TABLE OF CONTENTS
Regardless of the drug addiction, the rehab process stays the same. Some treatment settings and facilities only offer one or two steps of the process, but each of the following steps should be completed to finish rehab and have the best chance at recovery.
For more information, read our guide to the Rehab Process
Rehab facilities fall into two categories or “settings.” The two settings are residential (full-time rehab) and outpatient (part-time rehab). Residential means the patient stays overnight at the location, while outpatient centers are more flexible and do not include overnight services.
Rehab centers don’t typically focus on a single type of addiction like cocaine. Rather, facilities employ a range of treatment approaches that are effective for all kinds of addictions. Once you enter a program, the trained staff will work with you using the method proven most useful in treating your specific dependence. Below is a comparison of the most common program options.
|Setting||Type of Treatment||Description||Time Commitment||Duration|
|Residential||Short-term residential||Intensive treatment, sometimes in a hospital setting. Therapies offered are extensive. Typically 3-6 weeks, and often a modified 12-step approach.||Hours per Day: 24||14-30 days|
|Days per Week: 7|
|Long-Term Residential||Intensive treatment in a non-hospital setting, most often a therapeutic community facility with other patients. Therapies offered are extensive, and the focus is on treating the substance use disorder – typically when intensive medical or psychiatric supervision isn’t needed.||Hours per Day: 24||3-12 months|
|Days per Week: 7|
|Partial Hospital- ization||Intensive treatment, sometimes in a hospital setting. Patients do not stay overnight. Referred to as “hospitalization” due to the availability of more intensive medical and psychiatric services, and the near full-time commitment every week. Medical treatment is available to those who qualify.||Hours per Day: 6-8||14-30 days|
|Days per Week: 5|
|Outpatient||Intensive Day Treatment||Patients receive the extensive services of a residential program but return home after. After completion, patients often transition to less intensive counseling. Therapies offered are extensive. Medical and psychiatric treatment is often available to those who qualify.||Hours per Day: 2-4||3-4 months|
|Days per Week: 3|
|Counseling||Both individual counseling and group counseling focus on short-term behavioral goals to develop coping strategies. Therapies offered are moderate. Medical treatment is not available.||Hours per Day: 1-2||As long as desired|
|Days per Week: 1-3|
|Support Groups||Self-help groups are recommended to help maintain abstinence after another form of treatment. Typically meet one day a week for 1-2 hours.||Hours per Day: 1-2||As long as desired|
|Days per Week: 1|
The Substance Abuse and Mental Health Services Administration estimates that in 2015, 4,828,000 people (1.8 percent of the population) used some form of cocaine and 896,000 (0.3 percent) were addicted to cocaine and in need of treatment. Out of those who required treatment, only 615,000 enrolled in rehab programs, the majority of whom were treated for addiction to crack.
Assessments for Cocaine Addiction
Any illicit use of cocaine is dangerous, and it can lead to an addiction quickly. If you feel a craving for the substance when you don’t have it, or you spend your free time thinking of ways to acquire it, it’s likely you have an addiction. “Cocaine use disorder” is the clinical term used for cocaine addiction, and the criteria for this diagnosis include craving, spending lots of time to obtain or use the substance, reduced effect of the substance with repeated use (tolerance), withdrawal symptoms, persistent desires or efforts to reduce or stop using the substance, negative impacts of use on relationships with family and friends, physical health, or job performance; use in dangerous settings, etc.
Receiving an assessment for cocaine addiction is no different than the first step of any other drug rehabilitation; it starts with speaking to a medical professional. Whether it’s a family doctor or an addiction specialist at a rehab facility, a professional assessment is critical in determining your addiction level and the best rehab solution to address it.
All cocaine treatment is preceded by detox, which is a period when all of the chemicals associated with cocaine use are cleared from the body. Cocaine detox typically takes 3-7 days and is accompanied by withdrawal symptoms, some of which can last months (e.g. depression).
Cocaine use affects the brain’s dopamine receptors, which causes prolonged psychological symptoms that make withdrawal difficult. Prolonged cocaine withdrawal symptoms can last for months after the body has detoxed. These lingering symptoms can be dangerous as some people experience depression or suicidal thoughts. While there are no FDA approved medications to wean the user off of cocaine, sometimes doctors will give medications to help ease some of the withdrawal symptoms.
For more information about withdrawal, read our guide on Cocaine Addiction
Because cocaine withdrawal symptoms often include depression, anxiety, and irritability, some treatment facilities may prescribe anti-depressants and anti-anxiety medication during detox. The most commonly prescribed medications include:
Other drugs can help with other symptoms, such as sleep aids (e.g. trazodone, mirtazapine, hydroxyzine) can combat insomnia, while antipsychotics can treat psychosis (hallucinations and paranoia).
Relapse prevention medication
There are no FDA-approved drugs for pharmacological therapy for rehabilitation (i.e. medications to reduce risk of relapse by reducing craving and re-wiring the addiction pathways in the brain). However, a growing collection of studies point to the possibility that some medications, such as prescribed stimulants (e.g. medications prescribed and FDA-approved for Attention Deficit Hyperactivity Disorder), topiramate, disulfiram, galantamine, and ketamine, may promote recovery.
Therapy deals with the root of the drug addiction and is crucial for long-term success. The National Institute on Drug Abuse recommends at least three months of treatment and therapy for the best treatment outcomes.
The majority of proven and effective therapies for cocaine addiction are behavioral therapies. These therapies occur in residential and outpatient settings. Behavioral therapy involves individual or group counseling, and it equips addicts to overcome their addiction by giving them coping skills and addressing any other mental health needs.
For many illicit drugs, there are medication-assisted therapy options. However, there are currently no medications approved by the U.S. Food and Drug Administration to treat cocaine addiction. This may soon change as many medications are currently being tested.
Behavioral therapy is based on the idea that all behavior is learned and unhealthy behavior can be changed. For substance abuse, therapy seeks to identify and change the behaviors that lead to addiction.
The U.S. National Institute on Drug Abuse (NIDA) as well as the United Nations Office on Drugs and Crime list more than ten commonly used therapies for cocaine addiction; however, some are specific to certain demographics like children or pregnant mothers. Compiled below are some of the most prevalent, effective, and popular behavioral therapies currently used.
Cognitive Behavioral Therapy (CBT) helps patients acquire skills to identify triggering situations, avoid those situations, and cope with any problems brought about by drug use. CBT works by helping the brain reset neural pathways that were negatively affected by substance abuse. Cocaine rewires the brain’s pleasure center, and cravings become very intense and difficult to ignore. CBT equips patients with skills to change the brain’s response to difficult situations, cravings, and stress. Typical sessions last two hours per week.
CBT4CBT is an electronic version of CBT with videos and the same lessons. It has been successful in clinical trials and rated well by participants. It is also connected to longer rates of abstinence within six months after initial detox. Snow Patrol, a similar online program, is also available to anyone.
Contingency Management (CM) (or motivational incentives) is a voucher or prize-based system to reward abstinence from a drug. It has also been used to encourage drug users to participate in positive behaviors like getting Hepatitis vaccines or completing tasks that help them stay safe. Contingency management is often provided in conjunction with other behavioral therapy like Cognitive Behavior Therapy and lasts an hour or less per week.
The following list is an overview of other types of therapy that are currently used for unique situations.
Various treatment approaches have proven beneficial and effective for pregnant women including Contingency Management (incentives) coupled with other approaches like the Community Reinforcement Approach, which specifically targets pregnant mothers dealing with drug addiction.
Cognitive Behavioral Therapy led through group discussions is often one of the most popular approaches for teens. It reinforces positive peer pressure against using drugs, and it helps teens learn how to avoid relapse. Family Behavior Therapy can also help families who have been impacted by their teen’s drug addiction to heal.
Comorbid depression and paranoia can negatively impact addiction recovery. Medication and counseling for these comorbidities can significantly improve outcomes.
Aftercare, the final step in the rehab process, is a lifelong commitment that can take many forms from individual counseling to support groups. Aftercare can make a substantial, positive difference on your ability to stay clean. Aftercare for cocaine addiction is especially important due to cocaine’s high relapse rates.
The decision-altering nature of cocaine and its long-term effects on the brain make abstinence hard to maintain. Because cocaine increases the brain’s impulsivity, making a bad decision regardless of consequences is easier, even after quitting cocaine. Users who spend too little time in rehab, who encounter environmental stimuli associated with past use, and who fail to engage in aftercare programs are the most likely to relapse.
Studies vary, but the Substance Abuse and Mental Health Services Administration’s most recent survey of individuals in rehab shows that crack has a relapse rate of around 76% while cocaine is at 64%. When compared to other recreational drugs, cocaine has two of the highest relapse rates, second only to heroin by a small margin.
Cocaine users are more likely to maintain their abstinence if they undergo longer treatment periods, engage in aftercare programs, keep a positive attitude, and build a strong social support group.
The National Institute on Drug Abuse highly recommends that recovering cocaine users undergo some form of self-help aftercare upon completion of their rehab treatments. The most common form of aftercare is mutual support groups, many of which follow the 12-step model. There are dozens of national support group networks covering a wide range of substance addictions. The following groups represent the best groups for cocaine users.
|Name||Description||Who They Serve|
|LifeRing Secular Recovery||Secular support groups focused on abstinence and drug recovery. Find a personal account here and meeting information here.||Anyone previously addicted to alcohol or other non-medically indicated drugs, including cocaine|
|Cocaine Anonymous||12-step spiritual program and support available to anyone trying to overcome drug addiction.||Anyone recovering from cocaine addiction or wanting to stop|
|Co-Anon Family Group||12-step spiritual support group for loved ones of those addicted to drugs.||Family members or friends with loved one who is addicted to cocaine|
|Dual Recovery Anonymous||Provides mutual support for those suffering from both alcohol and cocaine abuse, each of which often fuels the other. You can find meetings in your area at their website here.||Those suffering from both alcohol and cocaine abuse|
|Secular Organizations for Sobriety||Comprehensive list of secular support for anyone struggling to maintain abstinence from addiction. Find meetings here.||Anyone recovering from addiction: eating, drug, sex, etc.|
Sober living homes (also referred to as recovery residences) are group homes that help recovering addicts transition from treatment facilities to living on their own while maintaining sobriety. They are especially helpful for those who don’t have a supportive and positive environment to live in after rehab.
