St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Cocaine withdrawal

    Cocaine withdrawal occurs when a heavy cocaine user cuts down or quits taking the drug. Complete abstinence and a serum drug level of zero are not required.

    Causes

    Cocaine produces a sense of extreme joy by causing the brain to release higher than normal amounts of some biochemicals. However, cocaine's effects on other parts of the body can be very serious or even deadly.

    When cocaine use is stopped or when a binge ends, a crash follows almost immediately. This crash is accompanied by a strong craving for more cocaine. Additional symptoms include fatigue, lack of pleasure, anxiety, irritability, sleepiness, and sometimes agitation or extreme suspicion or paranoia.

    Cocaine withdrawal often has no visible physical symptoms like the vomiting and shaking that accompanies the withdrawal from heroin or alcohol.

    In the past, people underestimated the how addictive cocaine can be. However, cocaine is addictive when addiction is defined as a desire for more of the drug, despite negative consequences.

    The level of craving, irritability, delayed depression, and other symptoms produced by cocaine withdrawal rivals or exceeds that felt with other withdrawal syndromes.

    See also:

    • Drug abuse
    • Drug abuse and dependence
    • Stroke secondary to cocaine

    Symptoms

    Primary symptoms may include:

    • Agitation and restless behavior
    • Depressed mood
    • Fatigue
    • Generalized malaise
    • Increased appetite
    • Vivid and unpleasant dreams
    • Slowing of activity

    The craving and depression can last for months following cessation of long-term heavy use (particularly daily). Withdrawal symptoms may also be associated with suicidal thoughts in some people.

    During withdrawal, there can be powerful, intense cravings for cocaine. 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.

    Exams and Tests

    A physical examination and history of cocaine use are sufficient to diagnose this condition.

    A toxicology (poison) screen may be performed to see if other drugs may have been taken.

    Other routinetests may include:

    • Blood chemistries and liver function tests such as CHEM-20
    • Cardiac enzymes (look for evidence of heart damage or heart attack)
    • CBC (complete blood count, measures red and white blood cells, and platelets, which help blood to clot)
    • EKG (heart tracing)
    • Chest x-ray
    • Urinalysis

    Treatment

    The withdrawal from cocaine may not be as unstable as withdrawal from alcohol. However, the withdrawal from any chronic substance abuse is very serious. There is a risk of suicide or overdose.

    Symptoms usually disappear over time. People who have cocaine withdrawal will often use alcohol, sedatives, hypnotics, or anti-anxiety medications such as diazepam (Valium) or lorazepam (Ativan)to treat their symptoms. Use of these drugs is not recommended because it simply shifts addiction from one substance to another.

    At least half of all people addicted to cocaine also have a mental disorder (particularly depression and attention-deficit disorder). These conditions should be suspected and treated. When diagnosed and treated, relapse rates are dramatically reduced. All prescription drug use should be monitored carefully in patients who abuse substances.

    Support Groups

    The 12-step support groups, such as Cocaine Anonymous or Narcotics Anonymous, have helped many people addicted to cocaine. Alternative groups such as SMART recovery should be recommended for those who do not like the 12-step approach.

    Outlook (Prognosis)

    Cocaine addiction is difficult to treat, and relapse can occur. However, the rates of achieving stabilization are as good as those for other chronic illnesses like diabetes and asthma.

    Treatment should start with the least restrictive option and move up if necessary. Outpatient care is as effective as inpatient care for most people addicted to cocaine, according to research.

    Presently there are no effective medications for reducing craving, although some are being tested. Some studies have reported that medications such as amantadine and bromocriptine may help to reduce patient's craving, increase energy, and normalize sleep, particularly among those with the most seriously addicted.

    • Depression
    • Craving and overdose
    • Suicide

    Because many users will abuse more than one drug, other withdrawal syndromes, such as alcohol withdrawal, need to be ruled out.

    When to Contact a Medical Professional

    Call your health care provider if you use cocaine and need help to stop using it.

    Prevention

    Avoid cocaine use. If you have previously used cocaine and wish to stop, try to avoid people, places, and things you associate with the drug. If you find yourself considering the euphoria produced by cocaine, force yourself to think of the negative consequences that follow its use. Group participation is helpful for many people.

    References

    Doyon S. Opiods. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 167.

    Wax PM, Barrera, R. . Drug Withdrawal. In: Wolfson AB, Hendey GW, Ling LJ, et al, eds. Harwood-Nuss' Clinical Practice of Emergency Medicine. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 337.

    BACK TO TOP

          A Closer Look

            Self Care

              Tests for Cocaine withdrawal

                Review Date: 4/5/2013

                Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

                The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
                adam.com

                A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


                Back  |  Top
                About Us
                Contact Us
                History
                Mission
                Locations & Directions
                Quality Reports
                Annual Reports
                Honors & Awards
                Community Health Needs
                Assessment

                Newsroom
                Services
                Brain & Spine
                Cancer
                Heart
                Maternity
                Orthopedics
                Pulmonary
                Sleep Medicine
                Urgent Care
                Women's Services
                All Services
                Patients & Visitors
                Locations & Directions
                Find a Physician
                Tour St. Luke's
                Patient & Visitor Information
                Contact Us
                Payment Options
                Financial Assistance
                Send a Card
                Mammogram Appointments
                Health Tools
                My Personal Health
                mystlukes
                Spirit of Women
                Health Information & Tools
                Clinical Trials
                Health Risk Assessments
                Employer Programs -
                Passport to Wellness

                Classes & Events
                Classes & Events
                Spirit of Women
                Donate & Volunteer
                Giving Opportunities
                Volunteer
                Physicians & Employees
                For Physicians
                Remote Access
                Medical Residency Information
                Pharmacy Residency Information
                Physician CPOE Training
                Careers
                Careers
                St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
                Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile