Crack Addiction and Treatment
Get on the path to ending your crack addiction. You really can break free.
With just a single phone call, you'll be connected with people who can direct you toward options for overcoming your cravings. Kind and supportive professionals will help you discover ways to live that no longer put your immediate future and well-being in danger. You'll have the chance to start learning how to get off crack and restoring your health, relationships, and other major aspects of your life.
No matter how far down the road of addiction you've already traveled, it's never too late to go somewhere better. So make today the moment when you start taking your life back. Learn about your addiction, and find treatment and recovery options.
What Is Crack Made Of?
Crack is a smokable form of cocaine that has been processed with water and baking soda or ammonia. It can be made or "cooked" easily in a home kitchen. Once processed, it is typically called "rock" because it is crystallized and broken into small hard pieces. These crack rocks look like small chunks of soap but feel much harder and sharper (Cleveland Clinic, 2014). It comes in solid blocks or crystals varying in color from yellow to pale rose or white (Foundation for a Drug Free World, 2014). The name "crack" comes from the crackling sound made when it is smoked in pipes.
Crack appeared in the U.S. during the 1980s, primarily in larger cities like Los Angeles, New York, and Miami. Crack was not the first smokable form of cocaine available, but it was the first that even poor people could buy. Prior to that, cocaine was an expensive drug to use. When crack became available, the cocaine clientele expanded and changed dramatically. Rather than a high-end, "rich man's" drug, crack took cocaine to another population—becoming available and used in poor urban neighborhoods. In many poverty-stricken areas, crack became a product and business that dramatically changed the economy of those neighborhoods (Reinarman & H. Levine, 1997). Over the years, addiction to crack has crossed the lines of "all races, classes (and) income levels." Adults, teens, and even children have now been reported to use it.
What Is the Difference Between Crack and "Coke?"
The first thing to remember is that crack and "coke" are both cocaine. They are just different chemical formulations of the same drug. And, because they are formulated differently, they are also used differently. Crack cocaine, which comes in rock form, is usually smoked and inhaled. In contrast, "coke" (i.e., powdered cocaine) is usually snorted or injected.
The effects of a drug depend upon how it reaches the brain and what happens in the brain once it is there. The amount used and how it is used determine effects, too. How long it takes to feel the euphoria or "rush" depends upon how quickly the drug reaches the brain. Smoking and injecting cocaine, for example, both have rapid effects—more so than "sniffing" or "snorting" the drug through the nose. The "high" of smoked and IV (intravenous) injected cocaine is more intense than other methods in part because cocaine reaches the brain more quickly. The drug also builds up in the brain more quickly when it is smoked or injected into a vein (U.S. Department of Justice, n.d.).
Cocaine powder is the more pure and more expensive form of cocaine. It is typically used by "snorting" or "sniffing" through the nose or by injection. It can also be used to "freebase" (a different smoking method than crack). It can be rubbed on mucous membranes or combined with tobacco or cannabis. Cocaine powder does not reach the brain as quickly or as intensely as does crack cocaine.
When used nasally or "snorted," cocaine travels a longer route to the brain than crack does. Snorted cocaine powder enters the blood vessels in the nose, goes to the heart, and then goes to the lungs. In the lungs, it is combined with oxygen and then carried back to the heart. From the heart, snorted powder cocaine is then distributed throughout the body's organs, including the brain. This process takes about three to five minutes.
The effects of intravenous or IV injected cocaine occur rapidly—usually within 15-30 seconds. Injecting cocaine produces a "rush" in 15-30 seconds (Alcohol-Drug Education Services, 2014) that lasts about 30 minutes (Grabowski, 1994).
Because crack is smoked, it gets to the brain much more rapidly—typically within 10-15 seconds (Wallace, 2012). Its route to the brain is more direct than in other methods of use. Crack smoke is absorbed into the lungs, enters the bloodstream, and goes to the heart. From there, it goes directly to the brain (Edwards, 2014). Smoking produces an almost immediate and very intense experience that lasts only five to 10 minutes (Alcohol-Drug Education Services, 2014).
