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Immediate Access for help and advice

Crack Cocaine Addiction Explained

Cocaine has been used and abused since the 19th century, but in the 1980s a new extremely potent form of the drug, known as crack, began to appear on the streets, first in cities in the United States and then around the world. Since then, crack cocaine has established itself as one of the most addictive and problematic drugs available. Crack addiction has become a profound social malaise, affecting countless people around the world and costing UK taxpayers tens of millions of pounds each year.

What Is Crack Cocaine?

Crack cocaine is a smokable form of cocaine, a stimulant derived from the leaves of the coca plant. Whereas cocaine is typically found in powder form, crack cocaine comes in white or off-white “rocks”, with a density ranging from slightly more solid than candle wax to a hard, brittle plastic. Smoking crack – usually through a pipe – creates an intense euphoric “high” that is, however, comparatively short-lived. This often compels users to engage in further crack consumption only minutes after the last dose in order to repeat and/or sustain the experience.

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Crack is commonly described as “the most addictive form of cocaine”. However, experts disagree as to whether the crack form of cocaine does genuinely increase the likelihood of dependence developing or if it is simply that the short-lived nature of the crack high that drives users to consume more of the drug that they would if it were in another form. The rapid rate at which crack can be consumed means that addicts often spend hundreds of pounds a day on the drug. [1]

In the UK, crack is not differentiated from “normal” cocaine in terms of its legal status: both are class-A controlled substances. Penalties potentially reach seven years imprisonment and an unlimited fine for possession, and life imprisonment and an unlimited fine for supply.

Crack cocaine chemical structure

Cocaine has the chemical formula C17H21NO4. Crack cocaine is simply a free base version of cocaine. This means that the cocaine alkaloid is “freed” chemically from the hydrochloride salt to which it was formerly bound in cocaine hydrochloride, the usual form of the drug. [2]

Nicknames/street names for crack

Crack is sold under a huge variety of street names in the UK, including (but not limited to):

  • candy
  • cookies
  • jelly beans
  • nuggets
  • piece
  • rocks
  • dice
  • gravel
  • white
  • W
  • wash
  • pebbles
  • cloud

It is important to note that street slang associated with any substance of abuse evolves very rapidly and is highly localised. It may be that certain terms for crack cocaine are used in your area that are not recognisable in other parts of the country and vice versa.

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Methods of use

Crack cocaine is specifically designed to be a smokable form of the drug and is usually smoked in specially purposed pipes (“crackpipes”) or other smoking paraphernalia. It can be smoked in cigarettes. Crack can also be dissolved in an acidic solution to be injected, but this simply reverses the process by which cocaine is transformed into crack cocaine, and is a somewhat labour-intensive means of obtaining injectable cocaine.

History of crack cocaine

The history of crack began in the late 1970s when a glut of cocaine on the US market caused prices to drop by up to 80% in many major markets. This left suppliers searching for ways in which to increase the rate of cocaine consumption amongst users, and thus boost profits back up towards desired levels.

Their solution was crack cocaine, a smokable version of cocaine which, despite being made available at a lower cost than traditional cocaine, proved incredibly profitable thanks to the huge demand it immediately created amongst users.

Crack first appeared in the USA in 1981 and very rapidly penetrated urban centres across the country. Partly because of its affordability, crack became associated very early on with more disadvantaged neighbourhoods and users from lower socio-economic backgrounds. From the start of what became known as the “crack epidemic”, there was a pronounced racial element to the public perception of crack use, with it being considered a predominantly “black” drug thanks to the overrepresentation of African-Americans in poorer neighbourhoods. However, this did not, of course, mean that crack did not also find many takers within other ethnic groups.

Crack first reached the UK in the mid-to-late 1980s and spread out across the country almost as rapidly as it had permeated the United States. [2] There, crack had already become the subject of an intense media frenzy, and politicians had reacted by creating a draconian legal framework governing the treatment of crack usage. There, a mandatory minimum sentence of five years without parole was established for the possession of 5g of crack cocaine, a sentence applied to the possession of 500g of cocaine powder.In Britain, crack became just as demonised as it had been in America. However, despite an intense media campaign,
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crack usage in the UK has never reached the same proportions as it has across the Atlantic. Though that is not to say that it has not caused very significant problems, especially in the more deprived areas of big cities. In 2016, 66,208 “problem users” of crack cocaine were identified as being in treatment in England. UK crack use appears to have peaked in 2008/09, with 3% of 16-to-59-year-olds surveyed saying they use crack in the last year, down to 2.4% by 2015/16. [4]

What Is the Difference between Crack Cocaine and Cocaine?

