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What Is The Most Addictive Drug?

The most addictive drug varies from person to person. Some genetic mutations make certain drugs more addictive than others. Or, you might find yourself drawn to a seemingly “less addictive” drug, like nicotine, that feels just as powerful as a narcotic. 

With that said, scientists have narrowed down a few of the top addictive drugs. Their addictive potential comes from reactions, communications, and changes in the brain. 

But for each addictive drug, you have resources for recovery. You can speak with your care team to decide which route of treatment works best for you—like going to rehab. 

Heroin

Heroin comes from certain poppy plants. As an opioid, heroin is highly addictive and can change the structure of your brain1 over time. It usually comes from South America. Dealers often cut heroin with starches, sugars, or sedatives—some of which can have unpredictable and unwanted effects. 

Pure heroin looks like a white powder and tastes bitter. Impure heroin is called “black tar” for its sticky feel and dark color (from impurities). 

You can snort powdered heroin or smoke it. For black tar heroin, you can inject it into your veins or muscles once it’s been dissolved and diluted.

Heroin absorbs into mucous membranes in your nose and lungs—or, if you inject it intravenously, it dissolves directly into your bloodstream. 

Once ingested, heroin bonds to mu-opioid receptors in your brain and activates them2, which turns off GABAergic neurons. GABAergic neurons keep dopamine from rushing along your reward circuit. Once the opioid receptor turns GABAergic neurons off, dopamine runs free, which causes a rush of euphoria and a strong sense of general well-being. 

Activating the reward system like this tells your brain opioids are about as great as it gets. Add in the distressing withdrawal symptoms, and getting more can feel like an urgent need. And as you keep taking heroin, you’ll need higher doses to feel the same high as your first time2—which means you’ve built up a tolerance. 

Much of heroin’s danger lies in this rapid high-low pendulum swing.  Soon, you might need high doses to keep from feeling sick. Trying to chase your first high, you might accidentally overdose. 

Taking too much could cause your breathing to slow to null3. You might also feel constipated, nauseous, and extremely itchy. Long-term use can knock your neuronal and hormonal systems off balance4—sometimes permanently. 

Alcohol

As a depressant, alcohol suppresses the central nervous system. And, alcohol is both socially accepted and easy to get—a tricky combination. Alcohol causes a sense of happiness and well-being5, which activates your brain’s reward system. It sees alcohol as medicine and, eventually, as something you inherently need to survive. 

Because of its addictive nature and easy access, alcohol is one of the most dangerous substances to abuse6. Over half the visits to emergency rooms have something to do with alcohol. It’s also one of the 2 most-used substances, the other being nicotine. 

Different alcoholic drinks have different levels, or percentages, of alcohol. For example, an alcoholic seltzer drink is usually 5-8% alcohol; in something like vodka, the rate goes up to 40%. 

As with illicit drugs, you can build a tolerance to alcohol. So, you might need to add a splash of vodka to your seltzer or have an extra glass of wine to feel how you’re used to feeling on alcohol. The longer this continues, the more you’ll need to drink. 

Withdrawals include insomnia, anxiety, tremors, and seizures. For many, safely detoxing from alcohol requires medical supervision. 

Nicotine

Nicotine, like many other drugs, causes a release of dopamine7. But with nicotine, the rush isn’t quite as intense as something like heroin. Nicotine has such addictive power because of its repetitive nature7 and because you can use it with other activities (and substances). 

Smoking a cigarette or vaping can enhance the pleasure of other activities7, like watching a movie, partying, having a cup of coffee, or listening to music. Even though nicotine only adds to these activities, your brain still associates it as the source of joy in those situations. And so, you learn to keep smoking, subconsciously chasing satisfaction.

What used to be fun and motivating might seem boring or too mundane without the added boost from nicotine, so stopping can be challenging7. You might even feel like nothing’s enjoyable without smoking. That’s because nicotine represses your natural dopamine-release functions, and once they’ve been suppressed for so long, it can take time for your brain to adjust and provide its own. 

Though unpleasant, nicotine withdrawals won’t hurt you8. You may have a bad headache and experience cravings. You might also feel more anxious and hungry. But all withdrawal symptoms pass with time. 

Benzodiazepines

Benzodiazepines, or benzos, subdue the central nervous system. They’re usually prescribed to help with anxiety, panic disorders, and insomnia9 for their calming, sedative effects. But benzos can also be highly addictive.

Some benzodiazepines can cause dependence faster than others. But usually, people use them with another drug9 to balance or complement other effects. Alcohol and benzos, for example, produce an enhanced calm but can dangerously suppress the central nervous system.

The benzodiazepine Rohypnol, AKA roofies, acts as a powerful sedative. Some misuse benzos like Rohypnol against others. But usually, benzodiazepines appeal for their countering effects against opioids and for self-sedation.

Benzodiazepine withdrawals9 can feel extremely uncomfortable. You could experience nightmares, anxiety, insomnia, psychosis, hyperpyrexia (extremely high fever), and convulsions. For those reasons, detoxing under medical supervision is a safer option. 

Methamphetamines

Doctors may prescribe the psychostimulant methamphetamine, or metamfetamine, to treat attention deficit hyperactivity disorder (ADHD)10. In healthy doses (for those who need it), methamphetamine’s effects resemble the brain’s fight-or-flight response10. This response  increases energy, alertness, and focus. But it’s also a drug of abuse with a high potential for addiction.

Methamphetamine looks like a white powder11 or crystal-like rocks. It’s relatively easy to make and cheap to buy. Many pseudo-scientists make methamphetamine in discreet labs, usually hidden off the beaten path.  But most meth comes from larger labs in Mexico and overseas countries. 

Methamphetamine releases dopamine, serotonin, and norepinephrine10, which contribute to pleasure, satisfaction, and alertness. Using methamphetamine for pleasure can cause binges, since the desired effects only last a few minutes. And because meth is one of the cheaper stimulants and easy to get, feeding the binges might not seem like a problem. 

