Key takeaway
The crash after cocaine or methamphetamine can feel like the opposite of the high, and the wish to sleep can push you toward alcohol or a benzodiazepine. Suicidal thoughts in the first one to two weeks need a clinician and 988. Tonight, tell someone every drug you used to come down.
Last updated: Mon Oct 05 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
The high is gone, and what is left is despair, agitation, and a wish to sleep that will not come. That crash is the problem tonight. A drink or a benzodiazepine to force sleep can start a second withdrawal that is medically dangerous.
If someone has chest pain, a seizure, a very high temperature, or trouble breathing, call 911. Those hours are an overdose emergency. If the mood includes thoughts of suicide, call or text 988.
Tonight, tell a clinician every stimulant and every drug you used to come down. In the first 1 to 2 weeks, some people have suicidal thoughts and need monitoring. Do not wait to see whether the feeling matches a phase name.
The crash, then the wall
TIP 33 says a characteristic withdrawal syndrome usually develops within hours to days after prolonged heavy stimulant use, and that it can also follow a shorter binge. Cocaine withdrawal is shorter than methamphetamine withdrawal. The early stretch, often called a crash, is dysphoria, anxiety, and agitation, then fatigue, deeper depression, and a strong wish to sleep that may come with insomnia. Craving in that stretch often leads back to use.
The chapter uses "the wall" for a later stretch of profound sleepiness, fatigue, mood swings, and increased appetite, which may extend to 2 weeks or more. People sometimes return to use there. After a binge, confusion about which events were real, and remorse, can add to the risk of impulsive self-harm. For methamphetamine, little pleasure and low mood can last for months. Craving can come back when you hit a place tied to use. One hard weekend does not finish that.
A pink-cloud stretch sometimes follows, and then a drop. Do not count on a cheerful month. Symptoms that outlast the usual acute window across substances are a different SAMHSA document from this chapter. The cocaine and methamphetamine day ranges are in the questions below. They are ranges from the protocol, not a promise with your name on it.
Landing gear is a second emergency
TIP 33 says people sometimes use alcohol, benzodiazepines, cannabis, or opioids to bring on sleep. That is a description of a risky habit. NIAAA says alcohol withdrawal can be life-threatening when prolonged heavy drinking stops suddenly. The FDA says stopping a benzodiazepine too fast can cause seizures. Alcohol withdrawal, benzodiazepine withdrawal, and opioids used in the same stretch are what you name at the first visit. Opioid withdrawal has its own medicines. Do not stop those drugs on a private schedule because the stimulant crash feels worse.
Psychotic symptoms from sleeplessness or a long run can continue into the crash. People in methamphetamine withdrawal have become violent when they felt persecuted. That is an emergency, not a phase to wait out. Withdrawal can also look like a separate depression. A clinician has to sort those. You can help by telling the truth about every drug.
What comes after the crash
NIDA says no medications are currently available to assist treatment for stimulants, so care is behavioral therapy, and detoxification alone generally leads back to use. TIP 33 adds that medication management of stimulant withdrawal has not been well established in major trials. Do not copy a pill from a forum. Contingency management belongs inside a program, not on a home reward chart. Behavioral care for these drugs is in methamphetamine treatment and cocaine treatment. A recovery plan separates the program's document from the week you actually live.
If the medicine is a prescribed stimulant, talk with the prescriber before you stop it because you read about a crash. Taking more than prescribed, early refills, and prescriptions from many clinicians are reasons to tell that doctor the truth.
Search FindTreatment.gov for a program that can watch mood in these weeks. Call or text (800) 653-9376 if you want help finding one.
Additional Resources
Sources cited on this page:
- SAMHSA TIP 33 (updated 2021), Chapter 3: Medical aspects of stimulant use disorders (NCBI Bookshelf)
- NIDA: Treatment and Recovery
- NIAAA: Understanding Alcohol Use Disorder
- FDA: Boxed warning to improve safe use of benzodiazepines
- 988 Suicide & Crisis Lifeline
- SAMHSA FindTreatment.gov
Common Questions
How soon can stimulant withdrawal start?
SAMHSA's updated TIP 33 says a characteristic withdrawal syndrome usually develops within hours to days after someone stops prolonged, heavy stimulant use. Symptoms can follow long-term use or a much shorter binge. Cocaine and methamphetamine do not share one clock. The chapter says cocaine withdrawal is shorter than methamphetamine withdrawal.
Do cocaine and methamphetamine follow the same timetable?
No. Some people with chronic cocaine use report symptoms beginning 1 to 2 days after the last dose, a crash lasting several days, and withdrawal persisting 1 to 2 weeks. Mood may return toward normal after several days to a month. For methamphetamine, symptoms often begin 2 to 4 days after stopping and may persist 2 to 4 weeks, and they seem most severe in the first days. Those are published ranges, not a promise about one person.
Is this as dangerous as stopping alcohol or a benzodiazepine?
TIP 33 says no consistent physiologic disruptions requiring a gradual withdrawal have been observed for stimulants. A sudden stop of alcohol or a benzodiazepine can be life-threatening. The greatest risk the chapter names during stimulant withdrawal is harm to oneself. In the first 1 to 2 weeks, some people have suicidal thoughts and need monitoring. Call or text 988 for that. Call 911 for a seizure, chest pain, collapse, or trouble breathing.
What is the crash, and what is the wall?
TIP 33 uses crash for the early stretch after a binge: dysphoria, anxiety, and agitation, then fatigue, deeper depression, and a strong wish to sleep that may come with insomnia. It uses postacute withdrawal, sometimes called the wall, for profound sleepiness, fatigue, mood swings, and increased appetite, which may extend to 2 weeks or more. For methamphetamine, low mood and little pleasure can last for months.
Can I use another drug to sleep through the crash?
Do not. TIP 33 says people sometimes use alcohol, benzodiazepines, cannabis, or opioids as landing gear to bring on sleep. If that use was regular or heavy, stopping those drugs can cause a withdrawal of its own. Tell a clinician every substance. If you cannot wake someone, or breathing is slow, call 911.