Crack is a form of cocaine, and the active ingredient in both forms of the drug is the same. The main differences between crack cocaine and traditional forms of cocaine are in appearance, means of administration, and in intensity and duration of effect. Crack comes in relatively solid “rocks” which are smoked to produce a high. Powdered cocaine can also be smoked, but with much less efficacy, and is more commonly insufflated (snorted), injected or rubbed onto the gums.[5]

When smoked, crack cocaine takes effect nearly instantaneously, producing an intense euphoric high which lasts only between 10 to 15 minutes. The effects of traditional cocaine take somewhatlonger to manifest when snorted and are significantly less intense, lasting anywhere between half an hour and a couple of hours.

In some jurisdictions, most notably the USA, crack cocaine and traditional cocaine are also differentiated legislatively. In the UK, however, they are treated identically as class-A controlled substances.

Addiction to Crack Cocaine

Addiction is fundamentally a disorder of the brain’s reward centres. The regular engagement in rewarding behaviour can cause an adjustment to the reward system which drives repeated engagement in that behaviour neurochemically. For example, this happens by increasing the levels of chemicals such as dopamine, associated with pleasure and motivation when the behaviour in question is repeated. The levels are decreased, causing negative sensations and emotions, when it is not. [9]

Why is crack cocaine so highly addictive?

Because smoking crack can be intensely pleasurable, the experience of its effects can prove extremely desirable. Users may feel compelled to repeat that experience that compulsion may manifest very quickly after the effects subside. Moreover, the short-lived action of crack cocaine means that the near-instantaneous “flood” of dopamine which it creates rapidly disappears, causing a “crash” in mood which can be unpleasant and can leave users craving more of the drug to stave it off.

Is crack cocaine instantly addictive?

At the height of the media frenzy surrounding crack cocaine in the 1980s and ‘90s, many reports claim that only one or two instances of smoking crack could leave users hopelessly addicted. This is not true: crack cocaine is not “instantly addictive”. However, the euphoria which it creates can be so powerful and pleasurable that some users have described it as a life-changing experience, and can leave even first-time users wanting to repeat it immediately. This compulsion to repeat crack consumption can make it much more likely that individual users will engage in such frequent crack abuse over time that addiction is effectively unavoidable.

Is crack cocaine physically or mentally addictive?

Like other forms of cocaine, crack is not considered to be particularly physically addictive. That is, it has a low physical dependence liability; the symptoms of withdrawal are very psychological in nature. However, it is possible that physical dependence may have developed in certain cases.

The debate is ongoing in medical and psychiatric circles as to whether or not crack is fundamentally more addictive than traditional forms of cocaine. Some experts believe that there is a basic difference between crack and cocaine powder in terms of its addiction liability. Others assert that it is merely the short-lived nature of crack’s effects, and the rapid compulsion to use again is what gives crack the appearance of being more addictive. According to the latter, when not experiencing the effects of crack, users are no more compelled to engage in substance abuse than are users of powdered cocaine.

The difference between crack abuse and addiction

Crack abuse and crack addiction are not synonymous. Crack abuse refers to the use of crack in ways which have a detrimental impact upon a user’s health and wellbeing, and those of others. It is possible to engage in crack abusewithout being addicted to crack. For example, bingeing on crack in a manner which causes damage to one’s health.

Why Do People Use Crack Cocaine?

There is an infinite number of possible reasons why someone may engage in recreational crack use. Each individual is unique and hugely psychologically complex; the circumstances in which they find themselves are also unique to them.
Some reasons why people may use crack cocaine either initially or on a regular basis include:

  • simple pleasure seeking
  • rebellion against familial or social structures and norms
  • as a means of self-medicating or escaping from mental health issues
  • dealing with trauma
  • as a means of escaping feelings of shame, despair or other negative emotions
  • as an aphrodisiac
  • to alleviate boredom
  • out of curiosity
  • as a means of fitting in with a peer group
  • because other more familiar forms of substance abuse are not available
  • because they are intoxicated by other substances and are experiencing disinhibition
  • because they are forced to by controlling partners or other individuals with power over them
  • because crack abuse may be the norm in their household
  • because they have been given it unawares in other smokable drugs
  • because they are addicted to crack

