Quick answer
Cocaine addiction is treated with behavioral therapies, because the FDA has not approved any medication for cocaine use disorder. NIDA identifies contingency management and cognitive behavioral therapy as the most effective approaches. Treatment can happen in inpatient, partial hospitalization or outpatient programs, often alongside care for depression, anxiety or other mental health conditions.
What are the signs of cocaine addiction?
Cocaine is a strong stimulant. It’s usually snorted as a powder, injected, or smoked as “crack.” Doctors diagnose cocaine addiction as a stimulant use disorder.
Clinicians use 11 DSM-5 criteria. In plain terms, they ask whether in the past year you have:
- Used more cocaine, or for longer, than intended
- Tried to cut back or stop without success
- Spent a lot of time getting, using or recovering
- Had strong cravings
- Fallen behind at work, school or home
- Kept using despite problems with family or friends
- Given up activities you enjoyed
- Used in risky situations
- Kept using despite health or mental health problems
- Needed more to get the same effect
- Felt withdrawal, such as exhaustion or low mood, after stopping
Two to three signs suggest a mild disorder, four to five moderate, and six or more severe.
Others may notice frequent nosebleeds or sniffing, dilated pupils, bursts of energy and talkativeness, followed by crashes, irritability, paranoia, money problems or secretive behavior.
Not sure what kind of help you need? Call (877) 847-2855 to talk through options and check your insurance benefits. It’s free and confidential.
What does cocaine withdrawal feel like?
Cocaine withdrawal is mostly emotional and mental rather than physical. It often starts with a “crash” after a binge. Common symptoms include:
- Exhaustion and increased sleep
- Depression, anxiety and irritability
- Trouble concentrating and slowed thinking
- Increased appetite
- Vivid or unpleasant dreams
- Strong cravings
While withdrawal is not usually physically dangerous, depression can be severe and suicidal thoughts can occur. If you or someone you love is thinking about suicide, call or text 988. If someone is in immediate danger, call 911.
Cocaine withdrawal timeline
| Phase | Typical timing | What may happen |
|---|---|---|
| Crash | Hours to a few days | Fatigue, heavy sleep, low mood, anxiety |
| Acute withdrawal | About 1–2 weeks | Depression, poor focus, irritability, cravings |
| Extended phase | Weeks to months | Cravings triggered by people, places or stress; mood slowly stabilizes |
Many people who use cocaine also drink heavily. If you also have alcohol or benzodiazepine dependence, withdrawal from those substances can be dangerous and needs medical supervision. In that case, a medically supervised detox program is the safest place to start.
What treatment works for cocaine addiction?
No FDA-approved medication
There is no FDA-approved medication for cocaine use disorder. NIDA supports research into several possible medications, but none is approved. Doctors may still treat related conditions, such as depression, anxiety or insomnia.
Contingency management
Contingency management (CM) rewards you for meeting goals, such as a negative drug test, with vouchers or small prizes. According to NIDA, CM has strong evidence for reducing cocaine use and keeping people in treatment. Some state Medicaid programs have started to cover it.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) helps you spot high-risk situations, manage cravings and build coping skills. NIDA notes that skills learned in CBT tend to last after treatment ends.
Other helpful approaches
- Community reinforcement approach, which builds rewarding, substance-free activities and relationships
- Family therapy to repair trust and strengthen support at home
- Peer support groups such as 12-step or SMART Recovery
- Therapeutic communities in long-term residential settings
Cocaine use often occurs alongside depression, anxiety, ADHD, trauma or other substance use. Dual diagnosis treatment addresses all of these together.
Which level of care should you consider?
Clinicians often use the ASAM Criteria, guidelines from the American Society of Addiction Medicine, to recommend a level of care.
| Level of care | What it offers | May fit if… |
|---|---|---|
| Inpatient/residential | 24/7 structure away from triggers | You have severe depression, an unsafe home or repeated relapses |
| Partial hospitalization (PHP) | Treatment most of the day, home at night | You need daily support with stable housing |
| Intensive outpatient (IOP) | Several therapy sessions per week | You want to keep working or studying |
| Outpatient | Weekly counseling and CM | You have milder symptoms or are stepping down |
A partial hospitalization program (PHP) provides structured treatment most of the day. An intensive outpatient program (IOP) offers several hours of therapy a few days a week. Ask any program whether it uses contingency management and CBT. Our guide on what happens in rehab explains a typical day.
What are the signs of a cocaine overdose?
Cocaine can cause dangerous heart rhythms, heart attack, stroke, seizures and very high body temperature, even in young and healthy people. Warning signs include chest pain, a racing or irregular heartbeat, trouble breathing, severe agitation or confusion, very high temperature, seizures and unresponsiveness.
- Call 911 immediately. There is no medication that reverses a cocaine overdose.
- Give naloxone if the person isn’t breathing well or won’t wake up. The CDC warns that cocaine is sometimes contaminated with illegally made fentanyl, and naloxone can reverse the opioid part of an overdose.
- Stay with the person until help arrives.
Mixing cocaine with alcohol adds risk. According to NIDA, the liver combines them into cocaethylene, which may be more harmful to the heart than either drug alone. Learn more about overdose risks on our fentanyl addiction page.
How do you pay for cocaine rehab?
Costs vary widely by setting, length of stay and insurance. Most health plans cover substance use treatment as an essential health benefit under the Affordable Care Act, and federal parity law limits stricter rules for addiction care. What you pay depends on medical necessity, prior authorization, whether a provider is in network, your deductible and your out-of-pocket maximum. See does insurance cover rehab? for details.
How do you get help for cocaine addiction?
Start with a conversation, whether with a doctor, a counselor or a trusted person in your life. Ask programs about CM, CBT and mental health care. You can also browse rehab centers by state.
Cocaine addiction is treatable, and many people build full lives in recovery. To find a program that uses proven therapies and fits your insurance, call our admissions helpline at (877) 847-2855. It’s free and confidential.
Frequently asked questions
Is there a medication to treat cocaine addiction?
No medication is FDA-approved for cocaine use disorder. Researchers are testing several options, but current treatment relies on behavioral therapies like contingency management and CBT. Doctors may prescribe medicines for related issues such as depression or sleep problems.
How long does cocaine withdrawal last?
The initial crash may last hours to a few days. Fatigue, low mood and cravings often improve over one to two weeks, though cravings can return for months, especially around triggers. Ongoing support helps you manage them.
Is cocaine withdrawal dangerous?
Cocaine withdrawal usually doesn't cause dangerous physical symptoms like alcohol or benzodiazepine withdrawal can. However, depression and suicidal thoughts can be serious. Call or text 988 if you or someone you know is thinking about suicide.
What happens if you mix cocaine and alcohol?
According to NIDA, the body combines cocaine and alcohol into a substance called cocaethylene, which may increase strain on the heart. Mixing the two raises health risks and is common among people seeking treatment.
Can cocaine contain fentanyl?
Yes. The CDC warns that illegally made fentanyl is sometimes mixed into cocaine. People who don't use opioids have no tolerance, so even small amounts can cause a fatal overdose. Keep naloxone on hand.
Can I go to outpatient rehab for cocaine?
Many people do. Intensive outpatient and outpatient programs that offer CBT and contingency management can be effective. Residential care may fit better if you have a mental health crisis, an unsafe home or repeated relapses.
