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Cocaine is a stimulant derived from coca leaves. First discovered and used as a medicinal tool after the creation of coca wine in the 19th century, cocaine today is an illicit drug capable of creating a powerful sense of joy and euphoria, followed by an extreme crash. It is highly addictive and has extensive side effects from cocaine withdrawal, including paranoia, anxiety, irritability, and insomnia.

Among the most common illicit drugs, cocaine can be counted as one of the most addictive. Breaking a cocaine addiction is not easy, in particular, because of its nasty set of cocaine withdrawal symptoms. Secondly, because of its effects on the brain and the euphoric feeling it produces, cocaine carries very powerful and moderately long-lasting cravings.

The hours after a crash are particularly hard, as the cocaine craving is strongest. Research shows that even a single hit can alter the brain’s reward system for months – although there is no evidence that any drug can cause an addiction instantaneously, cocaine is one of the few substances that opens a person’s brain up to being susceptible to addiction. To understand why cocaine withdrawal occurs and its symptoms can be so severe, it’s important to understand how cocaine hijacks the brain and creates a physical dependence on the drug.

How Cocaine Creates An Addiction

There is a reward system within the brain called the mesolimbic dopamine system. In a few words, this system reinforces certain behavior necessary for survival by introducing a neurotransmitter into the system called dopamine. Dopamine release to the brain’s cells induces feelings of joy and euphoria. Dopamine spreads by being released from one neuron to another through its dopamine receptors.

Food, sex, exercise, and laughter all help us release dopamine. These are all generally pleasurable aspects of life and are necessary for procreation, physical health, and mental stability. So, all in all, the reward system reinforces good things.

Cocaine, however, manipulates this system. Cocaine is an alkaloid compound found within the coca plant, which has been used as a stimulant in South America for thousands of years. It binds to the transporter, a part of the neuron responsible for removing dopamine from the cell. Dopamine accumulates, creating a far more powerful emotional signal throughout the brain. In a way, cocaine functions like an extremely powerful antidepressant. However, unlike most antidepressants, its intensity also opens the door to physical dependence and cocaine withdrawal.

Continuous use of cocaine creates a cocaine dependence, wherein the brain becomes unable to process dopamine normally and facilitate feelings of joy without a dose of cocaine. Unlike an ordinary craving, like wanting to get some ice cream or grab a cup of hot chocolate to cheer yourself up, physical dependence on a highly addictive substance like cocaine can drastically alter how the brain perceives things and reacts to certain stimuli. The same dopaminergic pathways that facilitated the reward system and are central to the human concepts of learning, motivation, and self-control can instead become hijacked by a single substance around which our mind revolves. Cocaine withdrawal creates a craving feeling akin to severe hunger or thirst. The danger of cocaine use truly grows exponentially when tolerance begins to set in.

Tolerance And Cocaine Withdrawal

Tolerance can be defined as increased resistance to the effects of a drug after continued use. Tolerance and dependence are separate – one can develop tolerance faster than dependence and vice versa. The underlying cause for increased resistance to a drug’s effects is related to how the body metabolizes the drug.

Continuous use of a substance causes the cells to more efficiently work the drug through the system, effectively diminishing the amount of time it stays in the body. This encourages people to ramp up their consumption, which becomes inevitable when tolerance is coupled with dependence.

The logic is that as you increase the dosage, you increase the risk of an overdose. Cocaine overdose is typically linked to heart failure, stroke, and other causes of death related to abusing stimulants. The longer someone uses cocaine, the higher their tolerance (and subsequent dosage) and the greater the long-term effects of the drug. As follows, this may also affect a person’s cocaine withdrawal period.

When the body’s cells begin to establish an affinity to a drug, as in tolerance, symptoms of cocaine withdrawal begin to manifest. Withdrawal is any symptom when you reduce or slow down your drug use. With cocaine, the symptoms can get quite brutal. Cocaine withdrawal symptoms include:

  • Restless behavior
  • Fatigue
  • Increased appetite
  • Lethargy
  • Physical discomfort (itching)
  • Depressive thinking
  • Craving

Heroin and alcohol withdrawal is typically stronger, exhibiting brutal physical symptoms such as severe bowel movements, nausea/vomiting, fever, and flu-like symptoms. Cocaine withdrawal is still very unpleasant. The cravings can last for months, while most other symptoms disappear within a week.

Getting Off Cocaine

Cocaine addiction is treated like many other cases of substance use disorder – through recovery treatment. While residential treatment is common, there are many ways to tackle post-rehab recovery, such as a Houston IOP treatment program for people who need help to get back into life while sober – without relapsing.


  1. Blickman T. Coca leaf: Myths and Reality. Transnational Institute. Published August 5, 2014. Accessed October 15, 2022.
  2. Borke J. Cocaine withdrawal: MedlinePlus Medical Encyclopedia. Published February 12, 2021. Accessed October 15, 2022.
  3. Taub B. Here’s What Cocaine Does To The Structure Of Your Brain. IFLScience. Published February 10, 2016. Accessed October 15, 2022.

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