But, as with other drugs, your brain changes with repeated doses. You might build up a tolerance12, prompting higher doses. Your brain may also stop producing dopamine and serotonin on its own. 

Methamphetamine withdrawals12 can cause cravings, depression, anxiety, violent behavior, confusion, insomnia, hallucinations, delusions, and psychosis. 

Cocaine

Cocaine is another highly addictive stimulant13. It’s also one of the most common illicit drugs14 in America. 

Cocaine prevents the reuptake of dopamine14, meaning dopamine stacks up on dopamine receptors. This sends an intense rush of pleasure and stimulates the entire reward pathway15, causing your brain to see cocaine use as intrinsically rewarding. Even the sights, sounds, and places associated with cocaine use can trigger the need for a dose. 

As with many other drugs, you can become used to the effects of cocaine, or “tolerant”. You’ll need more and more to feel the same high as your first time. This puts you at risk for an overdose. New dangers also lie in adding vermisol to cocaine15, which is used as a cutting agent. Sometimes, fentanyl even makes its way in. 

The withdrawals from cocaine16 include insomnia, tremors, cravings, and hyperactivity. 

Crack Cocaine

Crack cocaine is a smokeable version of regular cocaine17. So it’s also a stimulant, and addictive, but even more potent due to how it’s ingested. Before it’s smoked, crack cocaine looks like small rocks or crystals. 

The membranes in your lungs absorb crack cocaine18 easily and quickly, resulting in an almost immediate high. The high goes away faster than powder or liquid cocaine, which could prompt a binge—smoking until you run out of crack or money.  

The reinforcing action is even more powerful in crack cocaine17. Your brain thinks it’s a good idea to keep having more more often, trying to realize the pleasure it knows crack can give.

Barbiturates

Similar to benzodiazepines, barbiturates are a depressant19 generally used for anxiety, headaches, seizure prevention, and insomnia. Those who misuse this prescribed medication usually do to counter the effects of other drugs—typically stimulants like cocaine.

You can take barbiturates as a pill or liquid. Barbiturates make you feel sleepy, relaxed, and at ease19. They can also impair your memory and judgment, and make you irritable. You might also feel paranoid and suicidal.  

Overdosing on barbiturates19 causes your heart rate to rise, your breathing to slow, and your body temperature to lower. Overdoses can also cause comas and death.  

Methadone

Doctors prescribe methadone, a synthetic opioid20, to treat opioid use disorders (OUDs). It relieves cravings, reduces withdrawal symptoms, and doesn’t provide the same “rush” of euphoria as other opioids. At the correct dosage, these factors make methadone a valuable treatment element20 for OUDs. 

Part of what makes methadone maintenance treatment (MMT) effective is the low risk for addiction. And, in MMT, you don’t have to share needles or risk taking heroin, cocaine, etc., of unknown purity20. Doctor oversight adds another element of safety. 

But methadone does have an addictive element. The usual dose for OUD management ranges from 60+mgs20. Sometimes, patients in treatment buy extra doses from others or hoard doses to eventually get a euphoric effect from methadone. 

Taking too much methadone can cause dangerous effects, especially if you’re on other medications. Signs and symptoms of an overdose20 include dizziness, slurred speech, unconsciousness, slow pulse, shallow breathing, tiny pupils, and frothing at the mouth. 

Naloxone reverses the overdose effects of methadone20, as it does with other opioids. 

Marijuana

Marijuana, or weed, comes from the marijuana plant. Its addictive psychoactive properties lie in the THC21 (delta-9-tetrahydrocannabinol) in marijuana. You can ingest marijuana in many ways21—smoking the leaves, drinking it in tea, eating foods with weed, and smoking concentrated weed in the form of a sticky resin.

Weed produces a sense of relaxation22 and a milder feeling of euphoria. Weed can also make you pretty hungry (or, give you the munchies) and laugh easily. You’ll experience these effects right away if you smoke weed. 

Eating it slows the onset by a half hour or more, which could prompt you to redose, thinking it’s not working. Taking too much can cause anxiety, fear, paranoia, and panic22—the opposite of what weed usually feels like. Extremely high doses can even cause acute psychosis.  

Marijuana activates the reward system23 in your brain, causing a flood of dopamine to course along your reward pathway. After continued use, your brain teaches you to keep having weed as a way to feel reward and satisfaction. Continued usage can also impair your memory, learning abilities, and balance23.

Starting weed at a young age leads to a higher risk of addiction24. But anyone at any age can find themselves addicted, meaning they’d feel withdrawal symptoms and be completely unable to stop—even when they know they should. In states that don’t monitor distribution, the potency of THC continues to rise too. This creates consequences scientists and health professionals haven’t fully realized yet. 

But for each substance and its potential for addiction, you have opportunities to recover. 

Find Effective Drug Addiction Treatment Near You

The most addictive drug could vary widely from person to person. While you can’t stop smoking cigarettes, someone else might not feel able to stop drinking—but drinking isn’t a problem for you. 

Fortunately, treatment for drug addiction caters to this variance. You can get the care you need at a residential rehab, outpatient facility, or detox unit. Your care team can help you decide which type and level of care will best meet your needs. 
To see a comprehensive collection of rehab facilities, you can browse our list of drug addiction rehabs to see photos, prices, reviews, insurance information, and more.

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Is My Loved One Using Cocaine? How to Tell If Someone Is Using Cocaine

Cocaine doesn’t have to control your loved one. The first step to their recovery might be recognizing signs of use, and then you can help them find a rehab for cocaine addiction. 

You both have resources for recovery. But the more you know about cocaine use, and how to spot it, can help you help the ones you love. 

How to Spot Cocaine Use

Spotting cocaine use can be tricky. It has a seemingly endless list of slang names and pseudo-identities, making it hard to decipher what your loved one might be talking about. They could hide their behavior with more than sneaky names, too. But there are signs to look for1. 

