Outpatient Cocaine & Crack Detox
Managing the crash — psychiatric support for cocaine withdrawal
Cocaine withdrawal is primarily psychological rather than physical — there is no dangerous medical withdrawal syndrome like with alcohol or benzodiazepines. However, the "crash" after stopping cocaine involves intense depression, anhedonia, exhaustion, and powerful cravings that drive high relapse rates. Psychiatric medication support during this period dramatically improves outcomes.
Medications & Clinical Support
- Antidepressants — address crash depression and anhedonia
- Mood stabilizers — reduce irritability and mood swings
- Sleep aids — manage cocaine-induced insomnia during the crash
- Naltrexone — reduces craving intensity
- Anti-anxiety medications — address rebound anxiety
- Dopamine system support — emerging evidence for certain agents
Withdrawal Timeline
Hours 1–24 (The Crash)
Intense fatigue, hypersomnia, depression, increased appetite — direct rebound from cocaine's stimulant effects
Days 2–10 (Withdrawal)
Depressed mood, anhedonia, intense cravings, irritability, sleep disturbance
Weeks 2–10 (Extinction)
Gradual normalization; mood and energy slowly return; environmental cues trigger strong cravings
Long-term
Dopamine system recovery takes months; cue-triggered cravings can persist for years — therapy essential
Why Outpatient Detox?
Because cocaine withdrawal does not carry the medical risks of alcohol or benzo withdrawal, outpatient management is the standard of care. Inpatient admission is rarely medically necessary and removes patients from their real-world environment where long-term coping skills need to be built. The focus of outpatient cocaine detox is psychiatric symptom management and relapse prevention.
The Concierge Difference
During detox, you have Dr. Agresti's direct cell number. If symptoms become concerning at 2 AM, you call — not an answering service. This level of access is what makes outpatient detox safe and what separates concierge psychiatric care from standard treatment.
24/7
Direct physician access
No ER
Avoid unnecessary hospitalizations
Private
No inpatient admission record
Frequently Asked Questions
Is cocaine withdrawal dangerous?
Cocaine withdrawal itself is not medically dangerous — it does not cause seizures or DTs. However, the profound depression during the crash increases suicide risk in vulnerable individuals, and relapse rates are high. Psychiatric monitoring during the withdrawal period is important.
How long do cocaine cravings last?
Acute cravings peak in the first 1–4 weeks. However, cue-triggered cravings (triggered by people, places, or things associated with cocaine use) can persist for months to years. Therapy focused on identifying and managing triggers is essential for long-term recovery.
Does anything help cocaine withdrawal?
No FDA-approved medications exist specifically for cocaine withdrawal, but several off-label medications show evidence: propranolol for cravings, modafinil for cognitive symptoms, and certain antidepressants for the crash depression. Dr. Agresti customizes pharmacological support based on each patient's presentation.