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Crack Cocaine Withdrawal and Detox

Withdrawal from crack cocaine may cause symptoms like depression and anxiety, as well as intense cravings for the drug. The process is best managed with a medical detox.

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What Is Crack Cocaine Withdrawal?

Someone addicted to crack cocaine has developed a physical and psychological dependence on it, and will experience withdrawal symptoms when quitting.

Crack cocaine is a more concentrated form of powder cocaine. Because of crack’s potency, withdrawal from it is often more intense. Crack cocaine use causes changes in the brain and the body’s nervous system. When someone addicted to crack stops using, their body must go through an adjustment period to relearn how to function without crack cocaine in their system.

During withdrawal, the former user will often experience many uncomfortable symptoms, such as depression, paranoia, fatigue, anxiety, mood swings, restlessness, agitation, or vivid, unpleasant dreams. The physical and psychological symptoms of withdrawal will vary depending on many individual factors, such as the user’s tolerance, metabolism, length of addiction, severity of addiction, and the presence of underlying mental health conditions or other addictions.

Symptoms of Withdrawal

Crack cocaine is both physically and psychologically addicting. Because addiction to crack can be so hard to overcome, users are generally advised to go through detox in a supervised drug treatment center program. There are two phases of withdrawal: acute withdrawal, which refers to the immediate symptoms, and protracted withdrawal or post-acute withdrawal symptoms (PAWS), which refers to the extended psychological symptoms that may occur weeks or months after quitting use.

Common acute withdrawal symptoms include:

  • Anxiety
  • Exhaustion
  • Unpleasant dreams

  • Difficulty concentrating
  • Irritability
  • Mood changes


Protracted withdrawal symptoms may include:

  • Depression
  • Anxiety
  • Agitation or shaking
  • Cravings

  • Difficulty sleeping
  • Lack of motivation
  • Inability to feel pleasure
  • Anger or emotional outbursts

Duration of Withdrawal

How long withdrawal from crack cocaine takes varies for each user and is based on a number of different factors. These include the user’s body chemistry, tolerance and the severity and duration of the addiction. Withdrawal can begin anywhere from an 30 minutes to 72 hours after the last crack cocaine dose. Physical symptoms of crack withdrawal typically last anywhere from 1 to 3 months, although there is no exact timeframe for how long symptoms will last. Any withdrawal symptoms that last more than 3 weeks are considered PAWS. The psychological symptoms of crack cocaine withdrawal, including intense craving, drug dreams, and obsessive thoughts to use often last much longer. There have been reports of psychological withdrawal symptoms lasting for 6 months or more.

During the first week of crack cocaine withdrawal, the former user has generally recovered from the extreme physical symptoms and may feel as if they have been cured. Many people have unintentionally let their guard down and become vulnerable to relapse during this time. In order to avoid relapse during the withdrawal process, it is important to detox in a drug treatment facility and have a support system in place to help with difficult days and future cravings. Following the completion of detox, it is critical to follow the recommendations of addiction professionals and physicians, including possibly entering an inpatient or outpatient rehab program.

Crack Cocaine Withdrawal Timeline

24-72 hours During the first 72 hours of withdrawal, users may experience symptoms such as paranoia and body aches. There have also been reports of hallucinations during this period, though they are rare. It is not uncommon for anxiety, insomnia, severe fatigue, irritability, and cravings to set in during the first 24 hours. After this initial period, hallucinations and paranoia generally subside.
Week 1 During the first full week of withdrawal, other symptoms often set in, including irritability, extreme fatigue, trouble sleeping and a general lack of motivation.
Week 2 During week two, cravings for the drug become more intense and depression often sets in. The brain is still reacting to the withdrawal process, and typically will not produce enough dopamine for strong positive emotions. Anxiety may return during this period.
Weeks 3-4 During weeks three and four, the body’s chemistry is still changing and mood changes are fairly frequent. Though the physical craving for crack has subsided by this time, the psychological cravings generally remain through the first month. Feelings of anxiety or depression may remain as well.
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Crack Cocaine Detox

Physicians at drug treatment facilities develop detox strategies based on the person’s unique body chemistry and medical history. Unlike some other drugs, including prescription anti-anxiety medications, crack isn’t tapered down during detox. Users quit cold turkey under medical supervision, with medications to help counteract uncomfortable withdrawal symptoms.

Drugs that may be used during crack detox and what they treat include:

  • Clonidine – High blood pressure and anxiety reduction
  • Gabapentin – Seizures, restless leg syndrome, anxiety, and insomnia
  • Propranolol – Anxiety
  • Trazodone – Sleep
  • Seroquel – Sleep
  • Vigabatrin – Anxiety
  • Vistaril – Anxiety

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Treatment for Crack Cocaine

Individuals addicted to crack cocaine often have the best chance of recovery while detoxing at a drug treatment facility. Treatment programs are run by therapists and physicians who personalize recovery based on each patient’s needs. Many programs use a variety of therapeutic techniques, including individual psychotherapy, psychoeducational groups, process groups, support groups, cognitive behavioral therapy (CBT), motivational Interviewing, dialectical behavioral therapy (DBT). These therapies can help patients learn healthy relapse prevention skills and recognize and change the behaviors and thought patterns that led to their abuse and addiction to crack cocaine. In fact, many researchers have found that the social aspect of crack use may be the single most difficult part to overcome. Overcoming a crack addiction starts with finding new surroundings, healthy relationships and a positive support system.

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With just 30 days at a rehab center, you can get clean and sober, start therapy, join a support group, and learn ways to manage your cravings.

Crack addiction can be treated–the key is that the addict must be given a place in family and social structures where they may never have been before. Habilitation more than rehabilitation.

- Substance abuse specialist Dr. Herbert Kleber, The New York Times, 1989

The relationships and support groups in drug treatment facilities are vital in helping addicts through the recovery process. If you are looking for a crack cocaine addiction treatment program, reach out to a treatment provider for more information.


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