Since crack cocaine enters the brain rapidly and goes directly to the pleasure and reward centers of the brain, it is considered one of the most addictive drugs known today.
Whether a person becomes addicted or not when using a drug cannot be accurately predicted. There are two determining factors that are well-researched, however. These are how the drug works in the brain and how rewarding the drug use is. For instance, the faster an addictive drug reaches the brain, "the more likely it will be abused" (NIDA, 2019). So, how addictive is crack? Well, since crack cocaine enters the brain rapidly and goes directly to the pleasure and reward centers of the brain, it is considered one of the most addictive drugs known today (Wallace, 2012; Smith & Passik, 2008).
Crack addicts typically "binge"—using the drug for hours or even days. During these binges, they repeatedly use, building up higher and higher amounts in their systems (NIDA, 2019). This is followed by a "crash" in which the user feels depleted, depressed (Hanson, Venturelli, & Fleckenstein, 2014), and needs food and sleep. Cravings are said to be intense immediately after stopping and to intensify a few days later after the "crash." It is common to feel irritable, depressed, exhausted and restless, anxious and agitated during these times. Some experience intense paranoia or become totally out of touch with reality (NIDA, 2019).
The effects of crack intoxication are feelings of overwhelming euphoria and satisfaction along with increased energy. Also, there are feelings of improved self-esteem and confidence as well as feeling one's self to have more physical endurance, more social ease, and increased sexual abilities (Daigle, Clark, & Landry, 1988).
During intoxication, a crack addict (or even a first-time user) may also experience the following:
- Decreased appetite
- Increased blood pressure and heart rate
- Dilated pupils
- Constricted blood vessels
- Cold sweats
- Respiratory distress
- Muscular weakness
- Painful muscle contractions (dystonia)
- Involuntary muscle movements
- Bizarre, erratic, sometimes violent behavior
- Tactile hallucination that creates the illusion of bugs burrowing under the skin
- Depression (CESAR, 2014; Narconon, 2014; American Psychiatric Association, 2013)
Crack Cocaine Overdose
High doses of crack can cause many problems, including death. Overdose and sudden death, however, are possible with one-time use (CESAR, 2014). At toxic levels, people on crack can experience:
- Severe stomach pain
- Irregular heart beat
- Heart attack
- High body temperature
- Schizophrenia-like symptoms (i.e., hallucinations, paranoia, delusions)
- Death (McVay, 2004)
Consequences of Prolonged Use
The use of crack cocaine is illegal in the U.S., as is its manufacture, sale, and possession. Consequently, crack users are at risk for legal consequences. Financial consequences for users can also be quite severe, even catastrophic for some users and their families. It is not unusual for crack users to use until their money and supply of crack runs out during a binge.
Other longer-term effects for users are family disruption and child nonprotection problems that are common concerns in addiction of all types. There is also significant stigma attached to the use of crack cocaine that can affect users, recovering addicts, and their families.
Crack cocaine users are prone to more anger and violence than those who use other forms of cocaine.
Violence and Other Types of Criminal Crack Addiction Behavior
There is commonly a violent and criminal lifestyle surrounding the manufacture and sale of crack cocaine due to the amount of money involved in the drug trade and its illegal status. The manufacture and sale of crack cocaine has long been associated with pockets of organized crime and violence. Crack users themselves commit crimes in buying, possessing, and using crack. They also are often involved in other crimes to support their drug use such as facilitation of drug deals, theft, robbery, burglary, and prostitution. Users of crack also must "enter dangerous neighborhoods or agree to do risky things in order to obtain the substance. Crack addiction is a powerful motivator; many addicts are willing to do almost anything in exchange for some crack" (Coalition Against Drug Abuse, 2014).
