Crack is a shortened term for crack cocaine, which the Foundation for a Drug-Free World describes as the crystal form of the usually powdered illicit drug cocaine – an extremely addictive stimulant. It can be seen in different colors, such as white or yellow; it may also be seen in small, irregularly shaped blocks instead of crystals. Crack is the result of what is called freebasing – the powder form of cocaine is essentially transferred back to its rock form. Some street names that also refer to crack include base, hard ball, nuggets, and rock(s).
The United States Drug Enforcement Agency lists crack as a Schedule II drug, due to its high addictive potential. It has a high potential for abuse and is very rarely used medically. Its medical use was as a topical local anesthetic for the upper respiratory tract and to reduce bleeding in the mucus membranes in the nasal cavity, mouth, and throat.
The 2014 National Survey on Drug Use and Health estimated that 3.6 percent of individuals aged 12 and older who were interviewed reported they had used crack in their lifetime.
How Crack Is Used
Crack cocaine is most frequently smoked, either through a glass pipe or a water pipe, per the Center for Substance Abuse Research. This is done by heating the crystals, which causes a popping or cracking sound – hence the drug’s name. The drug can also be snorted or injected, but this is uncommon.
Smoking causes the drug to reach the brain faster, because the mucus membranes in the mouth and throat readily absorb the drug, causing immediate and intense effects that may only last 5-10 minutes, according to the National Institute on Drug Abuse. Because these effects are usually of short duration, some individuals binge by smoking repeatedly over a short period of time, increasing the dose as well. At times, crack can be combined with marijuana, heroin, or tobacco to create more intense effects, which can increase the chance of dangerous effects.
Effects on the Body
Since crack is the most potent form of cocaine – usually between 75-100 percent pure – it comes as no surprise that it is the most dangerous form of cocaine.
Crack works by causing a flood of dopamine – the neurotransmitter associated with pleasure – in the brain. Usually, dopamine is released when the brain is anticipating a reward, and afterward, it is transferred back to the cell that released it. This depletes the supply of dopamine and essentially turns off the reward center. When crack is used, dopamine cannot be transferred back to the cell that it was released from, causing the buildup. Repeated use of crack can cause a change in the reward system, which causes addiction, and individuals may not be able to feel pleasure unless they are under the influence of crack.
When the effects of crack begin to wear off, individuals may experience a crash, which can include depression, exhaustion, and cravings for the drug.
Crack also increases the chances that an individual will experience a stroke, heart attack, seizure, or respiratory failure. The amount of the drug used and how frequently it is used has no effect on this increase.
In the long-term, crack can cause many severe health problems, such as damage to the heart, liver, kidneys, and lungs. Individuals may experience respiratory difficulties, such as coughing and shortness of breath, and more infectious diseases.
NIDA states that individuals who use crack are also at risk for infectious blood-borne diseases, such as HIV/AIDS and hepatitis, even if they do not inject the drug, as crack can impair judgment and cause them to engage in unprotected sex.
Sadly, some women use crack during pregnancy, which can cause problems at any stage. In early pregnancy, the use of crack can lead to miscarriage; its use can also cause brain damage, stroke, and heart attack in the unborn child. According to NIDA, while the effects of cocaine on an unborn child may not be completely known, it is thought to cause low birth weight, smaller head circumference, and shorter length when compared to babies born to mothers who do not use crack.
Since crack is so readily absorbed, levels of the drug in the bloodstream can build rapidly, leading to accidental overdose. Overdose can also occur when individuals begin to binge on the drug. Some of the signs of an overdose may appear to be similar to the effects of crack, but they are much more serious. They can include:
- Cold sweats
- Excessive tremors
- Fainting or loss of consciousness
- Narrowed pupils
- Severe headache
- Slow or absent heart rate
- Shallow or absent breathing
If it is suspected that an individual has overdosed on crack, it is critical that emergency services be contacted immediately, so the individual can receive the appropriate medical care. This will give the individual the best chance of survival.
Crack Addiction and Dependence
Addiction generally happens quickly when crack is smoked, partly due to the fact that the duration of effects is so short. Also, crack cravings are said to be the strongest of any drug, which can attribute to individuals becoming addicted. For this reason, it is said that individuals can actually become addicted the first time they use crack cocaine. Individuals who have developed an addiction to crack may exhibit the following signs:
- Failure to meet responsibilities
- Withdrawal symptoms
- Continuing use, even if use may worsen a physical or mental illness
- Continuing use, even if it causes harm to self or others
- Deterioration in relationships
- Devoting more and more time to obtaining crack, using it, and recovering from its use
- Financial and/or legal problems
- Loss of interest in hobbies or other activities
- Lack of participation in social activities
In 2014, NSDUH determined that 8.5 percent of the population of the United States – or 22.5 million people – needed treatment for addiction to an illicit drug, including crack. Unfortunately, only 18.5 percent – or 4.2 million – were able to obtain the help they needed.
Medical detox is an essential step for individuals who are addicted to crack. This natural process involves around-the-clock medical supervision, so clients are kept safe and comfortable. Individuals may be prescribed medications during the medical detox process to alleviate some of the withdrawal symptoms experienced.
Currently, there are no medications approved by the United States Food and Drug Administration to treat crack addiction. NIDA states that there are several medications undergoing testing to determine if they will be beneficial for treating crack addiction in the future.
The most important part of any treatment plan is behavioral therapy. Certain types of therapy are recommended for individuals who are on the path of recovering from an addiction to crack. These therapies include Cognitive Behavioral Therapy (CBT), Contingency Management/motivational incentives, and 12-Step groups.
Cognitive Behavioral Therapy (CBT) is the most well-known therapy that is used for treatment of any drug addiction, including crack addiction. CBT helps individuals identify and change any thoughts and behaviors that are related to their drug use. They also learn how to recognize any situations that will put them at a high risk for using crack, so they may avoid these situations as much as possible.
Contingency Management (CM) is often very beneficial to those who wish to stop using crack, as it provides incentives for attending therapy sessions or negative drug tests. Such incentives can be vouchers or rewards. With a voucher system, individuals will be given vouchers of monetary value that may increase as they progress through treatment. They will be able to trade these vouchers for items that promote a healthy, drug-free lifestyle, such as membership to a local gym.
In addition to CBT and CM, various other types of therapies may be incorporated into a person’s individual treatment plan. Upon admission, treatment professionals will assess the individual and determine the best course of care for that person.
Cocaine Anonymous is a 12-Step self-help group for individuals wishing to stop using not only cocaine, but crack as well. Individuals can be paired with a sponsor – another group member with a longer history in recovery. This type of group can help individuals both seek and provide support, which may assist them in maintaining sobriety. Oftentimes, regular participation in 12-Step meetings is a critical part of sustained recovery.
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