Cocaine Cravings and Cocaine Withdrawal Symptoms Timeline

Something unappeased, unappeasable, is within me.” Friedrich Nietzsche¹

Nietzsche wasn’t talking about cocaine when he wrote this, but he might as well have been, because in the early days of cocaine withdrawal, the only thing you want in life (more cocaine) is the one thing you can’t have.

But how long do the cravings and withdrawal symptoms persist? Read on for:

• A timeline for common cocaine withdrawal symptoms.
• A timeline for cocaine cravings, plus – what worsens cravings and what you can do to manage your urges.
• A brief explanation of your detox options - should you do it alone or do you need outpatient or residential detox care?

Cocaine Withdrawal Timeline

• Primary cocaine withdrawal symptoms last 1 to 2 weeks, peaking in severity early and then progressively easing after that.

Studies show that symptoms peak within a day or two after abstinence and then gradually ease-up. If you’ve made it past the first couple of days, you can expect to feel a little better with each additional day of abstinence.  By a week or two, most symptoms should dissipate, though you may still experience thinking difficulties and you’ll almost certainly experience continuing strong cravings.²

Psychological Symptoms Include:³

• Depression.
• Strong cocaine cravings.
• Concentration problems.
• Anxiety.
• An inability to find pleasure in anything (anhedonia).
• Fatigue and lethargy.
• Increased appetite.
• An increased need for sleep.
• Increased REM sleep and also increased dreaming.
• Suicidal thoughts (less common).

In most cases, symptoms will dissipate significantly by 1 to 2 weeks.

Physical Symptoms Include:

• Muscle aches and pains.
• Chills.
• Tremors.
• Involuntary jerks and twitches.

Physical symptoms are rarely serious or dangerous and generally don’t require treatment.

Cocaine Cravings Timeline

• Cravings don’t peak in severity until 2 months post abstinence. They start to dissipate after 6 months of abstinence.

Though early withdrawal symptoms like irritability and fatigue aren’t any fun, most people say that long-lasting cravings are the largest obstacle to sustained abstinence.

Though general withdrawal symptoms ease up after a day or two and largely disappear by a week or more, cocaine withdrawal symptoms actually get progressively worse for the first 2 months! Research shows that:⁴

1. Cocaine cravings continue to worsen to a peak in intensity at 2 – 3 months.
2. Cravings start to decrease after 6 months of continuous abstinence. 

Six months is a long time to battle intense cocaine cravings. So what to do about it?

Since one slip-up in a moment of weakness can lead to full-blown relapse, to stay quit for good you have to learn effective cravings-management strategies, for example:⁵

• Urge surfing techniques – learning to ride your cravings like a wave.
• Learning to accept cravings as a normal and non-harmful experience that will pass in time.
• Learning to recognize and identify your cravings in the very early stages so you can stop them before they intensify.
• Learning distraction and relaxation techniques to employ against cravings. 

You can learn to manage cravings on your own, but since most addiction treatment programs focus extensively on teaching relapse prevention skills and cravings management techniques, getting cocaine addiction treatment can be a quick and easy way to enhance your odds of maintaining abstinence. You don’t necessarily need to start with costly rehab either, according to the National Institute of Health, for most people addicted to cocaine, outpatient treatment proves as effective as more disruptive residential care.

Stress Worsens Cravings

Going through withdrawal and dealing with cravings can be stressful. Unfortunately, high stress levels are associated with a decreased ability to resist cravings and greater amounts (larger binges) of cocaine used with relapse.⁶ Talk about a catch 22!

• To compensate, it’s important to reduce your daily stress exposure, especially during your first 6 months of abstinence, and to learn effective stress management techniques.

Depression Worsens Cravings

Research shows that having co-occurring depression along with cocaine addiction results in worsened drug cravings with abstinence. Given this, if you have depression, you should strongly consider learning cravings management strategies (getting addiction treatment) and treating your depression.⁷

Do You Need Inpatient Detox?

Most people can detox safely without needing professional assistance. In some more serious cases, heavy cocaine users will benefit from a short period of residential or hospital supervision during the first period of withdrawal. According to the Australian Department of Health, situations indicating a possible need for residential or hospital detox treatment include.

• You have failed to complete detox at home on multiple previous attempts.
  
• You have a poly-drug addiction and your dependence on at least one other substance is severe enough to warrant hospitalization (alcohol and benzodiazepines withdrawal are especially dangerous.)
• You have a severe cocaine dependence and complicated withdrawals are expected.
• You have a medical condition that could complicate withdrawals.
• You have co-occurring psychiatric condition, particularly concurrent psychosis or concurrent severe depression.
• You are having suicidal thoughts (more common during cocaine withdrawal).
• You are homeless or have no safe and stable place to detox.

So, unless any of the criteria listed above apply to your situation, you can probably detox at home

If you decide to detox at home, you have to choose between:

1. Doing it on your own, with no professional help.
2. Getting into an ambulatory detox program – where you detox at home, but still get the support and expertise of professionals.

While many can make it through the detox period without professional assistance (after all – quitting is easy, it’s staying quit that’s hard – ambulatory detox programs offer some compelling advantages, for example:

• They offer education about what symptoms to expect – what’s normal and what’s not – and advice on how to cope with the discomfort.
• Through interactions with detox staff you get a daily symptoms and mood check-up. This allows for early intervention if required (for example, transition to a residential facility in cases of severe psychosis or suicidal thinking.)
• Staff support and encouragement can help you stay motivated to keep at it.

When entering a treatment stream at the detox phase, whether in an ambulatory or residential detox – you also receive a needs assessment, an individualized treatment plan and a streamlined entry into an appropriate next stage of treatment. Therefore, if you plan on getting some form of cocaine addiction treatment at some point, it makes some sense to enter treatment at this first stage of care.