Residents can stay for a couple of months of for years, as long as they follow the rules and don’t relapse (most homes have a zero tolerance policy for using substances). Other rules usually include completing chores, attending mutual support groups regularly, and paying an equal share of the cost of renting the home.
Some halfway houses are listed in our database, and you can find them by using the appropriate filter in our tool below. Otherwise, head to our guide on sober living homes to learn more about sober living homes, and to find a certified recovery residence near you.
The current lack of drug therapy for cocaine addiction treatment is encouraging many pharmaceutical companies and government labs to experiment with various medications. The treatments below include experiments on existing behavioral therapies as well as potential medical treatments.
Behavioral therapy is the best-proven treatment for cocaine addiction, but recent studies are challenging certain practices. A 2016 study in Science highlights the complete ineffectiveness of punishing cocaine addicts and how over-rewarding causes a focus on the reward rather than making positive decisions. Research suggests that the answer lies in occasional rewards and a focus on changing negative habits.
The anti-cocaine vaccine prevents cocaine from reaching the brain and having any effects on the user. The vaccine works by absorbing the cocaine when it hits the bloodstream and before it gets to the brain. Researchers tested the vaccine on animals with positive results and are now testing it on human subjects.
Pfizer created a drug that may be able to inhibit memories associated with cocaine cravings. The drug is currently in cancer therapy trials, but it has only been tested on mice for its drug treatment benefits. If approved, it would be the first of its kind to target memory for drug treatment. If the results continue to be positive, the drug could be used for other drug addictions as well.
While the cocaine vaccine could stop or prevent addiction, other medications are being tested that could help alleviate some of the symptoms that cause relapse or prevent people from quitting cocaine.
Anecdotal evidence suggests alternative treatments for fighting cocaine addiction, but very little empirical evidence supporting most of them. Here, we analyze the scientific findings on the effectiveness of some popular suggestions including natural remedies, meditation, acupuncture, and neurofeedback.
Note: All of the examples below are suggested to be used in conjunction with proven behavioral therapies. They are not a substitute for traditional treatments.
|N-Acetylcysteine (NAC)||A form of an amino acid (protein) known as L-cysteine.||Decreasing cravings and preventing relapse||Over-the-counter pills|
|Rhodiola||Boosts dopamine, serotonin, and energy levels. In some studies, it was effective in preventing stress-induced cocaine relapse.||Decreasing cravings and depressive withdrawal symptoms||Herb, taken as an extract|
|Taurine||Has a calming effect and helps improve mental performance.||Combating depressive withdrawal symptoms and possibly preventing cocaine addiction||Over-the-counter pill form|
Mindfulness meditation is a form of meditation designed to focus attention on inner and outer experiences with acceptance, patience, and compassion. A recent study found that those addicted to stimulants, like cocaine, showed decreased levels of anxiety and depression. The study also found that those who partake in mindful meditation used stimulants at a lower rate than those who did not.
Auricular acupuncture has also been used to treat cocaine addiction. In this type of acupuncture, needles are inserted into the outer ear. The specific locations targeted are believed to aid in treating addiction problems. A study conducted by researchers at Yale University found that 54.8% of cocaine addicts who underwent auricular acupuncture treatment tested free of cocaine during the last week of treatment, compared to 23.5% and 9.1% in two control groups. Those who completed the treatment also had longer periods of sustained abstinence compared to participants in the control groups.
However, later trials by the same researchers found the results to be inconsistent. Likewise, a 2005 meta-analysis of 9 separate studies came to the same conclusion.
Neurofeedback is a form of biofeedback in which subjects respond to an EEG display of their brainwaves or other electrical activity of the nervous system. Therapists work with the subject to help them alter those involuntary processes. Neurofeedback is widely used to treat PTSD, epilepsy, and other brain disorders. Lately, it has been gaining popularity as a form of alternative substance abuse treatment.
Several studies have shown neurofeedback to be effective in treating opioid and alcohol addictions by improving mental health and reducing cravings. There has been less scientific research involving cocaine. However, one study did find that adding neurofeedback to an inpatient treatment program resulted in higher completion rates and future abstinence among cocaine users.
Our directory of rehab programs includes a comprehensive list of available treatment centers and programs as provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). In the directory, you will find tools to filter the programs by setting, price, and location.
Find out more on our guide to Choosing the Right Rehab
Cocaine addiction’s high relapse rate make it one of the toughest addictions to overcome – that makes going to rehab crucial to your success. Use our directory to find a rehab near you, and learn more about what happens in rehab in our guide “The Rehabilitation Process.”
If you are researching for yourself or for a loved one, read more about the chemistry of cocaine addiction and how it affects the human body and mind.
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