Crack cocaine users are also prone to more anger and violence than those who use other forms of cocaine (Giannini, Miller, & Liselle, 1993). "Crack cocaine intensifies emotional experiences, including anger and rage. People who are high on crack are more likely to commit murder, commit suicide, or physically abuse their spouses or significant others" (Coalition Against Drug Abuse, 2014). This increased aggression appears related to the brain's fight or flight center being activated by cocaine (Morton, August 1999).
Long-Term Physical Effects
For a crack addict, symptoms of prolonged use can include many negative physical consequences. Some of these are:
- Coughing and coughing up blood
- Heart, liver and kidney problems
- Tooth decay
- Sexual dysfunction
- Infectious diseases
- Respiratory failure
- Mood problems (Foundation for a Drug Free World, 2014)
Long term use of crack can also result in movement disorders in which muscles move involuntarily. Symptoms can include rapid, jerking movements; tremors; the need to be in constant motion (pacing, rocking, swaying from one foot to the other, fidgeting) and restlessness (Daras, Koppel, & Atos-Radzion, April 1994).
That's why pursuing crack addiction treatment and recovery is so crucial. By getting professional help, an addict can learn how to stop crack cravings and start returning to good physical and mental health.
Why Is Crack So Addictive?
Crack is a central nervous system stimulant that dramatically alters brain chemistry (Woolverton & Johnson, 1992). It reaches all parts of the brain, but particularly acts upon the brain's reward center, increasing dopamine, a brain chemical that produces pleasurable feelings. Crack use eventually causes the brain to stop producing natural dopamine (Diana, Chiara, & Spano, 2014). When this happens, a person no longer feels normal pleasures, such as from eating or having sex; they are only able to feel pleasure if using cocaine. This change in brain chemistry also produces depression. Crack use can cause repetitive behaviors such as pacing, nail-biting, and scratching (NIDA, 2019). The urge to use crack becomes very intense because of such factors. Also, because the high is brief—causing pleasure to be brief—people with such symptoms want to use again and again in order to feel better (Mate, 2010).
So, is crack more addictive than "coke" (i.e., powdered cocaine)? That's a hard question to answer with real certainty. Trying to compare the addictiveness of different substances or formulations is inherently difficult. And, to date, there isn't much evidence to say for sure one way or the other. That's because each drug user's experience is highly individualized. Addiction is never automatic, not even for crack. That said, smoking crack does usually cause faster, shorter, and more intense highs. And that leads some users to fall into a pattern of repeat binges, which can make them more vulnerable to addiction.
Signs of Crack Addiction Withdrawal
The crash is the beginning of withdrawal. Some crack addiction symptoms that can be observed during withdrawal are:
- Decreased cravings
- Poor concentration
- Lethargy (Australian Government Department of Health, 2014)
Children exposed to cocaine in utero are more likely to experience cognitive deficits for as long as two years after birth than are children not exposed to the drug.
Pregnancy and Crack
Cocaine use during pregnancy causes significant risk to the unborn baby. Babies are exposed to the mother's cocaine use while in the womb because the drug crosses through the placenta. Some of the risks during pregnancy include:
- Premature birth
- Low birth weight
- Fetal stroke
- Detached placenta
Birth defects are also a significant risk. These include defects in the baby's:
- Intestinal tract
Children exposed to cocaine before birth may also develop problems later in life such as:
- Attention problems
- Problems processing information
- Problems in performing cognitive tasks (NIDA, 2014; University of Rochester Medical Center, 2014)
Children exposed to cocaine in utero are more likely to experience cognitive deficits for as long as two years after birth than are children not exposed to the drug (Singer, 2002).
