The Emotions of Cocaine Withdrawal

Going through withdrawal from a drug or other substance is always unpleasant. It can range from mildly uncomfortable to so painful and potentially dangerous, that it should not be attempted without the supervision of a doctor or other professional. The physical symptoms of withdrawal frequently include sweating, tremors, nausea, muscle tension, racing heart or palpitations, and chest tightness. Less common but more severe symptoms may include grand mal seizures, delirium tremens, heart attacks, hallucinations, or strokes.

Withdrawal also involves negative emotional symptoms that can lead to a relapse or to other serious consequences if patients are not under care. These symptoms can include anxiety and depression, irritability, insomnia, restlessness, an inability to concentrate, and a feeling of social isolation.

The Brain Puts On the Brakes

In January of 2012, the University of Texas published a study that revealed how the human brain attempts to slow down the feelings of satisfaction and reward that can come with cocaine use. When individuals use cocaine, a protective mechanism is triggered that tries to switch off certain genes in the genome. These genes have been shown to be closely connected to the development of addictions.

The chemicals triggered during this process are called histone deacetylases (HDAC), and they are a just a few of the many chemicals in our bodies that are responsible for turning various genes on and off. The University of Texas study used rats to show that HDAC5 moved to the nucleus of cells following cocaine use, where it attempted to counteract the genes that are otherwise stimulated by the presence of cocaine in the system.

The researchers hypothesized that breakdowns in this natural system could help to explain why addiction occurs more readily in some individuals than in others. The researchers who led this study hoped that the results could provide insight into why some people are more susceptible to drug addiction.

When the Brakes Don’t Come Off

A related study later in 2012 shed light on how this gene regulation and emotional inhibition might play a role in the negative emotions experienced during cocaine withdrawal. This study took place at Washington State University, with the assistance of the University of Pittsburgh and the European Neuroscience Institute.

This study involved a molecule known as cannabinoid receptor 1, or CB1 for short. Like HDAC5, this molecule plays a role in regulating the brain’s emotional response to outside stimuli. When stimulated, the cells that are responsible for producing CB1 become increasingly more active, and create more and more CB1 to release into the bloodstream.

The result of this extra CB1 is like someone stepping on the brakes of your emotional system. CB1 does its best to slow down feelings of motivation and reward, both of which are strongly stimulated when individuals take cocaine. The brain does this in an effort to keep an individual’s emotions and behavior from spiraling completely out of control. While cocaine use still manages to produce a powerful high, the effect is nevertheless somewhat slowed by the efforts of the CB1 molecule.

However, what the Washington State University researchers also found is that this reaction on the part of the brain does not switch off once cocaine has left the system. As a result, the emotional impact of coming down from a cocaine high or attempting to detoxify from a cocaine addiction can be intensive.

The molecules – “brakes” – that were working so hard to slow down the rewarding emotions of cocaine use continue to act on the system when the cocaine is no longer present. The result is something akin to the emotional equivalent of riding a bicycle on flatlands to uphill with the brakes on, or trying to run through water.

This feeling of “crashing” – going from an emotional high to an extreme emotional low – is part of what puts individuals at such great risk for continued cocaine use or for relapse if they are trying to recover from substance dependency. These emotional crashes can also be dangerous in their own right, leading to feelings of severe depression and anxiety that may push individuals in the direction of more self-harming or otherwise self-destructive behaviors.