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Crack Abuse, Addiction, And Treatment Options

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

March 18, 2019

Crack cocaine abuse can lead to addiction and overdose, along with various other dangers. Crack addiction treatment programs can help individuals quit use of crack, manage cravings, and change their lifestyle for a lasting recovery.

Crack cocaine is a popular drug of abuse in the United States. Research shows that cocaine abuse has neither declined nor increased in the past few decades, with the highest rates of use among 18- to 25-year-olds.

Crack abuse can lead to addiction, overdose, and other dangerous consequences. Treatment for crack abuse can help individuals quit use of crack cocaine, manage symptoms like cravings, and alter their lifestyle to support recovery.

What Is Crack?

Crack is a solid, crystal form of the illicit drug, cocaine. So-called for the crackling noise it makes when abused, crack is a type of cocaine that is smoked.

Like other forms of cocaine, crack is a stimulant, meaning it leads to side effects like euphoria and increased energy and alertness. Crack is also called freebase cocaine.

How Do People Abuse Crack?

Crack is first heated to produce vapors, which are then inhaled (smoked). Crack may also be added to marijuana and smoked. In fact, many people mix crack cocaine with various other drugs, including alcohol, opioids like heroin, and more.

When mixed with central nervous system depressants, like alcohol and opioids, the combination is known as a speedball, a dangerous substance mix with compounded effects.

Reasons People Abuse Crack

Crack is abused largely for its most common side effects: euphoria (increased happiness) and increased energy and alertness.

People may also abuse crack specifically because it produces a quicker high than other forms of cocaine. Smoking any substance always produces quicker results.

Those who engage in polydrug abuse, or take two or more substances at a time, may abuse crack to enhance or counteract the effects of another drug.

Mixing crack with other stimulants, like amphetamines or methamphetamine, can enhance the effects of each. Mixing crack with other depressants can mask the effects of each substance.

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Signs And Symptoms Of Crack Abuse

The most common signs of crack abuse include side effects of the drug, like random bouts of happiness and being more energetic. Other side effects may also signal abuse.

Signs and symptoms of crack abuse include:

  • a burst of energy (immediately after use)
  • euphoria (immediately after use)
  • an enhanced focus right away
  • dilated pupils
  • feeling of restlessness
  • frequent nose bleeds
  • insomnia
  • lack of appetite
  • muscle twitches
  • increased breathing and heart rates

Individuals may also experience hallucinations, such as a crawling feeling on the skin (“coke bugs”). They may become psychotic with high doses, or become aggressive or violent.

Because crack is smoked, they may also have cracked lips or burned fingertips from smoking with a pipe.

How Crack Abuse Leads To Addiction

Crack cocaine use works to increase levels of the chemical messenger, dopamine. This affects the natural communication pathways in the brain responsible for pleasure and reward.

Repeated abuse of crack means a person’s dopamine levels are continually increased and disrupted. With time, this teaches the brain to rely on crack to produce dopamine, a brain chemical partly responsible for feelings of happiness.

This reliance becomes an addiction, characterized by an obsessive need to seek and use crack cocaine. Once addicted, a person becomes preoccupied with finding and using the drug, despite consequences and risk.

Effects Of Crack Abuse

Crack abuse results in many adverse side effects. Side effects of crack abuse can display in behavioral, emotional, psychological, and physical ways.

Short-term effects may depend on the amount of cocaine a person abuses. While some people find that crack cocaine may help them be more focused and alert, abusing crack in frequent, consecutive (one after the other) doses can lead to dangerous and unpredictable effects.

Short-Term Side Effects Of Crack Abuse

  • extreme feelings of happiness
  • greatly increased energy
  • enhanced focus and alertness
  • a hypersensitivity to sight, touch, and sound
  • irritability
  • paranoia, especially in high and frequent doses

Long-term effects of crack abuse may impact a person’s health, behavior, and lifestyle. Crack abuse can lead to psychosis, which can result in unpredictable, violent, and aggressive behavior. Other long-term side effects may result in dangerous consequences.

