Cocaine addiction

To quit cocaine, what helps most is combining three things: a professional assessment, specific changes to your daily routine that reduce the chances of using, and a plan for moments of intense desire (known as craving). It can be done, but doing it alone is usually harder than it seems, especially if you have been using for a while or if cocaine goes hand in hand with alcohol.

What cocaine is and why it is so addictive

Cocaine is a stimulant drug with a very powerful effect on the brain, obtained from the leaves of the coca plant. It is mainly used in two forms: as a white powder (cocaine hydrochloride), which is snorted or injected, and as freebase or crack, which is smoked.

It acts on the brain’s pleasure and reward circuits: it produces a quick, intense high that is short-lived and followed by an unpleasant comedown. That contrast between the high and the low pushes people to use again, and over time the brain links the substance to places, people and situations that trigger the urge to use almost automatically. That is why cocaine addiction is not a matter of willpower.

Effects of cocaine

In the short term

• Euphoria, a sense of confidence and well-being, talkativeness and sociability.
• More energy and activity, increased sex drive.
• Less hunger, less need for sleep and less tiredness.
• A racing heart and raised blood pressure.

When the effect wears off, the comedown (or crash) sets in: tiredness, apathy, drowsiness, irritability and a low mood that makes you want to use again.

With continued use

• Mental health: anxiety, depression, memory and concentration problems, and paranoid thoughts (feeling watched or followed) that can lead to delusions and hallucinations, known as cocaine-induced psychosis.
• Heart and circulation: arrhythmias and ischaemic heart disease, including heart attack.
• Breathing and nose: breathing difficulties and, if snorted, damage to the nasal lining and septum.
• Other effects: chronic insomnia, eating problems, abdominal and muscle pain, nausea, reduced sex drive and sexual dysfunction.

In recent years, hospital A&E visits for cocaine-related problems have risen.

Cocaine and alcohol

Combining the two substances is very common and particularly harmful. When they are mixed, the body produces a substance called cocaethylene, which is more toxic and addictive than either one alone and is also linked to greater aggression and impulsiveness. Alcohol is often the gateway, too: many people only use cocaine after they have been drinking.

Signs of cocaine use

If you are worried that someone close to you is using, these signs can give you some guidance, although none of them on its own is proof:

• Dilated pupils, rapid speech, restlessness or out-of-place euphoria.
• Frequent sniffing, a blocked nose or small nosebleeds.
• Frequent trips to the toilet during dinners or nights out.
• Sleepless nights and poor appetite, followed by days of exhaustion and irritability.
• Unexplained spending, debts or money going missing.

You will find more guidance on how to approach the conversation in how to detect an addiction.

How to quit cocaine step by step

1. Understand your pattern. Write down when, where, with whom and in what mood you use. Weekends, payday, alcohol, stress or certain friends tend to come up again and again.
2. Ask for a professional assessment. It helps to check your health (especially your heart), identify other substance use or problems such as anxiety or depression, and decide which type of treatment suits you.
3. Close the doors to using. Delete your dealer’s number, avoid the places and people you used with, at least at first, and limit the cash you carry.
4. Look at your drinking. Cutting down or stopping greatly protects you against relapse. If you drink every day or heavily, do not stop suddenly without medical supervision, because alcohol withdrawal can be dangerous.
5. Prepare a plan for cravings. Intense desire rises and falls like a wave and, if you do not feed it, it passes. It helps to have decided in advance what you will do: leave the place, call someone, get moving, put off the decision.
6. Lean on someone you trust who knows what you are doing and whom you can call at a bad moment.
7. Look after the basics: sleep, regular meals, physical activity and a routine with things that matter to you.
8. If you relapse, do not throw it all away. A relapse gives you useful information about what went wrong and what to adjust.

What you will notice when you stop using cocaine

Cocaine withdrawal does not usually involve dangerous physical symptoms like those of alcohol withdrawal, but it is emotionally hard. It is common to feel exhausted, to sleep a lot or badly, to be hungrier, to feel irritable, sad or unable to enjoy things, and to have intense urges to use. These symptoms gradually ease, although cravings can return for quite a long time in response to the usual triggers. If your mood drops sharply or you have thoughts of harming yourself, ask for help straight away: call 024 (the Spanish suicide prevention helpline) or, in an emergency, 112, the European emergency number.

Treatment for cocaine addiction

There is no medication that can eliminate cocaine addiction on its own. The core of treatment is psychological: individual sessions to understand your use and learn to manage cravings, group therapy and family therapy. The medical and psychiatric team assesses whether medication would help to reduce cravings or treat anxiety, depression or insomnia, and urine tests can provide support. Depending on each case, treatment can be outpatient or residential. If you would like to know what the whole process involves, read how addiction is treated.

When to ask for help

If you have tried to stop and keep going back to it, if using is costing you money, health or relationships, or if you only keep it under control “until you drink”, now is a good time to seek advice. At FSC you can start with a free first appointment in Barcelona, where your situation is reviewed and you are advised on the most suitable treatment. Call +34 93 424 04 00; your family members can call too.

If you have chest pain, a very strong pounding heart, difficulty breathing, seizures or severe confusion after using, call 112.

Frequently asked questions

Can you quit cocaine without help?

Some people manage it, but it is harder, especially if use is frequent or goes hand in hand with alcohol. With professional support, triggers are easier to identify, anxiety or low mood can be addressed and the risk of relapse is reduced.

How long does cocaine withdrawal last?

It depends on the person and on how long and how much they have used. The initial comedown and tiredness usually ease, but cravings can return for quite a long time in situations linked to using, which is why it is a good idea to have a plan.

Are there medicines to help you quit cocaine?

There is no drug that cures the addiction on its own. In some cases the psychiatrist will consider medication to reduce cravings or to treat anxiety, depression or insomnia, always as part of psychological treatment.

Is it dangerous to mix cocaine and alcohol?

Yes. The combination produces cocaethylene, a substance more toxic than either drug alone, which puts more strain on the heart and is linked to greater aggression. In addition, alcohol is often the trigger that leads to using cocaine.

Is using cocaine only at weekends an addiction?

Not necessarily, but it is worth looking at carefully. If you cannot go out without using, if the amount keeps increasing or if the comedown affects you during the week, these are signs that you are losing control.