Table of Contents
Guide to Cocaine Rehab

TABLE OF CONTENTS

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The Basics of Cocaine Rehab

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.

Four steps of the rehab process described

For more information, read our guide to the Rehab Process

Rehab Settings

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.

Overview of Treatment Settings
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

National Institute on Drug Abuse

Cocaine Rehab Statistics

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.

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Detox for Cocaine Addiction

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).

Withdrawal Symptoms

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.

Cocaine’s Withdrawal Symptoms
Body Mind
  • Hunger
  • Fatigue
  • Apathy
  • Remorse
  • Anxiety
  • Irritability
  • Mood changes
  • Disorientation
  • Insomnia
  • Paranoia
  • Depression
  • Suicidal thoughts

Fonseca (2013), Goldstein (2009), Riezzo (2012), NIDA, (2013)

For more information about withdrawal, read our guide on Cocaine Addiction

Detox Medication

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:

  • Desipramine: (aka. Norpramin) This antidepressant combats severe withdrawal symptoms like depression. While Desipramine can cause some mild side effects like drowsiness or constipation, it can also cause suicidal thoughts, especially for children or teens.
  • Amantadine: This antidyskinetic drug is typically used for Parkinson’s, but it can also help with cravings during withdrawal. Common side effects include nausea and insomnia, but more severe side effects exist for certain groups. People who experience seizures may have more seizures, those with heart problems could get heart failure, and Amantadine could cause suicidal thoughts in people with mental health issues.

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.

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Therapy for Cocaine Addiction

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 Therapies

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 Behavior Therapy is the most widely-used therapy for cocaine addiction

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 helps users regulate behavior with relatively little therapy time

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.

Additional therapies are used that may be beneficial for some

The following list is an overview of other types of therapy that are currently used for unique situations.

  • Motivational Interviewing: This approach uses counseling focused on increasing the patient’s awareness of negative aspects of abuse, behavior patterns, and an improved future. This counseling approach is used broadly for correcting many self-destructive behaviors. A large body of evidence shows positive outcomes, especially when the patient and counselor have a strong relationship.
  • Motivational Enhancement Therapy (MET): MET is a patient-driven counseling approach designed for quick results. Using aspects of other therapies like motivational interviewing and CBT, MET helps individuals care about and engage in treatment. However, this therapy has had mixed results for getting people to quit using drugs.
  • Family Behavior Therapy (FBT): FBT combines CBT and Contingency Management in a family-based environment. Sessions involve both the patient and at least one significant other. Therapists set behavioral goals, but when the patient reaches a goal, the family member provides the incentive. This process creates positive associations with both a drug-free lifestyle and the family being hurt by drug use. This type of therapy is helpful for teens and their families.
  • Multidimensional Family Therapy: Similar to family behavior therapy, this approach works best for treating adolescents and uses a whole-family therapy and intervention. This treatment course may be the best behavioral therapy for initial reduction in substance abuse frequency and intensity, but it has not been successful as a long-term treatment.
  • Matrix Model: The matrix model integrates aspects of many tested treatment approaches. It includes elements of relapse prevention, family and group therapies, drug education, social support groups and 12-step programs. It differs from other programs in that it is a 16-week intensive program provided in outpatient therapy. All sessions, lessons, and treatment phases are tightly structured. The longer the participants are in the program, the better the outcomes. However, the program’s frequency and rigid structure can be difficult for some participants.

Contingency Management reinforces positive behaviors and benefits pregnant mothers

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.

Family Behavior Therapy and Cognitive Behavioral Therapy help teens and their families

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.

Psychiatric care

Comorbid depression and paranoia can negatively impact addiction recovery. Medication and counseling for these comorbidities can significantly improve outcomes.

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Aftercare for Cocaine Addiction

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.

Cocaine has the second highest relapse rate

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.

Relapse Rates by Drug Type 2015

SAMHSA Treatment Episode Data Set 2015

There are four main factors that cause relapse

  • Stressful Events: Events that are unexpected and cause significant stress make the user want to escape by getting high.
  • Lack of a Support System: Without supportive loved ones to help, people may return to bad relationships and situations that encouraged them to use drugs in the first place.
  • Triggers: Seeing people or specific places associated with drug use triggers positive memories of using the drug and makes relapse more likely.
  • Unaddressed Mental Health Issues: Those who don’t get help for mental health problems have good chance of returning to the practice of self-medication by abusing drugs.

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.

Support Groups

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.

Basics of a 12 step meeting

Click your state listed below to find NA meetings near you

To find Narcotics Anonymous meetings near you, click on your state from the list below. From there you will be able to find the local organization that coordinates the meetings. They will be able to provide the most up-to-date information about the time and location of meetings, as well as the contact information for group leaders.

You can also check out alternative types of support groups listed in the table below.

Heroin Support Groups (NA Alternatives)
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

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.

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Developing and Alternative Treatments for Cocaine Addiction

Future Treatments

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 methods for cocaine rehab may start to shift

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.

Anti-cocaine vaccine currently being tested on human subjects

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.

New experimental drug may help treat addiction by erasing cocaine-associated memories

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.

Other medications for treating cocaine addiction are still being tested

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.

  • Modafinil: Previously used for treating narcolepsy, Modafinil has had mixed success for cocaine addiction treatment. Early studies show that it helped participants reduced their cocaine use in certain circumstances. However, it did not work when cocaine was easily accessible or affordable, leaving the study with mixed results.
  • Disulfiram (Antabuse): This drug was designed for treatment of alcoholism and reacts strongly with alcohol. It is too early to say for certain that Disulfiram will work for cocaine, and it is not yet approved. However, this looks to be a promising medication treatment thus far.
  • Topiramate: A 2013 study included subjects who took topiramate and were more likely to experience reduced cravings and preference for cocaine, compared with a placebo. Research is still ongoing.

Alternative Treatments

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.

Home Remedies and Over-the-Counter Medications for Withdrawal Symptoms
Remedy Description Helps With Type
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

Meditation has been shown to decrease withdrawal symptoms

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.

Acupuncture may help recovering cocaine addicts stay sober

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 improves mental health and reduces drug cravings

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.

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Finding Rehab for Cocaine Addiction

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

Click your state from the list below, then input your zip code to find rehabs near you

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Take Action

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.

Disclaimer: The information contained on Help.org is for informational and educational purposes only and should not be relied upon for any medical or diagnostic purpose. The information on Help.org should not be used for the treatment of any condition or symptom. None of the material or information provided on Help.org is not intended to serve as a substitute for consultation, diagnosis, and/or treatment from a qualified healthcare provider.

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