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How To Withdraw From Cocaine?

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Posted on Tue, 24 Nov 2015
Question: Hi, I am on cocaine for maybe 5 months and when I am not using I am very anxious. I would like to quit by myself no matter what. Please advice
doctor
Answered by Dr. Dr. Matt Wachsman (2 hours later)
Brief Answer:
It is rather difficult.

Detailed Answer:
First, unlike cigarettes, alcohol, and heroin there are zero drugs that have been shown to be helpful in this and many that are potentially dangerous (antidepressants probably interact with cocaine). Disorders of mood (depression, bipolar) make this really complicated and would definitely mean you should not do this by yourself.
Then, otherwise, you probably should not do this by yourself. That being said here are all the principles I know about on this.
1) First thing is having a gun to your head. I've seen many people quit; none did it until it was going to be fatal otherwise if they did not. Many many just don't know the gun is there. So... ekg, stress test are helpful in finding some heart irregularity. If it is there, then you have the obvious proof that if you do any more cocaine it is likely to be fatal. Or... a simple blood pressure cuff and see what the blood pressure is during cocaine if you use again.
2) Then, if you have something that you know that is bad for you and you are going to do it anyway due to addiction, there are limited ways to proceed. They are:
Avoiding it. Getting into a different milieu where the cocaine isn't going to be. Not having availability of cocaine. not having money to get it because your money is held by someone else

Substitution. Also tricky. On food I know that the triggers are not having anything to do, habits of when and what you do, emotions, envy, etc. These can be satisfied by other stuff that is not food or is very low calorie. With cocaine all the triggers are hard. Just wanting the thrill of it. Having social situations in which use of it is rather expected. These are hard to find substitutes for (see "avoid" above). Personally I've just learned to ignore hunger and pain. I visualize these feelings as warning lights on my car dashboard like "seat belt" "low Tire pressure" "engine about to explode". Hell, I ignore all those, what's a few more like "starvation" or "about to collapse" ?
This bridges into the next section, but with substitution, what has helped with my patients is called mindfulness. You picture what the outcome is going to be if you use and the picture you get if you don't. You substitute the feelings you'll have tomorrow with not using cocaine today, for the immediate feelings you have right now.

that brings up the last section... transcending. You have what you know is the right thing to do versus what you feel like doing right now. In transcending, you put this INTO A LARGER PICTURE. Ok, admittedly, this mostly means being inside a locked down rehab center, but there are other examples of transcending. The mindfulness mentioned above is one. Similarly, I have a bunch of stick on decorator gems for cell phone cases. I put them on places where I've resisted the urges to eat. (on fridge handle, on candy boxes, on car steering wheel). I become surrounded by signs I'm doing well. 12 step programs involving others is one BUT it only works WELL when you involve a lot of others into your life. Sharing, interacting with sponsors, going to multiple meetings, involving family into the meetings. If you do all of this the success rate rises over 50% this week.
To recap
1) motivation .. gun to the head, testing to verify you have to quit immediately
2) Avoid, substitute, transcend
3) transcending by
visualizing the good versus the bad outcome at ever time there is a triggering event.
Putting a sticker/gem/marker at the site of each triggering event
12 step programs.
There's a bit more but it would be specific to a person's specific situation and experiences.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (15 minutes later)
The problem is that when I don't take the damn cocaine I have withdrawal/anxiety symptoms and I can't control myself and I am very scared. I really want to stop taking coke, I know is not good for me but when I do not take the withdrawal symptom is horrible, is putting me off.
Please help.

Thank you
doctor
Answered by Dr. Dr. Matt Wachsman (48 minutes later)
Brief Answer:
the withdrawal isn't what kills you.

Detailed Answer:
sorry to be a bit blunt at the start on this.
The timing of this puzzles me. Cocaine is a really short acting drug. the withdrawal is feeling very down and depressed. Unlike sedatives, narcotics, nicotine, and even alcohol and food, the cycle of cocaine use is NOT to keep the drug going continuously, but having periodic binges. So, certainly there's withdrawal, but typically the withdrawal doesn't produce fear. The cocaine can put a lot of different emotions into someone's head. Fear, even total paranoia isn't rare with cocaine, but it is when the drug is there not from the withdrawal.

Ok, with withdrawal effects producing thoughts of anxiety, then getting over these thoughts is part of the process to get off of them.
This can be accomplished with professional help, probably with 12 step programs, and definitely with counseling and with other cognitive behavioral therapy programs that include online ones
http://www.yyyyyyyyyyyy.yyyy/yyyy.html


to summarize, withdrawal from cocaine generally is depression. Anxiety and upset in that context is not the usual case and implies a separate psychological process like a phobia/panic attack. These are helped by conventional counseling techniques especially cognitive behavioral therapy, which is also available online.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Dr. Matt Wachsman (2 days later)
Taking clonazepam 2mg/day and 300mg quietapine/day can help with anxiety from cocaine and even cure' it? If I tell my psychiatrist about my cocaine addiction will he mention' it in in his reports about me? Please advice.

Thank you
doctor
Answered by Dr. Dr. Matt Wachsman (58 minutes later)
Brief Answer:
No. They don't treat cocaine addiction.

