Treatment continuum
Cocaine rehab.
Residential treatment for cocaine use disorder. Cocaine's short half-life drives binge patterns and rapid escalation; modern overdose risk is elevated by fentanyl contamination of the cocaine supply.
Overview
Cocaine rehab is the structured clinical treatment of cocaine use disorder across the full continuum of care. Cocaine has a short half-life, which drives binge-use patterns and rapid escalation to compulsive use; in the modern illicit supply, cocaine is increasingly contaminated with fentanyl, elevating overdose risk substantially. There is no FDA-approved medication for cocaine use disorder; recovery is supported primarily by evidence-based behavioral therapy, contingency management, structured residential and outpatient programming, and long-term aftercare. SILC Health operates licensed cocaine rehab programs in California and Georgia, accepts most major insurance, and integrates overdose-prevention training (including take-home naloxone for clients with any opioid co-use history or any exposure to the contaminated illicit supply) into discharge planning.
Medically reviewed by Peter Scheid, MD
Medical Director, SILC Health
Clinically reviewed by Alexandra Truman, LMFT
Clinical Director, Substance Use Services — SILC Health
Last reviewed: June 16, 2026
Section 1
What this is.
Cocaine rehab is the full clinical continuum for cocaine use disorder. Acute cocaine withdrawal is rarely medically dangerous but is profoundly uncomfortable — fatigue, depression, anhedonia, and intense cravings can be severe in the first 1–2 weeks. The protracted withdrawal phase (subtler depression, sleep disturbance, cravings) can extend for 4–8 weeks.
Cocaine's pharmacology drives a particular use pattern: short duration of effect (30–60 minutes), rapid tolerance, and binge use as the drug runs out. This pattern produces a clinical picture distinct from longer-acting substances — clients often describe weeks of moderate use punctuated by escalating binges that put them in crisis.
Modern cocaine is increasingly contaminated with fentanyl. SILC's clinical protocols account for this: overdose-prevention education, naloxone planning, fentanyl test strip awareness, and the possibility of co-occurring opioid use disorder treatment are part of standard programming for cocaine rehab.
No FDA-approved MAT
There is no FDA-approved medication for cocaine use disorder. Treatment relies on behavioral therapy, contingency management, structured residential and outpatient programming.
Short half-life
Cocaine's 30–60 minute duration of effect drives binge-use patterns and rapid escalation to compulsive use, distinguishing its clinical picture from longer-acting substances.
Section 2
The continuum of care.
1. Medical detox (5–10 days, ASAM Level 3.7)
Cocaine detox at SILC is medically managed with 24/7 nursing and physician oversight. Withdrawal symptoms are managed pharmacologically; vitals and cognitive status are monitored continuously; complications are escalated immediately. Detox is the foundation — the work that follows is harder without it. See more →
2. Residential treatment (30 / 60 / 90+ days, ASAM Level 3.1–3.5)
Residential — sometimes called "inpatient" — is the longest and most intensive phase. Clients live on-site, participate in structured clinical programming daily, attend individual and group therapy, work with family when appropriate, build recovery skills, and stabilize physically and emotionally. Length of stay is clinically determined; most clients with moderate-to-severe substance use disorder benefit from at least 60 days.
3. Partial Hospitalization (PHP) — day treatment (ASAM Level 2.5)
PHP is the first step down from 24-hour residential care. Clients spend most of the day in clinical programming (typically 5–6 days per week, 5–6 hours per day) but return to sober living or stable housing each night. PHP supports reintegration into community life while still providing intensive clinical structure.
4. Intensive Outpatient (IOP) — 9–15 hours weekly (ASAM Level 2.1)
IOP runs 9–15 hours per week across 3 days, allowing return to work, school, or family responsibilities. Clinical focus shifts toward relapse prevention, ongoing therapy, and community reintegration. IOP often runs in parallel with recovery fellowship participation.