Physical Signs

  • Dilated pupils
  • Lack of appetite—it might seem like they barely eat
  • Rapid weight loss
  • Poor sleep
  • Disheveled appearance, lack of hygiene 

Emotional And Mental Signs

  • Paranoid without reason
  • Hyperactivity—“bouncing off the walls”
  • Irritability
  • Anxious, more so than usual 
  • Extreme startle reactions, like jumping at the sound of a cabinet shutting

Along with knowing the signs of cocaine use, you can also familiarize yourself with the street names for cocaine.

Slang Names for Cocaine

The nicknames for cocaine2 might surprise you. They’re creative, to put it positively. And they change based on the form of cocaine (crack, regular cocaine) and what it’s mixed with. 

There’s a lot to keep track of, but knowing even just a few can help.

  • Snow
  • Stardust
  • Stash
  • Bouncing Powder
  • Coke
  • Coca
  • Flake
  • Devil’s Dandruff
  • Florida Snow
  • Joy Flakes

You can also educate yourself on cocaine itself, and how it affects the mind and body.

What Is Cocaine?

Cocaine comes from the leaves of the coca plant1. It grows in South America. From there, it’s smuggled all across the globe.

Cocaine causes a rush of euphoria3, which can last 2-20 minutes. This rush comes from a build up of dopamine in the brain—dopamine stacks up on the transmitters meant to receive it4, causing an intense flood of pleasure. 

Neurotransmitters like dopamine jump between nerves and target cells. If the receptors aren’t working, all the received dopamine has nowhere to go—causing the high. Altering the usual transmission of dopamine can actually change the structure and function of your brain over time. 

The crash, or comedown, from this high can quickly prompt a redose, sometimes until supplies or money run out. This is considered a binge1.

You can ingest cocaine in multiple ways1. Some snort the white powder up their nose. Or, you might mix it with water and inject the mixture into a vein, using a syringe. If it’s crack cocaine, you can smoke it.

Is There a Difference Between Cocaine and Crack?

Chemically, no. Cocaine and crack are the same thing5, just in different forms. Crack isn’t any cheaper, either6. But it is more potent, easy to ingest, and wildly addictive.

Crack looks like rocks, or crystals. It’s a smokeable version of cocaine5, derived from the same coca plant as cocaine. 

For crack cocaine, you might see some of these slang terms:

  • Rock
  • Moon Rock
  • Apple Jack
  • Dice
  • Sleet
  • Yahoo
  • Yale
  • Top Gun
  • Base, Basing

Mucous membranes absorb cocaine and crack cocaine7. You have a huge plane of mucous membrane in your lungs—the alveoli responsible for bringing oxygen to your blood. The inhaled crack smoke absorbs into the alveoli in the lungs rapidly, causing a nearly immediate high.

A crack cocaine high fades faster, though. To avoid the crash, people might keep smoking until they run out of crack. And the more they ingest, the more likely they are to overdose and have negative long-term effects8. 

The Effects of Cocaine Use

Cocaine use can lead to heart problems8, like cardiac arrest and strokes. Inhaling it as crack can cause respiratory conditions. Snorting it could completely degrade your nasal passage over time. 

Short-term, the effects of cocaine could range from paranoia to seizures9. And rarely, cocaine can cause sudden death after just one use. 

Repeated use takes up more and more money and time. And the more it’s used, the more your brain changes. Addiction and tolerance to the drug can set in quickly1. 

Cocaine use can also have unpredictable effects, usually caused by what it’s been cut with. The cutting agent could be harmless, but that’s not always the case.

What Is Cocaine Cut With?

Dealers may cut cocaine to up their profit10, selling a “watered down” version to unsuspecting buyers. Powder cocaine could be cut with baking soda, caffeine, sugars, or anesthetics. Visually, you’d likely never know it wasn’t pure cocaine.

But cocaine could have harmful additives. Levamisole, a veterinary drug that kills parasites10, has made its way into 70% of cocaine in America. It causes necrosis11, which kills and rots the skin. 

You can also mix cocaine with other drugs for new, sometimes preferred, effects.

Cocaine Mixtures

Users seeking a different high mix cocaine with other substances, like marijuana and tobacco. Nicknames for these mixtures include Woo-Woo, Woolies, Candy Flipping, Cocoa Puffs, and Boy-Girl.

Certain blends, like alcohol and cocaine, are notably more dangerous. Cocaine and alcohol react12 and form a heart-toxic chemical, cocaethylene. Heroin and cocaine mix to form a speedball9, or an opiate and depressant blend. But cocaine wears off faster than heroin, potentially slowing your breathing to null as the full sedative effect of heroin hits.

No mixture is predictable, or safe. Neither is cocaine by itself. But, for single and blended use, you can find recovery. 

Treatment for Cocaine Addiction

Cocaine addiction often requires a multi-pronged approach—detox, therapy, and medications13. And the more research scientists do, the better these options become. There’s even a cocaine vaccine in the works14. 

Your loved one will most likely need to detox from cocaine in a safe, clinically monitored setting. There, they’ll have constant supervision, comfort medications, and begin the therapeutic healing process. This could be at a detox center or a residential rehab with on-site detox. 

Once cocaine has left their system, inner healing work can begin.

Therapy for Addiction

Therapy can address and heal the causing factors of addiction. It can also motivate and empower your loved one to commit to their recovery, even when it gets hard. 

Behavioral therapies like cognitive behavioral therapy (CBT) can challenge unhelpful thoughts and beliefs15. You’ll learn to shift your perspective of yourself to one that’s more positive. Rather than thinking “I’ll never get better”, CBT would challenge the thought with “Why not?”.

Dialectical behavioral therapy (DBT)16 addresses black-and-white thinking. Your loved one can accept the problem of cocaine use and know they can get better. DBT can help with relapse too, as it helps patients identify unhelpful thoughts that could lead back to old coping mechanisms. 

The 12 Steps

The 12-Step program offers a place for members to connect and recover in a respected treatment program. Members follow 12 steps together, learning responsibility, accountability, and forgiveness. And the 12 Steps can run in and out of treatment—you don’t have to be in rehab to find a local group to attend. 