Long-Term Side Effects Of Crack Abuse

  • effects from smoking: asthma, chronic cough, respiratory distress, and high risk of developing infections like pneumonia
  • strain on the heart due to continually having an increased heart rate
  • heart failure/cardiac arrest due to frequent, too-high doses of crack, leading to the body’s inability to regulate heart rate
  • malnourishment, due to long-term suppressed appetite
  • severe paranoia, which can lead to unpredictable and even dangerous behavior
  • loss of touch with reality due to extreme hallucinations

Dangers Of Crack Abuse

Perhaps one of the greatest dangers of crack cocaine abuse is that it can lead to an addiction. Addiction is a brain disorder which leads to vast impacts on a person’s health, behavior, and life.

Long-term crack abuse can lead to consequences for heart health, including straining of the heart muscles, irregular heartbeat, and cardiac arrest.

Crack cocaine abuse can also lead to overdose, which can be fatal in certain cases, such as when mixed with other, potent drugs of abuse.

Crack is an illicit drug, so each time a person buys it in cocaine form, they are risking taking a drug that is laced with other, possibly harmful substances, like fentanyl. Fentanyl is a highly potent opioid drug.

If smoked with crack, fentanyl would go straight to a person’s bloodstream and can have fatal results.

Mixing Crack And Other Drugs

When abusing crack with another stimulant, like prescription amphetamines, the mixture can have combined effects, like even higher energy levels.

Combining crack with depressants often results in each drug masking the effects of the other. This is particularly dangerous, as those abusing crack with depressants like alcohol or heroin may not feel the effects of each drug as readily due to this masking effect.

They may then keep abusing both substances, which increases risk of dangerous side effects, including overdose.
Side effects from mixing crack cocaine and other drugs will vary according to how much crack was abused, how often, and which drug crack was combined with.

Regardless of which substance, chances of overdose increase greatly when mixing crack with other drugs.

Risk Of Crack Overdose

It is dangerous to abuse crack long-term, but especially when mixing it with other potent drugs, especially alcohol, heroin, or other opioids. Risk of overdose is very high for these speedball combinations.

The following are signs of crack overdose:

  • agitation
  • extreme anxiety or aggression
  • increased breathing and heart rates
  • hallucinations
  • high blood pressure
  • high body temperature
  • trouble breathing

Crack overdose can lead to heart attack, seizures, stroke, or, in some cases when mixed with potent substances, death.

Crack Addiction Treatment Programs

Crack cocaine affects a person’s natural feel-good chemical production. Treatment for crack addiction works to help individuals retrain their brain to produce these chemicals on their own.

This is often largely achieved through rehab programs with strong behavioral therapy and counseling components. Essentially, individuals must learn to stop cocaine use, manage cravings for cocaine, and replace drug-seeking and drug-use behaviors with other activities.

Residential rehab programs can help those addicted to crack by immersing them in a supportive treatment environment. Here, those struggling with crack cocaine can detoxify their bodies, access 24-hour medical help, and engage in therapy, counseling, and support groups daily.

Other intensive programs, such as intensive outpatient and partial hospitalization programs, can also help those addicted to crack, depending on the severity of their abuse and their commitment to recovery.

Many forms of aftercare are also available to help crack-addicted individuals stay strong in recovery, including:

  • 12-step support groups
  • rehab program alumni networks
  • individual counseling
  • sobriety sponsors

The right rehab program exists for all those struggling with crack cocaine or other co-occurring substance use disorders. Finding a program that works for each individual is as simple as speaking to a treatment specialist to learn more about treatment options.

Center for Substance Abuse Research - Crack Cocaine

National Institute on Drug Abuse - What Is Cocaine?

U.S. Department of Justice - Crack Cocaine Fast Facts

U.S. Drug Enforcement Administration - Cocaine laced with fentanyl leads to multiple deaths, overdoses

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