Cocaine Use Disorder: Health Risks, Withdrawal, and Treatment

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Archangel Reviews For Cocaine Use Disorder

Google Reviews
5.0★★★★★

Verified Google reviews from former clients, family members, and visitors. Founder-led, recovery-grounded program.

John Pereira
Verified Google review
★★★★★

Archangels gave me my life back. Their team is the most amazing, caring people I have ever met. The housing they sent me to was amazing, the groups are amazing, and this whole project is amazing. If you're tired of being sick and tired, reach out and save your life.

Cisco Avila
Verified Google review
★★★★★

This facility is run by some of the best people you could ever ask for. They are extremely professional and truly dedicated to helping those struggling with mental health and addiction. They truly saved my life. I will be forever grateful for everything they did for me.

Priscilla Seamanik
Verified Google review
★★★★★

I had the honor of touring this facility, and it was absolutely beautiful, clean, and thoughtfully designed. But more than how it looked, you could feel the love in every detail. Watching the staff interact with clients genuinely touched my heart.

Key Facts

In 30 seconds

Plain, fact-first answers about how care works here. Want to talk to a person? Call (888) 464-2144.

  • The Archangel Centers is a licensed outpatient addiction treatment provider.
  • The Archangel Centers operates clinics in Tinton Falls, NJ and Charlotte, NC.
  • Cocaine use disorder is part of the outpatient continuum at The Archangel Centers.
  • Medication-assisted treatment (MAT) includes Suboxone, Vivitrol, and Sublocade.
  • The Archangel Centers works with most major commercial insurance plans with free benefits verification.
Inside the Clinic

Tour The Archangel Centers

A 60-second walkthrough of the Tinton Falls clinic, the space where the program actually runs.

Cocaine is a stimulant derived from the coca plant. It is one of the most rapidly addictive substances available, with a powerful but short-lived euphoric effect that drives a binge-and-crash pattern of use. Cocaine use disorder produces real cardiovascular, neurological, and psychiatric consequences, and is increasingly complicated by fentanyl contamination of the illicit cocaine supply. This page covers what cocaine use disorder is, the medical risks, what withdrawal looks like, and what evidence-based treatment can do.

There are currently no FDA-approved medications specifically for cocaine use disorder, which means the clinical work is concentrated in therapy, structured environment, and treatment of co-occurring conditions. The evidence-based approach is well-established.

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What cocaine is

Cocaine is a sympathomimetic stimulant that blocks the reuptake of dopamine, norepinephrine, and serotonin, producing a strong euphoric and energizing effect. It is encountered in two main forms:

The half-life of cocaine is short, which produces the characteristic binge pattern: repeated dosing within a session to maintain the effect, followed by a "crash" of exhaustion, low mood, and craving.

  • Powder cocaine (cocaine hydrochloride) Snorted, dissolved and injected, or rubbed into gums. Onset is fast; duration is short (30 to 60 minutes).
  • Crack cocaine A smokable form (free-base). Faster onset, shorter duration, more intense effect, often more rapidly habituating.
Mike Sorrentino, Founder, beneath the 'God is with me, I can't lose' wall
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Cocaine and the contaminated supply

The illicit drug supply has shifted in recent years to include unintended fentanyl contamination in cocaine, methamphetamine, and counterfeit pills. The CDC and many state health departments have reported a sharp rise in opioid overdose deaths in people whose primary substance was a stimulant. Many of these deaths were among people who did not knowingly use opioids.

Practical implications:

  • Carry naloxone, even if you do not use opioids. A friend's cocaine could contain fentanyl.
  • Fentanyl test strips can detect fentanyl in cocaine samples (yes/no, not dose).
  • Mixing cocaine with opioids (a "speedball") sharply elevates overdose risk; the stimulant masks early signs of opioid respiratory depression.
Inside the Clinic

A Place Built for Recovery

Group rooms, private therapy offices, the medical office, family programming rooms, and the wellness space, designed for clinical depth and nervous-system regulation.

Archangel Centers, front office and reception area
Archangel Centers, Situation Room with branded archangel wing
Archangel Centers, group and conference room
Archangel Centers, clinician meeting with a client in the Situation Room
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Health risks of cocaine use

Cocaine is hard on the cardiovascular system in particular.

Cocaine and the Heart

Cardiovascular

  • Acute hypertension and tachycardia
  • Coronary artery spasm and myocardial infarction (heart attack), even in young, otherwise healthy users
  • Arrhythmias, including sudden cardiac death
  • Cardiomyopathy in chronic users
  • Aortic dissection in extreme cases

Neurological

  • Stroke (both ischemic and hemorrhagic)
  • Seizures
  • Movement disorders in chronic users

Psychiatric

  • Cocaine-induced psychosis with prolonged binge use (paranoia, hallucinations)
  • Severe depression during the "crash" and in early abstinence
  • Suicidality in the post-crash window
  • Worsening of underlying mood and anxiety disorders

Other

If chest pain, severe headache, or neurologic symptoms occur during cocaine use, call 911 immediately.

