder. Additional longitudinal studies are needed to replicate these findings in individuals with cocaine use disorder who have a more restricted range of abstinence durations at baseline.

Where to get help for cocaine addiction or withdrawal symptoms

Magnetic resonance imaging studies among cocaine users consistently report smaller volumes and lower tissue density in the prefrontal cortex of cocaine users relative to non-drug using controls, which may be correlated with length of use (O’Neill et al., 2001). Bartzokis and colleagues (2002) investigated white matter volume in a large cohort of cocaine dependent individuals and demonstrated that cocaine dependent individuals did not have the same age-related increases in white matter volume observed in non-drug using controls. These data suggest that there may be an arrested development of white matter among users (Bartzokis et al., 2002). Franklin et al. (2002) were the first to demonstrate lower density of gray matter in cocaine users using voxel-based morphometry. They reported lower gray matter density in the insula cortex, medial orbitofrontal cortex, superior temporal cortex, and right anterior cingulate (Franklin et al., 2002). Sim et al. (2007) recently reported lower white matter density in the right cerebellum and lower gray matter density in the premotor cortex, temporal cortex, frontal cortex, left thalamus, and cerebellum in current cocaine users (Sim et al., 2007).

Medical and mental health professionals can help you manage your withdrawal and can give you the support you need to quit. Cocaine withdrawal can cause intense physical and mental symptoms — some of which can be life threatening. For example, a medical professional can prescribe medications to relieve muscle aches, mental health symptoms, or severe distress and agitation.

1. Whether cocaine is snorted, injected, or smoked as crack, users often suffer serious negative consequences to their health, social relationships, as well as severe economic hardships.
2. This website is using a security service to protect itself from online attacks.
3. When considering the relative role of the frontal cortex versus subcortical areas on the maintenance of abstinence, it is important to acknowledge that nearly all behaviors in the human repertoire are the result of complex interactions among neural systems which span multiple brain regions.
4. If you are going through cocaine withdrawal symptoms, or know someone who is, never hesitate to reach out for support.
5. Withdrawal can cause people to backslide and use again when they try to quit.
6. This ‘survivor’ effect may also explain the elevated levels of frontal glucose metabolism that have been observed in these long term abstainers (Connolly et al., 2012).

Given that neural structure is largely inherited and is sensitive to many other environmental stressors that coexist in chronic cocaine users (such as alcohol abuse, chronic hypertension, perinatal stress), however, it is difficult to interpret these data. An innovative study by Ersche and colleagues (2012), provided some insight into the potential heritability of these neurostructural abnormalities (Ersche et al., 2012). They investigated gray matter tissue density and white matter integrity among 50 sibling pairs (one cocaine dependent, one with no history of drug dependence), and 50 unrelated healthy controls. Relative to the controls, the sibling pairs (both the user and non-user) had region specific differences in gray matter density in multiple brain regions that are implicated in addiction (e.g. lower gray matter density in the posterior insula and higher density in the caudate). Between the siblings, the stimulant dependent individual had significantly lower tissue density in the vicinity of the orbitofrontal cortex.

Recovering from Cocaine: Insights from Clinical and Preclinical Investigations

They demonstrated that cerebral metabolism in the basal ganglia and ventral prefrontal cortex of cocaine abusers was elevated above control levels during the first week of abstinence (Volkow et al., 1991b). After 1 to 6 weeks of abstinence however, these acutely elevated cerebral metabolic rates had decreased. These decreases persisted in a subset of subjects tested again after 3 months, suggesting that many neurofunctional abnormalities persist after extended abstinence from cocaine. Finally, with regard to biomarkers that can predict successful recovery from cocaine abuse, we propose here that it is preservation of cortical function that is perhaps the most important predictor. This is supported by the lack of cortical structural and functional deficits in those cocaine abusers that have been able to remain abstinent for long periods of time, often beyond a year at the time of testing (references).

How long does cocaine withdrawal usually last?

On average, both groups were similar with respect to age, education, gender, and race. Relative to controls, the group diagnosed with cocaine use disorder had a greater proportion of nicotine users (84% vs. 50%) and reported more depressive symptoms as measured by the Beck Depression Inventory (although inventory scores suggested very few symptoms in both groups). Given the prevalence of smoking and psychiatric comorbidity among substance use disorder treatment-seeking populations, in general, these differences are not particularly surprising. But are such neuroadaptations permanent even with the cessation of cocaine exposure? Does the cessation of drug use lead to a restoration of structure and function disrupted during exposure? Furthermore, can social and environmental changes accelerate or otherwise affect the rate of brain-based recovery?

Symptoms of cocaine withdrawal include depression, excessive sleep, increased hunger, and a general sense of unease. The typical brain loses 1.69 milliliters of gray matter each year as part of the aging process. People who regularly use cocaine lose more than twice that in a year, according to a 2012 study. Sometimes, the long-term side effects of cocaine use are a sign of brain damage. If a person is experiencing cocaine addiction or withdrawal, they can contact a healthcare professional for support and treatment. A person experiencing cocaine withdrawal can consider reaching out to a qualified medical professional for support.

A doctor can also prescribe medications to help manage more severe NAS symptoms. The goal of pharmacological treatment is to improve these symptoms in the short term. Once acute withdrawal has ended, a person may experience protracted withdrawal symptoms. If you or a loved one is using cocaine or misusing other substances, reach out to a healthcare provider for help.