The 12 Steps are often called AA (alcoholics anonymous) meetings. For cocaine use, you’ll likely see them called CA (cocaine anonymous). Each uses 12-Step practices to help members stay accountable and sober.

Aftercare

Contingency management (CM) can inspire greater dedication, during and after residential treatment. CM programs usually give out money, snacks, or vouchers as a reward13. And since you’ll actually get a reward for staying sober, attending recovery meetings, and going to treatment, you might find yourself more motivated to do it. 

Your loved one can also keep attending 12-Step meetings as a form of aftercare. If they go to a residential rehab, they might have the opportunity to attend alumni groups, too. 

Continued therapy and medications, if prescribed, can both contribute to long-term success. That’s why they’re both common forms of aftercare for cocaine addiction. If your loved one goes to rehab, they might offer continued 1:1 therapy with the same therapist. If not, they’ll likely connect you to further therapy as part of their discharge service.

Find Power Through Recovery

If you think your loved one is using cocaine, know that they, and yourself, have recovery resources. They can find new power and hope through recovery—addiction isn’t the end. 

You can browse our list of rehabs for cocaine to see pricing, reviews, insurance, and photos of each facility. 


Family members, you can check out these support groups: Co-Anon, Families Anonymous, and Stronger Together.

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Finding Treatment for Cocaine Addiction

Cocaine addiction can wreak havoc on a person’s life. And once you’re caught in the cycle of substance misuse, healing may seem out of reach. That’s a misperception. Recovery is always possible. For some people, rehab for cocaine addiction is the best place to start.

“Cocaine is the most commonly reported illicit stimulant used in the U.S.”1 Because its abuse is so common, this drug has been the subject of widespread research. As a result, many treatment programs are well-equipped to help patients recover from cocaine misuse.

The Prevalence of Cocaine Addiction

Cocaine is a stimulant2 derived from the coca plant native to South America. It can briefly increase a person’s energy, self-confidence, sociability, and mood. Because the effects of cocaine3 are so short-lived, it can quickly become habit-forming. Long-term use may cause less desirable effects, such as cause paranoia, hypersensitivity, and irritability.

The history of cocaine4 is strongly connected to mental health. In fact, its popularity can be traced back more than a century. “In 1884, Sigmund Freud detailed his experiments with cocaine, recommending it for treatment of opiate addiction and melancholia.” However, he did not account for its negative effects, and reportedly struggled with addiction for much of his life. Unfortunately, his endorsement of the drug helped make it socially acceptable for some time, for both medical and recreational purposes.

Reported drug abuse statistics5 paint a clear and distressing picture of cocaine use today. According to the National Center for Drug Abuse Statistics, 2% of people in the U.S., or 5.5 million people, reported taking cocaine in 2018. As of 2022, more recent data is not yet available. Researchers also caution against comparing current data about drug use and health6 with surveys taken before 2020, since the COVID-19 pandemic has changed the way surveys are conducted.

Cocaine use can have serious ill effects on both physical and mental health. Deaths caused by cocaine overdose in the U.S.7 have skyrocketed in recent years, increasing from nearly 4,000 in 1999 to nearly 16,000 in 2019. Because cocaine increases blood pressure8 and heart rate, it may cause strokes or respiratory failure. “Even first time users may experience seizures or heart attacks, which can be fatal.”

Because of these potential outcomes, cocaine misuse is extremely dangerous. However, patients don’t develop substance use disorders by choice. You may be highly susceptible to addiction despite your own better judgment, or desire to remain healthy. And some patients may be at a higher risk for developing a psychological dependence on cocaine.

Risk Factors for Cocaine Addiction

Certain demographics are especially vulnerable to cocaine misuse. Patients who exhibit one or more of the following risk factors may be at higher risk for this condition, or may require specialized care.

Adolescence

Teenagers may be more susceptible to developing cocaine addictions.9 Relative to adults, “adolescents show greater intake of cocaine, acquire cocaine self-administration more rapidly, work harder for the drug and are less sensitive to increases in price.” In layman’s terms, young people do more of this drug than adults, and are willing to work harder to obtain it.

Adolescents also face social pressures that may not impact adult behavior. Specifically, many teenagers develop substance use disorders10 while trying to fit in with their peer groups. Parents of adolescents should take note of any drastic behavioral changes, as these may indicate the onset of addiction. Teens with substance use disorders may show less interest in activities they used to enjoy, pay less attention in school, or start spending time with new friends who encourage these behaviors. By itself, any one of these signs may be a normal part of adolescence; however, sudden and extreme behavioral changes can be a cause for concern.

Novelty-Seeking Personality Traits

According to one study, “cocaine addiction has been associated with several distinct behavioral/personality traits.” For example, novelty-seeking behavior is associated with cocaine abuse.11 And in particular, people with sensation-seeking tendencies may be more vulnerable to cocaine use. However, people with high impulsivity are more vulnerable to cocaine addiction.

These traits may be genetic, learned, or influenced by a person’s environment and life circumstances. More research is needed to understand the link between personality, behavior, and substance use disorders.

Neurochemical Effects of Cocaine Use

Cocaine has a direct effect on the way the brain processes dopamine, which regulates the reward system.12

During normal brain activity, this neurotransmitter is released, binds to dopamine receptors, and is then recycled by a protein called the dopamine transporter. “If cocaine is present,” however, “it attaches to the dopamine transporter and blocks the normal recycling process, resulting in a buildup of dopamine in the synapse, which contributes to the pleasurable effects of cocaine.”13

In the short term, this can be enjoyable. In the long term, however, cocaine use can change brain function.14 The drug causes neurochemical imbalances, which make it difficult for the patient to feel a sense of pleasure or achievement without substance misuse. Over time, “the brain will gain a tolerance to feelings of pleasure and it will take more and more of the drug to achieve the same level of euphoria.”