Detailed Answer:
Addiction treatment is not about getting to feel good. Indeed, taking drugs to get good feelings is connected to the addiction process. Being in a treatment program, getting off of drugs of abuse, changing one's entire circumstances away from drug use--those would be steps in the right direction. Not telling doctors all the drugs one is on, taking what drugs feel good at the time.. these would be steps in a not-so-good direction. Connected with moving in a bad direction are feelings of guilt, avoiding honest communication, misleading, etc. Further bad steps involve cutting ties to friends and family, doing illegal actions, and other activities that are going to lead to further negative emotions. The negative emotions mostly trigger more drug abuse.. and we can see this isn't going in a good direction...

So, Clonazepam has never been shown to be even slightly helpful except to prevent fatal seizures in alcohol withdrawal being given for under 1 week. Quietapine was a promising drug in cocaine. It failed.
http://www.yyyy.yyyy.yyyy.yyy/yyyyy/0000

People misuse it because they feel better on it
http://www.yyyy.yy.yyyy.yyyy/yyyyyy/0000

This sets up a bad pattern of behavior and doesn't work for people. Klonapin is worse.

Being in treatment for BIPOLAR, and receiving quietapine in this context is different; it is helpful for bipolar. BUT that isn't the total fix for cocaine addiction. At some point the addict has to tell people, open up, be open to the view that their thoughts are influenced by the drugs and addiction process and are not entirely reliable. This also requires being able to accept input from others.
And, staying off of drugs of abuse.

So, to summarize. In people with bipolar and addiction, both have to be treated. The treatments are separate and complementary. Both treatment regimens have to know about the other. The therapist treating bipolar has to know about drugs of abuse taht are taken. Generally they WILL take drug urine testing. Things will be happier if there are NOT surprises on these test results. But, people treating bipolars are not 'surprised' by positive drug test results.

Confidentiality issues have to be ironed out before interacting with the therapist. They are open to negotiation. Seriously. Set your own ground rules on what is allowed out from your records. You certainly aren't considering harming others, or doing other serious violations. In which case, all options on confidentiality including after a few years NOT having records kept, should be open to discussion.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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How To Withdraw From Cocaine?

Brief Answer: It is rather difficult. Detailed Answer: First, unlike cigarettes, alcohol, and heroin there are zero drugs that have been shown to be helpful in this and many that are potentially dangerous (antidepressants probably interact with cocaine). Disorders of mood (depression, bipolar) make this really complicated and would definitely mean you should not do this by yourself. Then, otherwise, you probably should not do this by yourself. That being said here are all the principles I know about on this. 1) First thing is having a gun to your head. I've seen many people quit; none did it until it was going to be fatal otherwise if they did not. Many many just don't know the gun is there. So... ekg, stress test are helpful in finding some heart irregularity. If it is there, then you have the obvious proof that if you do any more cocaine it is likely to be fatal. Or... a simple blood pressure cuff and see what the blood pressure is during cocaine if you use again. 2) Then, if you have something that you know that is bad for you and you are going to do it anyway due to addiction, there are limited ways to proceed. They are: Avoiding it. Getting into a different milieu where the cocaine isn't going to be. Not having availability of cocaine. not having money to get it because your money is held by someone else Substitution. Also tricky. On food I know that the triggers are not having anything to do, habits of when and what you do, emotions, envy, etc. These can be satisfied by other stuff that is not food or is very low calorie. With cocaine all the triggers are hard. Just wanting the thrill of it. Having social situations in which use of it is rather expected. These are hard to find substitutes for (see "avoid" above). Personally I've just learned to ignore hunger and pain. I visualize these feelings as warning lights on my car dashboard like "seat belt" "low Tire pressure" "engine about to explode". Hell, I ignore all those, what's a few more like "starvation" or "about to collapse" ? This bridges into the next section, but with substitution, what has helped with my patients is called mindfulness. You picture what the outcome is going to be if you use and the picture you get if you don't. You substitute the feelings you'll have tomorrow with not using cocaine today, for the immediate feelings you have right now. that brings up the last section... transcending. You have what you know is the right thing to do versus what you feel like doing right now. In transcending, you put this INTO A LARGER PICTURE. Ok, admittedly, this mostly means being inside a locked down rehab center, but there are other examples of transcending. The mindfulness mentioned above is one. Similarly, I have a bunch of stick on decorator gems for cell phone cases. I put them on places where I've resisted the urges to eat. (on fridge handle, on candy boxes, on car steering wheel). I become surrounded by signs I'm doing well. 12 step programs involving others is one BUT it only works WELL when you involve a lot of others into your life. Sharing, interacting with sponsors, going to multiple meetings, involving family into the meetings. If you do all of this the success rate rises over 50% this week. To recap 1) motivation .. gun to the head, testing to verify you have to quit immediately 2) Avoid, substitute, transcend 3) transcending by visualizing the good versus the bad outcome at ever time there is a triggering event. Putting a sticker/gem/marker at the site of each triggering event 12 step programs. There's a bit more but it would be specific to a person's specific situation and experiences.