The term crack is applied to a type of cocaine that is processed with ammonia or baking soda, producing solid rocks that look like cloudy, off-white, or brownish crystals. These rocks are more potent than powdered cocaine, partly because they are typically smoked, allowing the drug to reach the brain more rapidly, but also because the drug itself is more potent. While powdered cocaine is a Schedule II drug, with rare but important surgical uses, according to the Drug Enforcement Administration (DEA), crack cocaine is an illicit and dangerous drug intended only for recreational abuse. Because crack is so potent, addiction and dependence can occur quickly when a person begins abusing this substance.
Crack Cocaine Abuse
The epidemic of crack cocaine abuse peaked in the 1980s, and since then, the drug has become less popular. The Department of Justice (DOJ) reports that a survey found that about 6.2 million US residents, ages 12 and older, had abused crack cocaine at least once in their lifetimes. Around 150,000 adolescents, 12-17 years old, and a little over 1 million adults, 18 years old and older, abuse crack. The 2016 Monitoring the Future (MTF) Survey found that 0.9 percent of 8th graders, 0.8 percent of 10th graders, and 1.4 percent of 12th graders across the US had ever tried crack. Regarding abuse of the drug within one month before the survey – an indicator of potential drug abuse problems – 0.2 percent of 8th grade students, 0.2 percent of 10th grader students, and 0.5 percent of 12th grade students smoked or injected crack cocaine.
The 2015 National Survey on Drug Use and Health (NSDUH) found similarly low rates of crack abuse among people ages 12 and older. Lifetime abuse among different age groups was:
- 12 or older: 3.4 percent
- Adolescents 12-17: 0.1 percent
- Young adults 18-25: 1.5 percent
- Adults 26 and older: 4.1 percent
Rates increased among the adult population, suggesting that people are either exposed to crack later in life or that the substance is falling out of favor as a drug of abuse.
Although abuse rates are low in the US, crack cocaine is still an incredibly dangerous drug. Treatment for those who struggle with substance abuse is very important, as crack can cause chronic illness, overdose, and death.
Signs of Crack Cocaine Addiction
Cocaine and crack cocaine are both stimulant drugs, so people will appear very excited, nervous, or paranoid when they are high on these substances. Effects and side effects associated with crack abuse include:
- Raised blood pressure
- Rapid heartbeat
- Faster, shallow breathing
- Dilated pupils
- Intense euphoria
- Decreased appetite
- Anxiety and panic attacks
- Paranoid behavior
- Violence toward oneself or others
- Depression, especially as the drug wears off
- Intense cravings, leading to a cycle of bingeing
- Sudden death, even from one dose
Stimulation from drugs like cocaine occurs because the chemical binds to receptors in the brain that release substantial amounts of dopamine. This causes the person to feel euphoric and excited, and to potentially begin to hallucinate. With too much stimulation, however, the brain will stop releasing dopamine and other neurotransmitters, and it has a challenging time recovering a normal chemical balance once the drug wears off. For many people, this sudden drop in a mood-related neurotransmitter, as crack metabolizes out of the body, leads to intense depression, fatigue, and cravings for more of the drug.
People who struggle with crack addiction are at greater risk for overdose and long-term health complications. Some of these include:
- Severe, chronic depression
- Mood disturbances
- Aggression and paranoid behavior
- Tactile and auditory hallucinations
- Heart attack, stroke, and cardiovascular damage
- Respiratory failure
- Sexual dysfunction and infertility
- Risky behavior, leading to harm
In addition to potential overdose and chronic health issues, cocaine can raise blood pressure and heart rate, potentially inducing a stroke, pulmonary embolism, or heart attack. The drug restricts oxygen flow to the heart by constricting blood vessels, which can cause damage to the heart muscle. High blood pressure may also cause weakened blood vessels in the brain to burst, causing an aneurysm.
Trying to Stop Crack Cocaine Abuse
Cocaine withdrawal is likely to be uncomfortable, but it is rarely life-threatening. The most dangerous symptoms associated with crack come from the effects of the drug on the body, not from withdrawal symptoms. Still, it is important to work with a medical professional to safely detox from crack cocaine because attempting this alone may lead to relapse, which could cause an overdose.
- Mood swings
- General malaise
- Changes in appetite, especially eating more
- Nightmares or sleep problems
- Slower physical activity
- Reduced cognitive ability
If a person attempts to quit abusing crack without social and medical support, they are at risk of relapsing and overdosing. Overdoses from crack are life-threatening. It is important to call 911 immediately to get a person who is overdosing the medical attention they need to survive.
The Danger of Overdose
- Phase 1: Symptoms include raised blood pressure, changes to pulse, increased rate of breathing, dangerously high body temperature, paranoia or delusions of grandeur, pupil dilation, headache, teeth grinding, nausea, vertigo, uncontrollable tremors, pre-convulsive movements, and pseudohallucinations like formication (commonly referred to as cocaine bugs). These symptoms may seem like crack intoxication but are more intense.
- Phase 2: Swelling around the brain, hypertension, racing heart rate or irregular pulse, loss of blood flow and oxygen to extremities, decreased response to stimuli, incontinence, irregular breathing, and seizures are common.
- Phase 3: Symptoms include fixed dilated pupils, pulmonary edema, respiratory failure, bluish tint to skin from oxygen deprivation, heart attack, circulatory failure, stopped breathing, coma.
People who suffer an overdose from abusing crack need immediate medical attention, which may require long-term hospitalization. Harm to the heart, brain, lungs, and other organs may require consistent medical attention for the rest of the person’s life.
Treatment to Overcome Crack Cocaine Abuse
The National Institute on Drug Abuse (NIDA) reports that, in 2013, about 6 percent of admissions to treatment facilities involved addiction to cocaine, including crack cocaine; of those, 68 percent struggle with crack cocaine specifically. These individuals are also more likely to struggle with polydrug abuse, or the abuse of multiple substances at the same time.
There are no medications to treat crack cocaine addiction as there are for opioids or alcohol. However, several medications can ease the side effects associated with crack cocaine withdrawal, especially psychiatric medications like selective serotonin reuptake inhibitors (SSRIs) which take about a month to become fully effective. These can help to moderate mood changes or disorders induced by crack addiction.
Entering a rehabilitation program that provides evidence-based treatment approaches to behavioral therapy is the best way to maintain sobriety after detox. People who are overcoming cocaine and crack cocaine addiction respond well to Contingency Management (CM) therapy, NIDA has found. This form of therapy rewards positive behavioral changes with tangible prizes like gift certificates, which likely stimulates the same areas of the brain as cocaine. By associating dopamine release with better behavior, people ending their addiction to cocaine or crack can make lasting changes. Cognitive Behavioral Therapy (CBT) also works well for people working to overcome addiction.