What’s more, the act of abusing any substance affects dopamine levels.15 This is because the experience of ingesting a drug can trigger the release of the chemical, whether or not that drug has an effect on dopamine levels. This feeds into the cycle of addiction, in which the patient continues using illicit substances in order to feel any sense of reward. This effect is amplified with substances that have a direct effect on dopamine to begin with.

Treatment for Cocaine Addiction

Substance use disorders are treatable. No matter how long you’ve been using cocaine, or what impact it’s had on your life, change is always possible. And because its misuse is so prevalent, experts have been perfecting cocaine addiction treatment options16 for decades.

At present, “there are no medications approved by the U.S. Food and Drug Administration to treat cocaine addiction,17 though researchers are exploring a variety of neurobiological targets.” However, there are a number of effective therapeutic and behavioral interventions. And the first step toward healing is to learn about the options available.

Detox

Cocaine withdrawal18 may or may not have any physical symptoms. Unlike alcohol and opiates, detox from this substance is rarely life-threatening. That being said, it can be extremely uncomfortable and psychologically distressing.

If at all possible, it’s best to go through this process under medical care. If you attend a detox program, you’ll be closely monitored by a team of doctors, nurses, and therapists, possibly including a psychiatrist. Patients may receive non-addictive prescriptions to help them manage the symptoms of withdrawal. This experience can also help you transition into a longer-term rehab program.

Learn More: What You Need to Know About Detox

Rehab

Studies have shown that long-term rehab for cocaine dependence can be extremely effective.19 By attending a residential program, patients can take time away from triggers and difficult life circumstances, which may have been caused or exacerbated by their substance use. During that time, they can begin talk therapy, attend support groups, and make plans to live a healthier, more sustainable life after treatment.

Psychotherapy

Several therapeutic modalities can be effective in treating cocaine misuse. Researchers are most optimistic about contingency management (CM), a behavioral therapy that activates the patient’s reward system.

According to one study, contingency management is “perhaps the most effective psychosocial treatment” for cocaine use disorder.”20 In this treatment, patients receive vouchers redeemable for goods and services in the community, contingent upon achieving a predetermined therapeutic goal. CM treatment has been found to be especially effective in promoting initial abstinence from cocaine.”

Cognitive behavioral therapy (CBT) has also been shown to help these patients, although it may not be as productive as CM. This might be because CM has a more direct impact on brain chemistry, whereas CBT is skills-based.

Long-Term Recovery From Cocaine Addiction

Patients with a history of cocaine abuse can improve dramatically. In fact, detox and recovery from cocaine misuse can help you recover brain function.21 One 2017 study provided “early evidence that individuals with cocaine use disorder have the potential to at least partially reverse prefrontal cortex damage accompanying cocaine misuse, and regain associated cognitive abilities important for executive functions when cocaine use is stopped or significantly decreased.” In other words, you may be able to physically heal your brain during recovery.

But healing isn’t just about physical improvement. It’s also the process of building a better life. And in order to achieve that, patients must stay focused on recovery even after completing inpatient treatment. This ongoing commitment to healing may include regular talk therapy, attending support groups, or other modalities. For example, some studies have found that “greater participation in self-help programs” is an important factor in sustained recovery from cocaine dependence.221

Building a Better Life

When you have a history of substance misuse, recovery is often a lifelong process. That being said, it is absolutely possible to live a fulfilling life without cocaine use. Healing can even be fun! As you recalibrate your internal system of rewards, it’s important to do things you find enjoyable and exciting.

As you learn to make healthier choices, you can also begin building a new kind of confidence. And, best of all, you won’t be held back by the destabilizing pattern of substance abuse. Over time, you may find that joy is both more accessible and more sustainable.

If you’re ready to begin recovery, you can find a rehab center that treats cocaine addiction here.

Frequently Asked Questions About Cocaine Addiction Treatment

What are the treatment options for cocaine addiction?

Treatment options for cocaine addiction often include a combination of behavioral therapies, counseling, support groups, and medication in some cases. Individualized treatment plans are designed to address the specific needs of each person seeking recovery.

How long does treatment for cocaine addiction typically last?

The duration of treatment for cocaine addiction varies depending on factors such as personal progress, treatment goals, and circumstances. Treatment usually ranges from 2 weeks to 60 days. Some people benefit from longer treatment and ongoing aftercare support.

What should I look for in a luxury rehab for cocaine addiction?

When searching for a luxury rehab for cocaine addiction, it’s important to consider factors like clinical expertise, the level of personalized care, comfort, staff credentials, and confidentiality. It’s also important to verify accreditation and success rates. Most centers list accreditations directly on their site; CARF and the Joint Commission are the most common accreditation bodies.

  1. McKay, J. R., Van Horn, D., Rennert, L., Drapkin, M., Ivey, M., & Koppenhaver, J. (2013). Factors in sustained recovery from cocaine dependence. Journal of Substance Abuse Treatment, 45(2), 163–172. https://doi.org/10.1016/j.jsat.2013.02.007 [↩]
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Detoxification: Frequently Asked Questions

Detoxification is the first step in addiction treatment for many people. We’re here to help you learn more about what it entails, what it feels like, and whether or not you can detox at home.

Understanding Detox

How Does Detox Work?

Detoxing is the process of allowing substances to leave your system and managing withdrawal symptoms that may follow. Your substance use history will affect your detox experience and determine whether or not you need medication-assisted treatment.

A few hours after you stop using substances, your body begins to recalibrate as they leave your system. During this adjustment period, you may develop withdrawal symptoms, which occur in stages:1 early, peak, and late.

Early stage: Generally 6 to 12 hours–or even up to 30 hours after you’ve stopped using–mild withdrawal symptoms like anxiety or difficulty sleeping may occur.

Peak stage: At the peak stage, symptoms are at their worst and can include vomiting, tremors and chills. This usually occurs 72 hours after you’ve stopped using opiates or 24 to 48 hours after you’ve stopped drinking. Because of the discomfort, relapse is likely during this stage. It’s important to have a strong support system around you, along with medical supervision.