5. Outpatient + aftercare (indefinite)
Standard outpatient — individual therapy, psychiatric medication management when indicated, group therapy with a community provider — extends after IOP and continues indefinitely. Aftercare also includes recovery fellowship participation, sober living when appropriate, and ongoing alumni programming.
Section 3
Who this is for.
Cocaine use disorder is treated as stimulant use disorder under the DSM-5 framework. The criteria are the same as for any other substance — impaired control, social impairment, risky use, pharmacological dependence — graded by severity.
Residential cocaine rehab is most clearly indicated for: any history of overdose, any exposure to fentanyl-contaminated cocaine, daily or near-daily use that has not responded to outpatient intervention, polysubstance use, co-occurring mental health conditions (particularly bipolar disorder, depression, or anxiety), or environments that don't support safe outpatient recovery.
Crack cocaine and powder cocaine are pharmacologically the same drug but produce somewhat different use patterns; clinical assessment and treatment planning are adapted to the specific pattern of use.
Section 4
A day in residential.
Residential cocaine rehab is structured but not regimented. Most days at a SILC facility follow a clinical rhythm designed to balance therapeutic work, peer connection, physical wellness, and rest.
- •Morning: Wake, vitals check during detox phase, mindfulness or meditation, breakfast, community meeting.
- •Mid-morning to lunch: Individual therapy session or process group; psychiatric or medical check-ins when relevant.
- •Afternoon: Skill-building group (CBT, DBT, relapse prevention), or experiential work (movement, art, equine therapy depending on facility), or family session when scheduled.
- •Late afternoon: Physical wellness (exercise, beach walk at coastal California facilities, fitness room), peer time, dinner.
- •Evening: Recovery fellowship meeting (AA, SMART, or alternative), reflection group, journaling, rest.
Family communication is supported per the client's preference. Family programming — visits, family therapy sessions, and structured education on supporting recovery — is clinically encouraged once initial stabilization is complete, typically after the first 5–10 days.
Fentanyl contamination
Fentanyl contamination of the cocaine supply has elevated overdose risk substantially. SILC's standard programming includes overdose-prevention education and naloxone access for clients exposed to the contaminated illicit supply.
Contingency management
Contingency management — structured positive reinforcement for measurable recovery behaviors — has the strongest evidence base for stimulant use disorder treatment outcomes.
Section 5
Insurance + cost.
Most major commercial insurance plans cover residential treatment at SILC facilities, including Aetna, Anthem Blue Cross / BCBS plans, Blue Shield of California, Cigna, UnitedHealthcare, Surest, MultiPlan / PHCS, ConnectiCare, Oxford / Harvard Pilgrim, NYSHIP (Empire Plan), Empire BCBS, and Prairie States Enterprises. Network status with any given carrier varies by SILC facility and the patient's specific plan.
Out-of-state insurance is commonly accepted under most plans' out-of-state benefit provisions — Empire BCBS (NY), BCBS Texas, BCBS Florida, Aetna nationwide plans, and UnitedHealthcare nationwide plans typically cover treatment at SILC California facilities.
The SILC admissions team verifies your specific benefits, in plain language, before any clinical commitment. Most insured clients pay a manageable share after coverage; private-pay and financing options are available for clients without insurance or whose plans don't cover residential treatment at the clinically indicated level.
See all accepted insurance carriers →Section 6
Where SILC operates.
SILC Health operates licensed substance use treatment programs in two regions: coastal California (San Diego County) and North Georgia (Towns County). Medical detox is available at Cove Detox (Carlsbad), Leucadia Detox (Encinitas), Seaside Detox (Oceanside), Harbor Detox (Dana Point), and Riverfront Recovery Center (Hiawassee, GA). Residential addiction treatment is anchored by Southern California Recovery Centers (Carlsbad) and Riverfront Recovery Center (Hiawassee, GA).
Roughly two-thirds of SILC's California admissions originate from outside California — the climate, the recovery community, the distance from triggers at home, and the depth of California's continuing-care ecosystem are the most common reasons families choose to travel here for treatment. The Riverfront catchment skews more regional — drive-distance from Tennessee, Kentucky, Indiana, and surrounding states.
