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What Is a Cocaine Comedown or Crash?

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Cocaine is a central nervous system (CNS) stimulant that produces brief but intense physical and mental effects, including euphoria, increased energy, talkativeness, and hyperactivity. A cocaine comedown or “crash” is when these effects begin to subside and are replaced with unpleasant symptoms, such as fatigue, irritability, and dysphoria. To prevent this from occurring, users tend to ingest cocaine in a binge-like pattern to sustain their high, leading to an increased risk of dependence and addiction.

If you’ve been using increasing amounts of cocaine to prevent a comedown and suspect you have become dependent, you are urged to seek professional help. Guardian Recovery offers integrated rehab programs equipped to address drug and alcohol misuse and co-occurring mental health conditions. If you’re ready to break free from an active cocaine habit, contact us today to learn more about our individualized treatment programs and multiple levels of care.

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Signs & Symptoms of a Cocaine Comedown

Changes in mood and physical state during a comedown are related to cocaine’s ability to increase dopamine levels in the brain dramatically during use. (1) Dopamine is a chemical messenger responsible for feelings of reward and well-being. When cocaine’s desired effects wear off, dopamine levels begin to plummet, and unwanted symptoms such as headaches, irritability, and fatigue manifest.

Physical Symptoms of a Cocaine Comedown Include:

  • Runny nose.
  • Headache.
  • Body aches and pains.
  • Nausea.
  • Restlessness.
  • Excessive sweating/chills.
  • Accelerated heartbeat and arrhythmia.
  • Fatigue/exhaustion.
  • Increased appetite.
  • Sore face and jaw (related to teeth grinding and clenching).
  • Nasal dryness and pain, runny or bloody nose.

The comedown period lasts much longer than the high itself, and the body may need significant time, often up to 72 hours, to recover.

Psychological Symptoms of a Cocaine Comedown Include:

  • Anxiety and irritability.
  • Depression and suicidal thoughts.
  • Mood swings.
  • Sleep disturbances and nightmares.
  • Intense drug cravings.
  • Impaired concentration.
  • Paranoia.
  • Delusions and hallucinations.

Comedown, Rebound Effects, & the Crash

As the body begins to recover from the intense energy expended during cocaine use, extreme exhaustion (also known as a “crash”) onsets. (2) This is also known as a rebound effect, which is essentially the opposite of the desired effects the user seeks. For example, other rebound effects of cocaine include increased appetite (cocaine suppresses appetite) and depression (cocaine enhances mood). In addition to rebound effects, a cocaine comedown can result in various other physiological and psychological symptoms.

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How Do the Effects of a Comedown Compare to Withdrawal Symptoms?

Individuals who use cocaine repeatedly over a prolonged period will develop dependence. Chemical dependence is a neurological disorder characterized by physical reliance on a substance that leads to unpleasant withdrawal symptoms upon discontinuation. (3) Comedown and withdrawal effects are similar, but withdrawal differs because it requires dependence, lasts longer, and is more intense. A person who uses cocaine only occasionally, even if they binge, will not go through the clinical withdrawal process that results from dependence. Nonetheless, they will still experience a comedown as cocaine’s effects subside.

The cocaine withdrawal period, like the comedown and crash, is characterized by extreme fatigue, anxiety, sleep disturbances, and sometimes extreme depression. (4) Withdrawal symptoms last longer than comedown, however, and cravings and psychological issues can persist for months. Although these effects and the chemical imbalances that cause them are temporary, they are nonetheless distressing and can lead to suicidal ideations or behaviors.

Withdrawal Symptoms Associated With Cocaine Dependence Include:

  • Reduced libido.
  • Anxiety.
  • Agitation.
  • Deep depression.
  • Suicidal thoughts and actions.
  • Extreme exhaustion.
  • High anxiety.
  • Inability to feel pleasure.
  • Increased appetite.
  • Intense drug cravings.
  • Muscle aches.
  • Nerve pain.
  • Poor concentration.
  • Tremors.
  • Vivid nightmares.

Long-Term Effects of Continued Cocaine Use & Comedowns

Over a period of sustained use, individuals can develop cocaine dependence, as noted above. They can also experience tolerance, which is the need to use ever-increasing amounts of a substance to achieve the desired effects. Both dependence and tolerance fuel addiction and long-term health consequences, such as the following:

Nose & Mouth

Snorting cocaine causes injury to the nose‘s mucous membranes, creating a dry environment with reduced blood flow. This can significantly damage soft tissue, cartilage, and bone, and excessive use can result in a perforated septum or palate. In addition, sense of smell may be reduced or lost, and nosebleeds, swallowing difficulties, and infections can also occur.

The Heart

Chronic cocaine use can increase the risk of blood clots, possibly leading to heart attacks, strokes, pulmonary embolisms, and deep vein thrombosis. It can also cause the death of heart muscle tissue, reduced ability for the heart to contract, aortic ruptures, angina, and irreversibly increased blood pressure.

Breathing & Respiration

Smoking cocaine can result in severe respiratory issues as it prevents oxygen from entering the bloodstream and destroys capillaries that carry oxygen to the remainder of the body. This can lead to a higher likelihood of pneumonia, acute respiratory distress, and asthma.

The Brain

Because cocaine use causes blood vessels to constrict, ongoing use can decrease the amount of oxygen the brain receives, resulting in brain damage and raising the risk of aneurysms. Other risks include strokes, cerebral atrophy, and seizures.

Prolonged cocaine use can also impair cognitive functioning, impacting areas like attention, impulsivity, decision-making, and motor skills. (5) It can also cause premature aging of the brain and lead to long-lasting memory problems and mental health issues.

Digestive System

Cocaine can limit blood flow to the stomach and intestines, causing ulcers and tears. Likewise, it can increase the likelihood of ischemic colitis, in which the large intestine is injured and becomes inflamed.

Kidneys & Liver

Both short- and long-term cocaine use can cause the death of muscle fibers (rhabdomyolysis), which can enter the bloodstream and lead to severe kidney complications. (6) In addition, the toxicity of cocaine as it breaks down can also cause acute injury to the liver. (7)

Recovering From a Cocaine Comedown

The following suggestions may be beneficial in facilitating recovery during a comedown from cocaine use. While this can be achieved at home, you are urged to seek medical detox and professional treatment, which can improve comfort and safety and lessen the likelihood of relapse. In either case, remember that comedown effects are temporary, and the discomfort will subside over time with sustained abstinence.

Cocaine Comedown Recovery Tips Include:

  • Drink water/stay hydrated.
  • Adopt a healthy diet.
  • Take vitamins and minerals as appropriate.
  • Exercise regularly.
  • Engage in hobbies and activities.
  • Practice stress-avoidance.
  • Develop a plan for sleep hygiene.
  • Make use of holistic strategies, such as mindfulness.

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How Guardian Recovery Can Help With Cocaine Addiction

Cocaine misuse can be detrimental to a person’s health and well-being and adversely impact the lives of those who love them. Individuals struggling with addiction are urged to seek comprehensive, long-term treatment that can address the underlying factors contributing to the development of drug and alcohol dependence.

Guardian Recovery offers individualized programs in inpatient, partial hospitalization, and outpatient formats. Our holistic approach to mental and physical health and wellness includes various evidence-based services and treatment methods, such as medical detox, behavioral therapy, group support, aftercare planning, and more.

Reach out to us today to speak to an experienced Treatment Advisor and learn more about our streamlined admission process and multiple levels of care. You can also receive a free, no-obligation assessment and health benefits check. So call now to begin your journey to a healthier, happier, more fulfilling life.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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