Withdrawal

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Benzodiazepines may ameliorate the "crash" or early phase withdrawal from cocaine. However, the high abuse potential of benzodiazepines limits their therapeutic value (Kosten, 1988). The most serious complication of early withdrawal is depression, with the potential for suicide. Patients must be watched closely when manifesting depression and agitation. If symptoms of depression do not remit within 10 days to 2 weeks, despite relative normalization of sleep patterns, underlying major depression requiring psychiatric intervention is suggested. In addition, repeated exposure to cocaine followed by withdrawal leads to an activation of the neuroendocrine stress response, which may increase susceptibility to infection during the initial stages of withdrawal (Avila, Morgan, & Bayer, 2003).

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