See all SILC facilities →Related
Dig deeper.
First step
Cocaine Detox
Medical management of cocaine withdrawal — timeline, medications, and what to expect.
The diagnosis
Cocaine rehab
Clinical overview, signs and symptoms, and how this condition is diagnosed.
The setting
Residential Treatment
What residential treatment looks like — daily schedule, therapies, length of stay.
Coverage
Insurance Verification
How SILC verifies your benefits — including out-of-state coverage.
The process
What to Expect
From the first phone call through arrival at the facility — step by step.
Co-occurring
Dual Diagnosis
Treating substance use and mental health conditions together.
FAQ
Frequently asked questions.
- How long does cocaine withdrawal last?
- Acute cocaine withdrawal — fatigue, depression, intense cravings, anhedonia — typically peaks in the first week and resolves over 2 weeks. Protracted withdrawal symptoms can persist for 4–8 weeks. Residential treatment during this period substantially improves outcomes.
- Is cocaine withdrawal medically dangerous?
- Cocaine withdrawal is rarely medically dangerous in otherwise healthy adults — it is profoundly uncomfortable but does not typically produce seizures, DTs, or life-threatening physiological complications. However, severe depression during withdrawal can carry suicide risk, and dehydration or co-occurring medical conditions can complicate recovery. Medically supervised detox is the appropriate level of care.
- Is there a medication for cocaine use disorder?
- No FDA-approved medication is currently available specifically for cocaine use disorder. Off-label medications are sometimes used to manage specific symptoms (sleep, mood, anxiety, cravings) but no medication treats the use disorder directly. Treatment relies on behavioral therapy.
- How long is residential cocaine rehab?
- Length of stay is clinically determined. Most clients with cocaine use disorder benefit from at least 60 days of residential treatment to manage the protracted post-acute phase and establish sustainable recovery practices.
- What therapies are used in cocaine rehab?
- Evidence-based modalities include Cognitive Behavioral Therapy (CBT), Matrix Model, contingency management approaches, motivational interviewing, family systems therapy, twelve-step facilitation (Cocaine Anonymous), and trauma-informed care for clients with co-occurring trauma.
- Is cocaine being cut with fentanyl?
- Yes, increasingly. Fentanyl contamination of the cocaine supply has been documented across most U.S. markets and has driven a substantial share of stimulant-involved overdose deaths. SILC's clinical protocols account for this with overdose-prevention education, naloxone planning, and fentanyl-specific awareness.
- What's the difference between crack and powder cocaine treatment?
- Both forms are pharmacologically the same drug. Crack cocaine produces a faster, more intense, and shorter-duration effect than insufflated powder cocaine, which often drives more rapid escalation and binge-use intensity. Treatment is broadly the same but adapted to the specific use pattern.
- Does SILC accept insurance for cocaine rehab?
- Most major commercial plans cover cocaine rehab at SILC, including Aetna, Anthem Blue Cross / BCBS, Blue Shield, Cigna, UnitedHealthcare, Surest, MultiPlan / PHCS, ConnectiCare, Oxford / Harvard Pilgrim, NYSHIP, Empire BCBS, and Prairie States Enterprises.
- Does SILC treat cocaine use disorder with co-occurring conditions?
- Yes. Cocaine use disorder co-occurs frequently with depression, anxiety, ADHD, bipolar disorder, and PTSD. SILC programs treat both presentations concurrently rather than sequentially.
- What happens after cocaine rehab ends?
- Continuing care typically includes outpatient programming (PHP, then IOP, then standard outpatient), recovery fellowship participation (Cocaine Anonymous, SMART, or alternatives), sober living when appropriate, and ongoing psychiatric care for co-occurring conditions. SILC coordinates direct handoff with home-state providers.
Talk to admissions
Recovery starts with a call.
One call confirms benefits, walks through what arrival looks like, and sets a clear plan from detox through aftercare.