Late stage: At this stage, your body is starting to get used to the absence of substances. Any withdrawal symptoms you may have had will start to die down.

Why supervised detox? Remember that the purpose of a supervised detox is to minimize the severity of withdrawal symptoms and ensure you’re safely clearing your body of substances.

When Is Detox Required?

Whether or not you need detox depends on your history of substance use, including factors such as the type of substance used as well as the duration and level of use.

Withdrawal from certain substances, such as benzodiazepines or alcohol, can be life-threatening. That, combined with the physiological effects of frequent exposure to substances,2 means it’s recommended to receive a medical evaluation from a medical professional before attempting to detox.

You may want to consider getting an evaluation for detox if you notice the following signs of substance or alcohol abuse, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

  • Cravings for substances
  • Using more substances than you plan to
  • Inability to cut down or stop substance use
  • Taking substances for longer than intended
  • Trouble maintaining relationships due to substance use
  • Continuing to use substances, even when it negatively impacts your life

Can I Detox From Drugs at Home?

For your safety, it’s never recommended to detox from drugs at home without supervision.

Not all substance detoxification is lethal. However, withdrawal from certain substances, such as alcohol withdrawal, can potentially be life-threatening.3 More serious symptoms include hallucinations, seizures, and delirium tremens.

It’s always safest to detox under the supervision of specialized, experienced medical professionals.

You don’t always have to go through detox at a hospital or rehab facility. If you have a strong support system at home and your condition doesn’t require hospitalization, you may be able to opt for outpatient detox.4

How Long Do I Need to Detox For?

How Long Does Detox Typically Last in Rehab?

The duration of the detoxification process in rehab depends on your substance use background and the substance you’re detoxing from. On average, detox takes 3 to 7 days.

The time it takes to detox from commonly used substances varies:

  • Alcohol: 5 to 7 days
  • Benzodiazepines: One day to several months until treatment is introduced
  • Opiates: Up to 7 days (however, it’s possible to develop post-acute withdrawal symptoms5 that last weeks, months, or even years)
  • Cocaine: Up to 7 days
  • Heroin: 5 to 7 days

Detoxing From Different Substances

Alcohol

Do I Need to Detox From Alcohol?

Whether or not you need to detox from alcohol depends on how long and how much you’ve been drinking.

The media often portrays people who are addicted to alcohol as living disarrayed lives. The truth is, addiction can affect anyone—many people suffer from high-functioning alcoholism. If you notice signs of alcohol addiction, you may consider getting an evaluation for detox:

  • drinking more, or for a longer, than intended;
  • trying to stop drinking, but being unable to;
  • spending a lot of time drinking or dealing with the aftereffects of drinking;
  • continued drinking even when it negatively interferes with work or relationships;
  • and more.

Alcohol detox carries a high risk for potentially life-threatening withdrawal symptoms, like delirium tremens (DT).6 It’s safest to detox from alcohol under medical supervision.

If you plan to attend rehab, most residential facilities require you to be substance-free for a certain period of time before starting treatment. You can find out whether or not you’ll need to detox from alcohol during the admissions process. You have several options for detox, including on-site detox at certain luxury rehabs.

Can I Safely Detox From Alcohol at Home?

No. Complications from alcohol withdrawal7 can pose severe to life-threatening side effects. It’s never recommended to detox from alcohol at home.

Side effects like delirium tremens (DT) can lead to chronic memory disorders or life-threatening seizures. DT side effects often don’t show up until 2 to 3 days after you’ve last ingested alcohol.

Even if you don’t experience life-threatening side effects, because of the extreme discomfort of withdrawal, you’re more likely to relapse if you try to detox from alcohol at home8 in comparison to detoxing under medical supervision.

How Long Does It Take To Detox From Alcohol?

It usually takes about 5 to 7 days to detox from alcohol.

What Does Alcohol Detox Feel Like?

Most people experience varying levels of discomfort when detoxing from alcohol. As alcohol leaves your system, you can experience mild to severe alcohol withdrawal symptoms:9

  • Sleep disturbances, like insomnia
  • Nausea
  • Vomiting
  • Sweating
  • Irritability
  • Tremors
  • Headaches
  • Anxiety
  • Visual and auditory disturbances
  • Cardiovascular complications, like rapid heart rate
  • Muscle pain and stiffness

The discomfort alcohol withdrawal causes can lead people to relapse, especially if they try to detox alone at home.

When you detox under medical supervision, clinical staff help monitor your condition, soothe your symptoms, and offer round-the-clock support. Detoxing under medical supervision enhances both your safety and comfort.

Benzodiazepines

Can I Detox From Benzodiazepines at Home?

You should never try to detox from benzodiazepines, or “benzos,” alone at home.

Unsupervised withdrawal from benzodiazepines can result in life-threatening side effects.10 Because of the potential severity of these withdrawals, the U.S. Food and Drug Administration recommends “patients taking benzodiazepines should not suddenly stop taking them11 without first discussing a plan with your health care professional for slowly decreasing the dose and frequency.”

It’s also not recommended to quit cold turkey following long-term use; a large number of people have reported negative and long-lasting side effects of benzo withdrawal.12

How Long Does It Take To Detox From Benzodiazepines?

It takes one day to several months (until treatment is introduced) to detox from benzodiazepines. Withdrawal symptoms such as anxiety, vomiting, and nausea peak within the first 14 days after you last ingested benzodiazepines.

What Does Benzodiazepines Detox Feel Like?

Detoxing from benzodiazepines can present a wide range of uncomfortable side effects. Because detoxing from benzos can be so uncomfortable, one of the goals of medically supervised detox is to help soothe patients’ discomfort while ensuring their safety.

Some of the most commonly prescribed benzodiazepines13 include Valium, Xanax, Halcion, Ativan, and Klonopin. They have similar withdrawal symptoms, however, Xanax may cause more severe symptoms.