Babies Born With Cocaine Addiction
Symptoms of cocaine withdrawal in full-term babies may include:
- Tremors (trembling)
- Irritability (excessive crying)
- Sleep problems
- High-pitched crying
- Tight muscle tone
- Poor feeding
- Seizures (U.S. National Library of Medicine, 2014; University of Rochester Medical Center, 2014)
Psychiatric Complications of Cocaine
Many psychological issues can occur with the use of crack cocaine. Some of these conditions can be dangerous for the addict or others. They include such issues as the inability to care for one's self, malnutrition, disorientation, aggression, thoughts of suicide, and psychosis. Some people require hospitalization for safety and the treatment of these conditions, along with treatment for the crack addiction. At times, these problems are severe. That's why it's frequently difficult for friends or loved ones to know how to deal with a crack addict they care about. Psychiatric treatment and medication, at least for a while, is often required to reduce the distress of these disorders and better increase the addict's chances of recovering from the addiction. Some of these conditions are:
- Cocaine Intoxication Delirium
- Cocaine-Induced Psychotic Disorder
- Cocaine-Induced Anxiety Disorder
- Cocaine-Induced Sexual Dysfunction
- Cocaine-Induced Sleep Disorder
- Cocaine-Induced Depressive Disorder
- Cocaine-Induced Neurocognitive Disorders (amnesia, dementia, and other conditions that indicate a decline in mental abilities and functioning) (American Psychiatric Association, 2013)
How to Tell If Someone Is Using Crack: Addiction Signs
Crack use becomes more apparent as time goes on. The signs and symptoms of someone on crack are obvious and devastating in prolonged use. A person's appearance declines significantly with poor hygiene and grooming. Overall health is poor, and there is frequently lost weight, even malnutrition. Prior to that, the most telling signs are changes in mood, behaviors, and lifestyle that occur with use.
Crack abuse typically causes mood swings, irritability, anger, suspiciousness, paranoia, anxiety, and depression.
Crack Addicts' Behavior
Behavior becomes erratic and intense when using or having cravings. There is typically restlessness, agitation, impulsive action, angry outbursts, and evasive behavior. Communication becomes vague and deceitful, even manipulative. Lying and stealing are common as addicts seek the means to support their use and to conceal it as well.
When crashing, crack addict behavior can include the appearance of being lethargic and slow, unmotivated, and disinterested. Addicts can become withdrawn and seem unable to enjoy anything. They may sleep excessively or not well at all. Their appetite for food goes from one extreme to the other.
Friends change as crack use continues. Non-using friends are discarded for those who use. Social and leisure activities once enjoyed are also discarded. There are commonly long periods of absence when using, including lost time with family obligations and work obligations. It is not uncommon for crack users to eventually become unemployed or to have performance problems at work. Illegal activity is not uncommon as a means to support their use.
Other Signs of a Crack Addict
The paraphernalia used to smoke crack includes glass or metal pipes. Other items are used with the pipe such as cigarette filters, metal foil, steel wool, or metal scrubbing pads for washing dishes to hold the crack in place and to filter it. Also, lighters or small powerful mini torches are used to heat the crack. You may also see small glass vials, small pieces of plastic, or the corners of baggies and other small containers for the drug. Improvised pipes can be made from soda cans, TV or car antennas, pens, or any hollow item that can simulate a pipe. Also, crack users may have burnt lips or fingers from using a pipe.
How to Help a Crack Addict
It is a heartbreaking situation for the loved ones of people who are addicted to crack. The tolls of this addiction are tragic and difficult to watch. Taking care of yourself is crucial. This may mean setting difficult limits to keep your loved one out of your daily life and to protect your mental and emotional health if the addict is not yet ready for treatment. Meanwhile, finding support in counseling or self-help groups from people who are trained in addiction treatment or who are dealing with the same issues can be very helpful. These help clarify your thoughts and feelings and can give you information about how to further proceed.
Be open, honest, and non-judgmental.
Educating yourself about crack addiction is invaluable. It prepares you to address the problem with your loved one and helps you to have a balanced and calmer approach if you do. Talk with treatment providers in your area about rehab options for your loved one, and ask for suggestions about how to help. Have the information on hand when you suggest treatment, and be prepared to help when you have the talk. Be open, honest, and non-judgmental. Express your love, concern for him or her, and talk about your support for treatment now and as long as it lasts. Offer your loved one any help he or she needs to go to rehab now. If your help is declined, decide what you need to do to take care of yourself and your life until your loved one is ready for help.
