The second phase, or withdrawal phase occurs 1–10 weeks after cocaine users quit, symptoms include: lethargy, anxiety, erratic sleep, strong craving, emotional lability, irritability, depression, poor concentration, and bowel issues. Finally the last phase or the extinction phase occurs up to 28 weeks after discontinued use, symptoms include: episodic cravings and some dysphoria. Epidemiology and prevalence rates
In the United States, past year cocaine users in 2019 was 5.5 million for people aged 12 or older. When broken into age groups, ages 12–17 had 97,000 users; ages 18–25 had 1.8 million users and ages 26 or older had 3.6 million users.Past year cocaine users with a cocaine use disorder in 2019 was 1 million for people aged 12 or older. When broken into age groups, ages 12–17 had 5,000 people with a cocaine use disorder; ages 18–25 had 250,000 people with a cocaine use disorder and ages 26 or older had 756,000 people with a cocaine use disorderIn the United States, cocaine use overdose deaths have been on the rise and in 2019, the CDC reported over 16,000 deaths from cocaine overdose. Risk
A study consisting of 1,081 U.S. residents who had first used cocaine within the previous 24 months was conducted. It was found that the risk of becoming dependent on cocaine within two years of first use was 5–6%. The risk of becoming dependent within 10 years of first use increased to 15–16%. These were the aggregate rates for all types of use considered, such as smoking, snorting, and injecting.
Many people who habitually use cocaine develop a transient, manic-like condition similar to amphetamine psychosis and schizophrenia, whose symptoms include aggression, severe paranoia, restlessness, confusion and tactile hallucinations; which can include the feeling of something crawling under the skin (formication), also known as "coke bugs", during binges. Different ingestion techniques have their own symptoms that accompany them. Snorting it can cause a loss of sense of smell, nose bleeds, problems swallowing and an inflamed, runny nose. Smoking it causes lung damage and injecting it puts users at risk of contracting infectious diseases like HIV and hepatitis C. Heavy users of cocaine have also reported having thoughts of suicide, unusual weight loss, trouble maintaining relationships, and an unhealthy, pale appearance. Withdrawal symptoms
When used habitually, cocaine, because of its highly addictive nature, can change brain structure and function. Circuits within the brain structure, that play a part in stress signals become more sensitive. When cocaine is not being used this increases an individuals displeasure and negative moods. In 1986, Gawin and Kleber led an important study on the withdrawal symptoms of cocaine users. In this study, three distinct phases were reported. These phases are the crash, withdrawal and extinction. The crash phase or phase 1 occurs directly after cocaine is not being used anymore. Withdrawal symptoms for this phase are exhaustion, hypersomnia, no cravings to use, dysthymia, increased appetite, restlessness, and irritability.