When you detox from benzodiazepines after your body has become physiologically dependent on them, you may experience mild to severe withdrawal symptoms:

  • Headaches
  • Increased anxiety
  • Sweating
  • Racing heartbeat
  • Insomnia
  • Muscle spasms
  • Nausea or vomiting
  • Restlessness
  • Hand tremors
  • Aches and pains

Benzos withdrawal symptoms occur in stages and depend on your history of substance use.

Stage 1: You may first notice short-lived symptoms such as anxiety and insomnia within 1 to 4 days of benzos discontinuation.14

Stage 2: Peak withdrawal symptoms occur in the second stage, which many people describe as the most difficult phase to overcome. This usually lasts 10 to 14 days.

Stage 3: An estimated 10 to 25% of people who use benzodiazepines for an extended period of time experience post-acute withdrawal symptoms,15 or PAWS. During this stage, you’ll notice a return of anxiety and other withdrawal symptoms until you begin to address them with some form of professional addiction treatment.

Opioids

What Does It Feel Like to Detox From Opioids?

Detoxing from opioids can present highly uncomfortable psychological and physical effects16 depending on your past substance use and severity of dependence. These symptoms can arise whether you’re detoxing from medically prescribed pain relievers like oxycodone, hydrocodone, and codeine, or illicit opiates, such as heroin.

During detox, as substances leave your system, you’ll begin to experience withdrawal symptoms. The extent of these symptoms depends on your substance use history, severity of use, and whether you’re detoxing from immediate-release opioids17 (such as morphine) or extended-release opioids18 (such as methadone), as defined by the CDC.

Opioid withdrawal symptoms19 are often uncomfortable. They can include anxiety, rapid heart rate, muscle pain, runny or watery eyes, nausea and vomiting, insomnia, and more.

Opiate withdrawal can be lethal.20 It’s always recommended to detox under the guidance of an addiction-specialized healthcare professional.

With short-acting opioids, withdrawals typically begin 8 to 24 hours after your last use. With long-acting opioids, withdrawal symptoms can onset 12 to 48 hours after the last use.

How to Detox From Opioids

While usually not life-threatening, opiate withdrawal can be lethal. Therefore, you should always detox from opiates under the guidance of a qualified healthcare professional.

Whether you detox at a hospital, private detox center, or on-site at a residential rehab facility, you should have healthcare workers available to you 24 hours a day.

If you were using short-acting opioids, withdrawal symptoms will onset 8 to 24 hours after your last use. For long-acting opioids, withdrawal symptoms present themselves 12 to 48 hours after last use.

Mild opioid withdrawal management:
If you have mild withdrawal symptoms, treatment providers will ensure you consume 2 to 3 liters of water a day, along with vitamin B and C supplements to replenish lost fluids. They will also observe and monitor your symptoms 3 to 4 times a day using a Short Opioids Withdrawal Scale (SOWS).21

Moderate to severe opioid withdrawal management:
Clinicians will follow the same management techniques as with mild withdrawal cases. However, they may also use medication to minimize the severity of symptoms.

It should be noted that while detox is the first step in addiction treatment, it should be followed up with an addiction treatment program to create lasting changes to addictive behaviors.

How Long Does Opioid Detox Take?

It may take up to 7 days for opioids to fully leave your body. However, withdrawal symptoms may last longer than that.

For immediate-release opioids, withdrawal symptoms can last 4 to 10 days. For extended-release opioids, withdrawal symptoms can last 10 to 20 days

Depending on your opioid use background, it’s possible to develop post-acute withdrawal symptoms (PAWS).22 These can last weeks, months, or even years after you’ve last taken opiates. Some of these symptoms include memory issues, irritability, and depressed moods.

There is treatment for PAWS, which can be administered over the period of time you’re experiencing symptoms. Aftercare is critical to addiction treatment. If you’ve completed a treatment program, your aftercare counselor or therapist can help you identify PAWS symptoms and recommend a treatment plan. Or, you can search for rehabs that offer detox programs and speak to an intake specialist about PAWS treatment.

Cocaine

How long does it take to detox from cocaine?

It takes up to 7 days to detox from cocaine. Cocaine withdrawal symptoms are generally more psychological than physical and can include agitation, depression, anxiety, and other effects on your mood.

Where can I Detox?

You can detox at several different types of facilities. While it should be noted that not all at-home detox is lethal, detoxing from certain substances can pose life-threatening risks. It’s always recommended to detox under the guidance of a healthcare professional.

You can undergo substance abuse detox at several types of facilities:

  • Hospitals
  • Residential rehabs (not all inpatient rehabs offer on-site detox)
  • Private detox centers

How Long Do Withdrawal Symptoms Last?

On average, it takes 3 to 7 days for substances to leave your system. However, withdrawal symptoms can persist even after you’re substance-free.

Alcohol withdrawal timeline: Withdrawal symptoms from alcohol typically begin about 6 hours after you’ve last ingested a drink. They can last up to 72 hours after your last drink. In more severe yet rare cases, moderate withdrawal symptoms, such as alcohol hallucinosis, can last for up to a month.23

Benzodiazepines withdrawal timeline: Withdrawal symptoms from benzodiazepines usually last 10 to 14 days. However, some people can develop post-acute withdrawal symptoms (PAWS), which is a return of withdrawal symptoms several months after last use.

Opioid withdrawal timeline: For immediate-release opioids, withdrawal symptoms can last 4 to 10 days. For extended-release opioids, withdrawal symptoms can last 10 to 20 days. Depending on your substance use history, it’s also possible to develop PAWS from opioids. These symptoms may last weeks, months, or even years after you’ve last taken opioids.

Cocaine withdrawal timeline: Withdrawal usually begins 90 minutes following the last dose. Cocaine withdrawal symptoms,24 such as irritability and cravings, can last up to 10 weeks depending on your level of dependency.

Detox Costs

How Much Does Detox Cost?

The cost of detox This depends on the substance you’re detoxing from, the level of care, the length of treatment, and the detox facility.

