Cocaine is a stimulant drug that can produce euphoric feelings when taken; however, its effects are relatively brief.
How Long Are the Effects of Cocaine?
The way that cocaine is used impacts when the effects of the cocaine start:
- Smoking: immediate
- Intravenous (IV) injection: immediate
- Snorting: about 3 to 5 minutes
- Oral use: about 10 minutes
For the most part, after one takes cocaine, its effects do not last very long. Like onset of action, the duration of action depends on the mode of cocaine use:
- Smoking: about 15 to 20 minutes
- Intravenous (IV) injection: about 15 to 20 minutes
- Snorting: about 45 to 90 minutes
- Oral use: about 90 minutes
Cocaine metabolites are often detectable in an individual’s urine for only two to three days after last use of the drug, although individuals who use large amounts of cocaine may have detectable levels for up to two weeks.
The organ in the body that is responsible for metabolizing cocaine is the liver. It breaks down the drug into smaller compounds that are called metabolites. A major metabolite for cocaine is called benzoylecgonine, which is often measured during urine analysis to determine if someone has used cocaine recently since it can be detected in urine for a longer period of time than cocaine itself.
There are several different methods to test if cocaine is present in a person’s system.
- Cocaine can be detected in perspiration for up to a few weeks after last use.
- Cocaine metabolites can typically be detected in urine samples for two to three days after last use, but individuals who are heavy users may have detectable metabolites in their urine for up to two weeks.
- Cocaine in blood samples is often detectable for 12 hours after last use. Benzoylecgonine can be detected in blood for about 48 hours after last cocaine use.
- Hair samples may have detectable levels of cocaine for months and even years after last use.
- Cocaine or its metabolites can be detected in saliva for about one to two days after last use.
Several different factors influence the amount of time that cocaine remains in an individual’s system.
- An individual’s metabolism has an important influence on the amount of time that cocaine or any drug remains in an individual’s system.
- The amount of cocaine a person uses and how often they use it can impact how long the drug remains in their system. Cocaine and its metabolites may be detectable for longer periods of time in heavy users.
- Since most individuals who use cocaine obtain it from illicit sources, there is no regulation of the purity of that cocaine. Thus, the actual dosage of cocaine that a person uses can vary greatly. As aforementioned, the amount of cocaine that a person uses can affect how long it is present in their body.
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Regular use of cocaine can lead to tolerance and dependence. Tolerance is when more of the drug is needed to produce the effects that were once produced at lower doses. Dependence is when a person needs the drug to function normally. If someone who is dependent on cocaine suddenly stops taking the drug or drastically reduces their use, they may experience withdrawal.
Withdrawal symptoms occur when the person’s system has learned to only function normally when the drug is present and drug use is stopped or noticeably decreased. This can occur after consistent use of cocaine. A heavy user of cocaine may experience worse or longer-lasting withdrawal symptoms. When a person with cocaine dependence stops using cocaine or significantly decreases their use, the person begins to experience symptoms that can include strong cravings, irritation, depression, restlessness, tiredness, discomfort, appetite increases, decreased activity, and vivid nightmares.
When a person takes cocaine, dopamine levels are increased in the brain’s movement and reward circuits. A build up of dopamine in the synapses (the space between nerve cells) occurs due to cocaine preventing dopamine from being recycled back into the cells that release it. This excess dopamine contributes to the feelings of euphoria that cocaine produces. The reward circuit becomes used to having larger amount of dopamine and become less sensitive to dopamine, so if the person stops using cocaine, they experience withdrawal, sometimes referred to as a “crash.” This can happen if the person runs out of cocaine to use or if they intentionally stop using it.
It is common for individuals who use cocaine to use it in binges, where they use the drug multiple times in short period of time to sustain their high. Once a person becomes dependent on cocaine, they are even more compelled to use the drug repeatedly because it helps them avoid withdrawal symptoms. Depression and cocaine cravings can persist for months after heavy users stop using cocaine.
Cocaine withdrawal symptoms can include:
- General discomfort
- Appetite increases
- Slowed activity
- Vivid nightmares
Interestingly, withdrawal from cocaine often does not produce many observable physical symptoms. It is typically not as dangerous as the withdrawal process for drugs like alcohol or benzodiazepines.
Some researchers conceptualize cocaine withdrawal as occurring in three phases:
- The crash: The first phase starts quickly after heavy cocaine use is stopped, typically beginning within hours or a few days. Symptoms during this phase include anxiety, irritability, fatigue, increased appetite, and unhappiness. There is reportedly decreased craving during this phase.
- Withdrawal: The second phase involves increased cravings. Other symptoms include lethargy, trouble concentrating, and irritability. This phase is purported to last as long as 10 weeks.
- Extinction: During the last phase, the individual may experience cravings when they encounter certain triggers. These triggers may include stressful situations, certain friends with whom they used the drug, or certain places where they used cocaine. This phase is asserted to last up to 28 weeks.
However, several later studies indicated that there are not distinct phases but instead a gradual decrease in withdrawal symptoms.
The withdrawal process from cocaine is typically not as dangerous in and of itself as withdrawal from alcohol or benzodiazepines. However, cocaine withdrawal can cause depression, and this depression can persist for months in previously heavy users. Individuals experiencing depression are at risk of self-injury and suicide. The cravings and other unpleasant symptoms an individual experiences during withdrawal may prompt them to relapse, and this puts them at risk of overdosing.
Do I Need Medical Detox?
Even though going through withdrawal from cocaine is typically not associated with severe physical symptoms, there are several reasons for an individual to choose medical detox as opposed to trying to quit the drug on their own. These include:
- Relapse after stopping cocaine use is common. According to a study of individuals addicted to cocaine, one quarter of participants relapsed in less than a week. Medical detox programs involve close supervision, which can prevent relapse. Furthermore, medications and other treatments may be available to help with the symptoms of withdrawal, which may lower the risk of relapse.
- Many individuals with substance use disorders also have comorbid (co-occurring) mental illnesses. Based on data from the 2016 National Survey on Drug Use and Health (NSDUH), it is estimated that over 43 percent of American adults with a past-year substance use disorder also had a mental illness in the past year. Medical detox programs can potentially identify comorbid mental illnesses, monitor for safety, and provide some treatments. Subsequent addiction treatment programs can provide more thorough assessments and treatments for mental illnesses alongside substance use disorder treatment.
- Medical detox programs involve monitoring the person’s health and safety, and medical providers are on hand to intervene if needed.