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 completely over time. People experiencing cocaine withdrawal often attempt to self-medicate with alcohol, sedatives, hypnotics, or antianxiety medications, such as diazepam (Valium). Self-medication or replacement is not advised, because each simply shifts addiction from one substance to another.

Because at least 50% of people addicted to cocaine have a co-existing mental disorder (particularly depression and attention-deficit disorder), these conditions must be considered and treated aggressively.

Relapse rates are dramatically reduced when these conditions are treated appropriately. All prescription drugs 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.

Expectations (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 for most people addicted to cocaine, according to the research.

Presently there are no effective medications for reducing craving, though 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 serious problems.

Complications:

• 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.

Calling your health care provider:

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