Crack Addiction: Signs, Symptoms, Risks, and Treatment Resources
Crack cocaine is a potent stimulant drug that often leads to dangerous and even fatal consequences. Because of its intense and short-lived euphoria, people who use crack tend to use it repeatedly to recapture that feeling — leading to abuse and dependence.
If you suspect a loved one is using crack, there are important signs and symptoms to look out for. Though crack addiction is a deadly problem, it can be treated effectively.
What Is Crack?
Crack is derived from powdered cocaine that is dissolved in baking soda and boiled until it becomes solid. About 6.2 million people in the United States have used crack at least once.[1] It is a Schedule II drug, and it is often used illegally for recreational purposes.[2] Street names for crack include white ball, base, and fat bags.
Side Effects of Crack
Stimulants like crack directly affect the heart and often cause hypertension (high blood pressure) and tachycardia (high heart rate).[3] These effects are sometimes severe enough to cause heart attacks, strokes, or death. Other common effects include paranoia, increased alertness, and psychotic symptoms.
How is Crack Taken?
The most popular method of administration for crack cocaine is smoking, which causes instant, intense euphoria. Some may also dissolve the drug and inject it or crush and snort it, which brings additional risks.[4]
Crack Quick Reference
Drug Category
Stimulant
Commercial & Street Names
White ball, fat bags, base
DEA Schedule
Schedule II
Administration
Smoking, snorting, injecting
Effects of Crack Abuse
Crack targets the brain’s reward pathway and causes intense euphoria that fades within a few minutes to an hour. Small amounts usually cause feelings of happiness, invincibility, alertness, and hypersensitivity to sights, sounds, and touch.[6] Some users may experience behavioral changes, however, such as increased violent behavior or irritability. Others may engage in risk-taking behaviors.
Can You Overdose on Crack?
Taking too much crack or mixing it with other substances can cause a potentially fatal overdose.[7] The heart rate rises, which can lead to heart attack or stroke. Seizures, delirium, and hypoxia, or lack of oxygen, can also occur.
Signs and Symptoms of Crack Overdose
It’s important to recognize the signs of a crack overdose to get prompt medical treatment. The signs of a crack overdose can include:
- Elevated heart rate (tachycardia)
- Rise in body temperature (hyperthermia)
- Nausea and vomiting
- Seizures
- Delirium
- Paranoia
- Chest pain
- Tremors[8]
What to Do If You Suspect Someone Is Overdosing on Crack
If you suspect a crack overdose, it’s crucial to call 911 immediately. Wait for emergency medical services to arrive and administer treatment. You can use cold compresses to lower the person’s body temperature. If the person begins seizing, don’t hold them down. Instead, move objects out of the way to avoid injury.
Dangers of Long-Term Crack Use
With repeated use, crack cocaine causes changes in the brain that make it less sensitive to natural sources of pleasure, such as food or sex, while increasing the sensitivity to stress.[9] This creates a one-track fixation on getting and using crack. Some of these effects are reversible with treatment and abstinence.
Crack also damages other organ systems in the body, including the gastrointestinal tract. Some of the most toxic effects are on the cardiovascular system, however.[10] Heart attacks, strokes, and aortic ruptures are common in people who use crack long term.
Statistics on Crack Use, Misuse, and Addiction
According to the 2021 National Survey on Drug Use and Health, about 4.8 million people reported cocaine use in the past 12 months.[5] Crack is a popular alternative to powdered cocaine because it is cheaper, less refined, and e
Crack Addiction and Abuse
Regular use of crack can cause tolerance, which means you need to take higher doses to get the same effects.[11] More and more time, money, and energy is spent trying to get and use crack, leading to disruptions in work, school, and home life and eventual addiction.
Signs of Addiction to Crack
Crack cocaine addiction is a stimulant use disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The symptoms include:[12]
- Using crack more frequently, for longer periods, or in higher amounts than intended
- Trying to reduce or stop using crack without success
- Spending a lot of time sourcing, using, or recovering from crack use
- Experiencing strong cravings for crack
- Having problems in daily life due to crack use
- Continuing to use crack despite issues at work, school, or home
- Using crack despite physical or mental health effects
- Developing a tolerance for crack
- Experiencing withdrawal symptoms from stopping or reducing crack use
Crack Addiction and Mental Health
Substance use disorders often co-occur with mental health disorders, with both influencing each other. This is known as co-occurring disorders. Typically, substance use disorders like stimulant use disorder co-occur with:[13]
- Anxiety
- Depression
- Bipolar disorder
- Impulse control disorder
- Drug-induced psychosis
Crack Addiction Treatment
Though crack addiction can be deadly, treatment is available. Treatment involves breaking the physiological hold crack has over the body and treating the underlying issues that contribute to the addiction. Comprehensive addiction treatment programs involve different levels of care and therapies according to your individual needs.