Alcohol-Drug Education Services. (2014). Drug Facts: Cocaine. Retrieved 2014, October 11 from Alcohol-Drug Education Services.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5. Arlington, VA: American Psychiatric Publishing.
Australian Government Department of Health. The cocaine withdrawal syndrome. Retrieved 2020, January 23 from Australian Government Department of Health.
CESAR. Crack Cocaine. Retrieved 2014, October 10 from CESAR (Center for Substance Abuse Research).
Cleveland Clinic. (2014). Cocaine and Crack. Retrieved from Drugs & Supplements.
Coalition Against Drug Abuse. Crack Abuse Signs, Symptoms and Addiction Treatment. Retrieved 2014, October 10 from Coalition Against Drug Abuse.
Daigle, R., Clark, W., & Landry, M. (1988). A primer on neurotransmitters and cocaine. Journal of Psychoactive Drugs, 20 (3), 283-295.
Daras, A., Koppel, B., & Atos-Radzion, E. (April 1994). Cocaine-induced choreoathetoid movements ("crack dancing"). Neurology., 44(4):751-2.
Diana, M., Chiara, G. D., & Spano, P. (2014). Progress in Brain Research: Dopamine. Amsterdam, The Netherlands: Elsevier.
Edwards, D. (2014). Facts About Cocaine. Retrieved from PsychCentral.
Foundation for a Drug Free World. (2014). The Truth About Cocaine. Retrieved from Foundation for a Drug Free World.
Giannini, A., Miller, N., & R.Liselle RH, e. a. (1993). Cocaine-associated violence and relationship to route of administration. Journal of Substance Abuse Treatment, 10: 67–69.
Grabowski, J. (1994). NIDA Research Monographs 50, Cocaine: Pharmacology, Effects, and Treatment of Abuse. Darby, PA: Diane Publishing Co.
Hanson, G., Venturelli, P., & Fleckenstein, A. (2014). Drugs and Society. Burlington, MA: Jones & Bartlett Learning.
Mate, G. (2010). In the Realm of Hungry Ghosts: Close Encounters with Addiction. Berkley, CA: North Atlantic Books.
McVay, D. (2004). Drug War Facts. Delray Beach, FL: Common Sense Publishing.
Morton, W. (August 1999). Cocaine and Psychiatric Symptoms. Journal of Clinical Psychiatry, 109-113.
Narconon. FAQ About Cocaine. Retrieved 2014, October 11 from Narconon.
NIDA. (2019). The Neurobiology of Drug Addiction. Retrieved 2020, March 2 from NIDA.
NIDA. Cocaine: What are the effects of maternal cocaine use?. Retrieved 2014, October 10 from NIDA.
Reinarman, C., & H. Levine, e. (1997). Crack in America: Demon Drugs and Social Justice. Berkley, CA: University of California Press.
Shaw, L. (2001). The Clinical Toxicology Laboratory: Contemporary Practice of Poisoning Evaluation. Washington, DC: American Association for Clinical Chemistry.
Singer, L. (2002). Mother's prenatal cocaine use is associated with poor fetal growth, developmental delay, learning disabilities, and lower IQ in her child. Journal of the American Medical Association, 287(15):1952-1960.
Smith, H., & Passik, S. (2008). Pain and Chemical Dependency. Oxford University Press.
U.S. National Library of Medicine. (2014, January 14). Neonatal Abstinence. Retrieved from MedlinePlus.
University of Rochester Medical Center. Neonatal Abstinence Syndrome. Retrieved 2014, October 9 from University of Rochester Medical Center.
U.S. Department of Justice. (n.d.). Drug Fact Sheet: Cocaine. Retrieved 2014, October 9 from DEA.
Wallace, B. (2012). Crack Cocaine: A Practical Treatment Approach For The Chemically Dependent. New York, NY: Routledge.
Woolverton, W., & Johnson, K. (May 1992). Neurobiology of cocaine abuse. Trends in Pharmacological Sciences, 13(5):193-200.