Stimulant detox is mostly about safety, sleep and the crash.

Unlike alcohol or opioid withdrawal, stimulant detox is rarely physically dangerous. The challenge is different: a brutal post-use 'crash' marked by overwhelming fatigue, depression, and cravings that drive relapse. Our medical and clinical teams address all of it — safely, comfortably, and with serious attention to what comes next.

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Cocaine and meth do not produce dramatic physical withdrawal. They produce a depression so heavy it drives people back to use within days. We treat the depression.

5–10

Days typical

Cardiac

Monitoring as needed

Sleep

Restoration priority

Dual-Dx

Assessment from day 1

Section 01

What the 'crash' looks like

After a binge ends, stimulant users typically experience days of exhaustion, depression, hypersomnia, increased appetite, vivid dreams, and powerful cravings. This crash phase peaks at 1–3 days and gradually improves over 1–2 weeks. The lingering anhedonia (inability to feel pleasure) can persist for weeks, which is why so many patients relapse — using stimulants becomes the only way to feel anything at all.

Exhaustion and hypersomnia
Severe low mood
Anhedonia for weeks
Overwhelming cravings

Section 02

Medical safety during stimulant detox

While stimulant withdrawal itself is not typically dangerous, chronic stimulant use causes real medical risks: hypertension, cardiac arrhythmias, malnutrition, and (with methamphetamine) dental and skin complications. We complete a thorough medical workup, monitor cardiac status as needed, address nutritional deficiencies aggressively, and coordinate dental and dermatologic referrals when appropriate.

Cardiac assessment and monitoring
Blood pressure stabilization
Nutritional rehabilitation
Dental & dermatologic care if needed

Section 03

Sleep restoration

Stimulants devastate sleep. Many cocaine and meth users have not slept normally in months or years. Restoring sleep is central to early recovery — it directly impacts mood, cravings and cognition. We use non-addictive sleep medications (trazodone, mirtazapine, hydroxyzine, melatonin), strict sleep-wake regulation, and gentle morning movement to reset the sleep architecture.

Non-addictive sleep medications
Sleep-wake regulation
Morning light and movement
Restored architecture over days

Section 04

Mood and craving management

We treat the depression that drives stimulant relapse aggressively from the first days. SSRI initiation when appropriate, bupropion as both an antidepressant and craving-reduction agent, and (when indicated) referral for advanced treatments. We pair pharmacology with daily therapy work focused on dopamine recovery, pleasure rebuilding, and the meaning-making that makes life worth living without stimulants.

Antidepressant initiation in detox
Bupropion for mood + craving
TMS/ketamine referral when appropriate
Daily therapy from day 1

Section 05

Dual-diagnosis assessment

Stimulant use disorder has unusually high rates of underlying ADHD, bipolar disorder, depression and trauma. Our psychiatric team begins comprehensive diagnostic assessment during detox so that the residential phase begins with a real treatment plan — not just sobriety. For patients with genuine ADHD, we discuss non-stimulant medication options and the rare circumstances under which careful stimulant prescribing can be considered.

ADHD assessment & non-stimulant options
Bipolar screening
Trauma history evaluation
Integrated treatment plan

Section 06

Step-down to real treatment

Stimulant use disorder responds best to extended psychosocial treatment — Contingency Management (the most evidence-based behavioral intervention for stimulants), CBT, group therapy, and community-based recovery support. From detox you step directly into residential or PHP, with the modalities and timeline that stimulant recovery genuinely needs.

Contingency Management protocols
CBT for stimulant use disorder
Group & community-based recovery
Extended residential when needed

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