Crack Addiction Treatment Levels of Care
There are different levels of care for crack addiction, but it often begins with medical detoxification, or detox. While stimulant withdrawal is not often life-threatening on its own, crack withdrawal can be extremely uncomfortable and increases the risk of relapse. Detox provides a safe, secure space with a full medical staff to keep you as comfortable as possible while the drug clears your system.
After detox, you may enter an inpatient or residential treatment program. This is a 24/7 treatment program that involves staying in a hospital or residential facility with other residents and medical staff to support recovery. Inpatient care is ideal for people who need intensive treatment and a structured program or lack a stable home environment.
Outpatient treatment is another option for people who need more flexibility to balance their addiction treatment with the responsibilities of daily life. You will attend treatment sessions during the day before returning home in the evening to spend time with family and sleep in your own bed.
Therapies Used in Crack Addiction Treatment
All levels of care involve a personalized combination of therapies to address the underlying causes of addiction.
Behavioral therapies, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), contingency management, and motivational interviewing, are among the most effective therapies for crack cocaine addiction.[14] These therapies focus on identifying unhelpful thoughts and behaviors and replacing them with healthier ones, inspiring self-motivating, and incentivizing abstinence.
Typically, behavioral therapies are combined with more traditional therapies like Twelve-Step Facilitation, individual therapy, and group therapy, depending on your specific needs.
Co-Occurring Disorders
Co-occurring disorders can be especially challenging to treat due to the effects that both conditions have on each other. Both conditions must be treated concurrently to not only treat the individual disorders themselves but the ways they contribute to thoughts and behaviors.
Treatment for co-occurring disorders is available at every level of care and involves many of the same behavioral therapies, including DBT, CBT, motivational interviewing, and contingency management. Like treatment for substance use disorder on its own, these therapies are combined with other traditional therapies in a personalized care plan.
Common co-occurring disorders with crack addiction include:
- Anxiety
- Depression
- Borderline personality disorder
- Impulse control disorder
- Drug-induced psychosis
Crack Detox and Withdrawal Management
Crack withdrawal isn’t usually life threatening, but it can be extremely unpleasant.[15] You may experience extreme fatigue, depression, anxiety, paranoia, slowed movements, and intense cravings that can encourage relapse.
Medical detox can help with the extreme symptoms of withdrawal. You will be supervised by a medical team to keep you as comfortable as possible. There’s no drug specifically used for cocaine withdrawal, but medications may be used to manage symptoms like nausea or insomnia.
Frequently Asked Questions
Where Does Crack Come From?
Crack is derived from powdered cocaine, which is dissolved and boiled until it becomes a solid. It’s then broken up into crystals, “rocks,” that can be smoked.
Why Do People Use Crack?
Crack is cheaper and easier to produce and creates an intense high, leading to its popularity. People may use crack recreationally to “feel good” or to escape unpleasant thoughts, emotions, or experiences.
What Are Crack Withdrawal Symptoms?
Crack withdrawal may cause depression, anxiety, paranoia, fatigue, intense cravings, poor concentration, and increased appetite.
What is crack cocaine? what does it look like? what are the risks? (n.d.-g). Retrieved from https://www.justice.gov/archive/ndic/pubs3/3978/3978p.pdf on 2023, July 5.
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Lankenau, S. E., Clatts, M. C., Goldsamt, L. A., & Welle, D. L. (2004). Crack cocaine injection practices and HIV risk: Findings from New York and Bridgeport. Journal of drug issues. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2136406/ on 2023, July 5.
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Richards JR, Le JK. Cocaine Toxicity. [Updated 2022 Oct 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430976/ on 2023, July 5.
Richards JR, Le JK. Cocaine Toxicity. [Updated 2022 Oct 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430976/ on 2023, July 5.
U.S. Department of Health and Human Services. (2021b, July 9). What are the long-term effects of cocaine use?. National Institutes of Health. Retrieved from https://nida.nih.gov/publications/research-reports/cocaine/what-are-long-term-effects-cocaine-use on 2023, July 5.
U.S. Department of Health and Human Services. (2021b, July 9). What are the long-term effects of cocaine use?. National Institutes of Health. Retrieved from https://nida.nih.gov/publications/research-reports/cocaine/what-are-long-term-effects-cocaine-use on 2023, July 5.
American Psychological Association. (n.d.). Substance use, abuse, and addiction. American Psychological Association. Retrieved from https://www.apa.org/topics/substance-use-abuse-addiction on 2023, July 5.
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Co-occurring disorders and other health conditions. SAMHSA. (n.d.-a). Retrieved from https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/co-occurring-disorders on 2023, July 5.
U.S. Department of Health and Human Services. (2020, June 11). How is cocaine addiction treated?. National Institutes of Health. Retrieved from https://nida.nih.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers on 2023, July 5.
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