  • Nasal septum damage, chronic rhinitis (snorted cocaine)
  • Pulmonary damage (smoked cocaine)
  • HIV and hepatitis C from injection or shared paraphernalia
  • Pregnancy complications
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Cocaine withdrawal

Cocaine withdrawal is more psychological than physical, but no less serious clinically. The pattern:

The depression and suicidality risk in the post-acute window is a clinical concern that needs active management. Cocaine withdrawal is rarely a medical emergency in itself, but the psychiatric component is.

  • Crash phase (within hours of stopping): exhaustion, depression, increased appetite, often heavy sleep
  • Withdrawal phase (days 2 to 10): low mood, anhedonia, fatigue, intense craving, vivid dreams
  • Extinction phase (weeks to months): intermittent craving triggered by people, places, and emotional states associated with use
Mike Sorrentino in the Archangel Centers lobby
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Cocaine use disorder, formally

Diagnosis follows the DSM-5 substance use disorder framework, applied to cocaine: at least two of eleven criteria across impaired control, social impairment, risky use, and pharmacological themes, within twelve months. Severity is graded mild, moderate, or severe.

Common patterns include weekend binge use that escalates over months, daily use following a period of life stress, and use that began as recreational and is now compulsive.

Evidence-Based Care

Licensed clinicians. Evidence-based modalities.

Treatment integrates cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational interviewing, narrative therapy, and trauma-informed care with EMDR available in individual therapy. The medical provider manages MAT (Suboxone, Vivitrol, Sublocade) and psychiatric medications when indicated.

Intake uses the full evidence-based battery: ASAM Criteria, LOCUS for mental health acuity, PHQ-9, GAD-7, the Columbia Suicide Severity Rating Scale, plus biopsychosocial, nutrition, and pain screens. The assessment drives the treatment plan from day one.

See Our Modalities
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Treatment for cocaine use disorder

There are no FDA-approved medications specifically for cocaine use disorder. The clinical work concentrates in:

Behavioral therapies with the strongest evidence

  • Contingency management Structured positive reinforcement for verified abstinence. The strongest evidence base of any behavioral intervention for stimulant use disorder.
  • Cognitive behavioral therapy Trigger identification, coping skill building, cognitive restructuring around use. See CBT.
  • Community Reinforcement Approach Building a rewarding lifestyle that competes with the rewards of use.
  • Motivational interviewing Working through ambivalence about change. See motivational interviewing.
  • Twelve-step facilitation alongside non-12-step alternatives.

Treatment of co-occurring conditions

Cocaine use disorder is heavily comorbid with depression, anxiety, ADHD, and post-traumatic stress. Treating the underlying conditions reduces use and supports retention. See the dual diagnosis cluster.

MAT considerations

While no medication is FDA-approved specifically for cocaine use disorder, medications may be used to treat co-occurring conditions that drive use, including antidepressants and ADHD medications, when clinically indicated. Decisions are made by the medical provider on a case-by-case basis.

The outpatient continuum

The Archangel Centers outpatient continuum is well-suited for cocaine use disorder:

For clients who need medical stabilization first (acute medical complications, severe co-occurring psychiatric symptoms), we coordinate placement at an accredited partner inpatient facility before step-down to our outpatient program.

Questions

Frequently Asked Questions

Is cocaine addictive after one use?
Cocaine has high abuse potential. Single use does not produce a use disorder, but the pattern of bingeing and craving establishes quickly with repeated use, particularly with crack cocaine.
Why is there no medication for cocaine like there is for opioids?
The mechanism of cocaine in the brain has resisted decades of pharmacological research aimed at finding agonists or antagonists that work the way buprenorphine and naltrexone work for opioids. This is an active area of research; in the meantime, the strongest treatment evidence is for behavioral approaches.
Can I just quit cocaine on my own?
Some people do, particularly with mild use disorders and strong support systems. For moderate or severe presentations, the structured environment of outpatient or higher-intensity treatment dramatically improves outcomes.
What about the depression after stopping?
Post-cocaine depression is real and can be severe. It usually improves over weeks. Clinical monitoring during this period is part of treatment, and antidepressant medication may be used if symptoms persist.
Is cocaine in the workplace urinalysis panel?
Yes. Standard urine drug screens detect cocaine metabolites for 2 to 4 days after use, longer with chronic heavy use.
What about powder cocaine vs. crack cocaine?
The pharmacology is the same, but smoked crack produces a faster, more intense, and shorter effect, which tends to drive more rapid escalation. Treatment approach is similar regardless of route. ---
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The Team Behind Your Care

Founder-led, clinician-led, and small enough to know you

Every client at The Archangel Centers is supported by Mike and Lauren Sorrentino, Medical Director Dr. Justin Skolnick, Program Director Trevor Eyerkuss, the Managing Partners, and a Director of Admissions who actually answers the phone.

Why We Opened Archangel

A program built by people who have been there

I came back from rock bottom. I'm here because I want to show others they can too. This isn't just a business. It's my mission.- Mike Sorrentino, Founder

Mike and Lauren Sorrentino did not set out to build a generic treatment center. They wanted a recovery-grounded program that mixes lived experience, licensed clinical expertise, and family programming that actually moves the needle for the people who love someone in active addiction.

The clinic that resulted is small enough that each client knows their primary therapist by name, but resourced enough to deliver the full ASAM continuum from Partial Care through outpatient continuing care, with MAT and EMDR available when clinically indicated.

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