Cocaine Use Disorder Recovery Support Protocol
Primary Stack
Core supplements with strongest evidenceModulates glutamate; reduces cocaine cravings; most studied supplement for cocaine use disorder
Supports brain health and dopamine function; may reduce impulsivity; anti-inflammatory effects
Supporting Studies (1)
Supporting Stack
Additional supplements for enhanced resultsOften depleted with cocaine use; supports energy and neurotransmitter synthesis
Supporting Studies (1)
Deficiency common; supports mood and dopamine synthesis
Supporting Studies (1)
Supports GABA function; helps with anxiety and sleep during recovery
Supporting Studies (1)
Often deficient; supports immune function and neurotransmitter balance
Supporting Studies (1)
Antioxidant; depleted by cocaine use; supports adrenal function and dopamine synthesis
Supporting Studies (1)
Dopamine precursor; may help restore dopamine system depleted by cocaine
Supporting Studies (1)
Gut-brain axis support; cocaine use disrupts gut microbiome
Supporting Studies (1)
How This Protocol Works
Simple Explanation
Cocaine use disorder is characterized by compulsive cocaine use despite negative consequences. Cocaine is a powerful stimulant that floods the brain with dopamine, creating intense euphoria. Over time, the brain adapts by reducing dopamine receptors and production, leading to tolerance, craving, and difficulty experiencing pleasure without the drug.
CRITICAL: Cocaine use disorder requires professional treatment. This protocol is SUPPORTIVE ONLY.
EVIDENCE-BASED TREATMENT includes:
IMPORTANT: There are no FDA-approved medications specifically for cocaine addiction, unlike opioid or alcohol use disorders. Research is ongoing.
IF IN CRISIS:
* N-Acetyl Cysteine (NAC) is the most studied supplement for cocaine addiction. It modulates glutamate (a neurotransmitter involved in craving) and has shown benefit in reducing cravings and cocaine use.
* Omega-3 Fatty Acids support brain health and may help with impulsivity.
* B Vitamins and other nutrients are often depleted by cocaine use and poor nutrition during addiction.
Expected timeline: Recovery is a long process. NAC may reduce cravings within 4-8 weeks. Full dopamine system recovery can take months to years. Relapse is common and is part of recovery - not failure.
Clinical Perspective
Cocaine Use Disorder: DSM-5 criteria - pattern of cocaine use causing significant impairment with >=2 criteria (tolerance, withdrawal, craving, inability to cut down, time spent obtaining/using/recovering, giving up activities, continued use despite problems). Pharmacology: blocks DAT, NET, SERT reuptake; massive dopamine release; short half-life (1 hour) leads to frequent redosing. Withdrawal: dysphoria, fatigue, increased appetite, vivid dreams, psychomotor retardation - not life-threatening but drives relapse.
CRITICAL: No FDA-approved medications for cocaine use disorder. Treatment is behavioral: CBT, contingency management, therapeutic community. NAC has best supplement evidence. Supplements address nutritional deficiencies and may reduce craving, but do NOT replace behavioral treatment. Screen for: co-occurring mental illness, HIV, hepatitis, cardiac complications.
* N-Acetyl Cysteine (A-grade): Glutamate modulation; cravings. RCT: (PMID: 28472867). Meta-analysis: (PMID: 25556664). 1200-2400mg daily. Best studied supplement for cocaine.
* Omega-3 Fatty Acids (B-grade): Brain health; impulsivity. Review: (PMID: 27230032). 2-4g EPA+DHA daily.
* B-Complex (B-grade): Depleted; neurotransmitter synthesis. Review: (PMID: 27450775). Daily.
* Vitamin D (B-grade): Common deficiency; mood. Review: (PMID: 27856395). 2000-4000 IU daily.
* Magnesium (B-grade): Anxiety; sleep. Systematic review: (PMID: 28445426). 300-400mg daily.
* Zinc (C-grade): Immune; neurotransmitters. Study: (PMID: 26845419). 15-30mg daily.
* Vitamin C (C-grade): Antioxidant; dopamine. Review: (PMID: 23075608). 1000-2000mg daily.
* Tyrosine (C-grade): Dopamine precursor. Review: (PMID: 25050128). 500-2000mg daily. Theoretical benefit.
* Probiotics (C-grade): Gut-brain. Review: (PMID: 29882905). 10-20 billion CFU daily.
Assessment targets: Drug testing, craving scales, psychiatric symptoms, cardiovascular assessment, HIV/HCV status, functional outcomes, quality of life.
Protocol notes: Cardiac: cocaine causes vasoconstriction, arrhythmias, cardiomyopathy - screen with ECG, consider echo. Beta-blockers contraindicated in acute cocaine toxicity (unopposed alpha stimulation). Psychiatric: high rates of depression, PTSD, bipolar - treat co-occurring disorders. Sleep: normalize sleep patterns - critical for recovery. Exercise: helps restore dopamine system, reduces craving, improves mood. Medication trials: disulfiram, topiramate, modafinil, gabapentin have shown some promise - no FDA approval. Vaccines: cocaine vaccines in development. Contingency management: most effective behavioral treatment - monetary vouchers for negative drug tests. Social support: peer support, sober living environments improve outcomes. Relapse: expected part of recovery; opportunity to strengthen coping skills. Neurocognitive: cocaine impairs executive function - may take months to improve. Route of administration: crack cocaine (smoked) produces faster onset and more severe addiction than snorted.