In the U.S., the cost of detox at a private luxury rehab can range from less than $10,000 to over $75,000 per month. Since the Affordable Care Act (ACA), most of these private rehab centers accept insurance.

To learn more about your options for detox treatment, browse through our list of luxury detox centers.

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Addicted Attorneys: How to Identify Your Addiction and Get the Help You Need

A 2016 study held by the Hazelden Betty Ford Foundation and the American Bar Association found that out of the participating 12,825 licensed attorneys, 21 percent of lawyers qualify as problem drinkers,1 while 28 percent struggle with mild or more serious depression and 19 percent struggle with anxiety.

What’s worse, only 3,419 lawyers responded to the question about drug use. As explained by the study’s lead author, Patrick Krill, in the New York Times:

“It’s left to speculation what motivated 75 percent of attorneys to skip over the section on drug use as if it wasn’t there.”

Substance use disorder among lawyers isn’t just prevalent in the United States. In fact, much of the Western world’s legal profession is built on drink and drugs. But the true problem does not lie in the substance use itself, it lies within the culture surrounding it.

In this blog post, we shed light on some of the common factors of addiction for those in the legal profession, why lawyers need to be vigilant in recognizing them, and how you can seek the help you or a colleague might need to get sober and stay sober.

Death by Drugs: The Story of Peter

In July 2017, the New York Times published an article about the life of Peter, a high-level Silicon Valley attorney who overdosed on drugs.2

According to the article, it was a problem that his ex-wife, children, colleagues and close friends didn’t see coming. Further, it was a problem Peter felt he could fight on his own, but he failed to make the necessary priority adjustments to make time for doing so. His work always came first.

The article is eye-opening for any lawyer experiencing similar issues, and we urge you to read it. In the article, the writer depicts a scene prior to Peter’s death. The line reads:

“Of all the heartbreaking details of [Peter’s] story, the one that continues to haunt me is this: The history on his cell phone shows the last call he ever made was for work. Peter, vomiting, unable to sit up, slipping in and out of consciousness, had managed, somehow, to dial into a conference call.”

In any scenario, it’s difficult to understand why humans put their work before their own lives.

Perhaps it’s because we don’t want to let others down. Perhaps it’s because self-punishment is an all too common illness we’ve yet to talk about. Whatever it is, work is work and will remain so for the rest of time. Your health is precious; and it requires intentional effort to keep it stable.

A Few Addiction Factors to Watch Out For

There are many reasons people turn to drugs to deal with the realities of life. Failed careers, a lack of income, the death of a family member, stress … each person becomes addicted for their own reasons.

In the legal profession, however, there are some specific warning signs to watch out for. For example:

1. Overworking

attorney overworked

We can only work so hard.

We need sleep, food, water and rest to ensure we can sustain a peak level of performance in anything we do. But due to the nature of the legal profession, lawyers tend to work more than most other people.

Sure, they might bill 40 or 50 hours of work in a week, but in truth, lawyers likely work 60 or 70 hours3 just to keep up.

Balancing this level of work with a social life often means staying awake and “on” to get the job done, and some people may turn to artificial substitutes. According to the same study, 5.6 percent of respondents used cocaine, crack and other stimulants, 5.6 percent used opioids, and nearly 16 percent used sedatives to turn themselves off after a long day.

Be sure to recognize the signs of overworking and proactively deal with these problems by speaking up. There’s no shame in admitting you need help.

2. A Lack of Time With Family

In Peter’s story, it was expressed that he didn’t have enough time to spend with his family and that he’d often go out in the evening and not return.

Isolation is an all too common addiction factor, and it makes it difficult for people to identify personality changes. If you begin to notice that you’d rather be alone and taking drugs instead of around the people you love, it’s time to speak up and seek expert help.

3. Stress

Often people use smoking, alcohol and drugs as ways of trying to evade the reality of a situation and “calm down” when life gets overwhelming. In 2015, Bloomberg estimated that workplace stress contributes $190 billion in healthcare expenses4 and more than 120,000 deaths each year.

Given the nature of hard work, stress can be classified as an epidemic in the legal profession.5 Last year, legal website Above The Law wrote an article titled Stressed-Out Lawyers in First 10 Years of Practice More Likely to Have Mental-Health and Wellness Issues and they’re accurate in their statement.

As explained in the article:

“If you know 10 lawyers, three of them are likely depressed, and two of them are suffering from a drinking problem or anxiety.”

Get the Help You Need With Rehab

The stigma behind going to rehab is slowly diminishing, and the acceptance of seeking help is becoming more prevalent.

In the medical profession, which is also a high pressure, high-stress career path, doctors can enter rehab, get the treatment they need, and still continue practicing medicine once they’re sober.

The legal profession is similar. No longer should you or your colleagues fear losing your legal license and getting fired; you’re human. However, continuing down a path of substance use and overworking can be detrimental to any career.

We finish this article by addressing you personally:

If you notice that you’re becoming reliant on drugs, it’s difficult to balance work and life, or if you’re failing to treat yourself with the respect you deserve, help is available.

The United States has several lawyer assistance programs and we urge you to pick up the phone and call them.

If you feel that rehabilitation is your ticket to recovery, we urge you to find a rehab center that fits your needs.

Remember: You are not alone.

Frequently Asked Questions About Addiction Among Lawyers

Are lawyers more prone to addiction?

Certain factors increase the likelihood of addiction among lawyers. These include the normalization of drinking and drug use, overwork, and chronic stress.

How prevalent is drug use among lawyers?

Self-reported figures show 22.6% of lawyers engaged in problematic drug use or drinking at one point in their lives. Actual numbers may be higher. (75% of respondents in the same study skipped over questions about drug use.)

Can lawyers continue practicing after rehab?

If you were disbarred due to drinking or drug use, you can practice again under 3 conditions: 

1. You received appropriate rehabilitation.
2. You’ve abstained from drinking and drug use for one year minimum. 
3. You’ll likely continue to abstain.