Crack cocaine dependence

Dependence is a phenomenon whereby the system of someone consuming a substance regularly over time becomes reliant upon the presence of that substance in order to function normally. Withdrawal symptoms may manifest when the substance becomes suddenly absent (is withdrawn) from the system. “Dependence” is frequently taken to mean physical dependence, i.e. the affected individual becomes physiologically reliant upon the substance. When this happens, physical withdrawal symptomsare likely to present.However, psychological dependence may also develop. This is when the individual in question becomes psychologically reliant upon the repeated experience of consuming a substance and experiencing its effects; psychological symptoms can manifest in instances of withdrawal.

Crack cocaine is not usually considered to have a high physical dependence liability. However, users can become profoundly psychologically dependent, with the quest to repeat the experience of the crack cocaine high coming to dominate their daily lives at huge and potentially devastating expense.

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Crack Cocaine Effects

Upon smoking crack, users will almost immediately feel an intensely euphoric and pleasurable high, typically accompanied by feelings of extreme alertness, confidence, hyperactivity and excitability and, often, by an upsurge in sexual desire. This may last between five and fifteen minutes, after which the sensation will very rapidly dissipate, typically leaving users feeling intense cravings for more to repeat the experience and to stave off the resultant mood crash.

In the short term, the physiological effects of smoking crack include increased heart rate, temperature and blood pressure, constricted blood vessels and dilated pupils. In some cases, sudden death from cardiac arrest, seizures or respiratory arrest can result even on the first instance of crack use.

Longer-term crack use can lead to an array of potentially significant physical and mental health issues including respiratory and cardiovascular problems, damage to organs including the liver, psychosis and delusional parasitosis, as well as to addiction. There are also concerns that smoking crack whilst pregnant or breastfeeding can damage a foetus or infant, though the precise nature and severity of the danger is not particularly well-established.

Stages of Crack Cocaine Addiction

There is no universal roadmap for addiction, and every addict’s experience is unique. Nevertheless, certain key stages may be identified through which an addict may pass during their addiction journey.

Initial exposure: first coming into contact with, consuming, and experiencing the effects of crack cocaine (including the subsequent crash and desire for more). This first episode of crack consumption may include only one instance, or several successively.

Familiarisation: becoming familiar with crack as a drug, including recognising its effects and aspects such as taste and smell, as further instances of consumption follow; beginning to develop a desire to consume the drug regularly.

Habituation: incorporating crack consumption (as well as procuring crack) as a regular, possibly daily, facet of life; experiencing increasingly strong cravings and beginning to prioritise crack use above other parts of life.

Addiction: being unable to stop smoking crack and experiencing significant symptoms of withdrawal when unable to procure it; prioritising crack consumption at the expense of all other aspects of life; continuing to smoke crack regardless of the negative effects it may have upon health and life circumstances.

Signs and Symptoms of a Crack Cocaine Addiction

It is often difficult to recognise an addiction, even someone very close to you, because addicts often go to great lengths to keep their condition secret. The stigma associated with addiction (especially to crack, often considered a “dirty” and “poor” drug) can be extreme. Significant reputational damage can result from the revelation that an individual is addicted to crack. They may engage in deceitful and/or furtive behaviour in order to conceal their activities, and some addicts are able to compartmentalise their lives to the extent that little or no evidence of their condition spills over into other aspects of their existence.

Nevertheless, a number of signs may indicate the presence of addiction (though it is important to recognise that there may also be other causes, many potentially harmless, of some of these symptoms which may be entirely unrelated to substance abuse and addiction).

Physical symptoms

Some of the more noticeable physical symptoms of crack cocaine abuse and addiction might include:

  • red eyes
  • frequent sweating
  • burns on fingers or lips
  • accelerated and/or exaggerated breathing
  • dilated pupils
  • muscle spasms and tics
  • visible arousal
  • frequent coughing
  • nausea
  • the manifestation of respiratory and/or cardiovascular disorders
  • loss of consciousness
  • seizures

Psychological/behavioural symptoms

Some prominent psychological and/or behavioural signs of crack abuse and addiction include:

  • visible euphoria
  • difficulty maintaining concentration
  • egomania/inflated sense of self-worth
  • aggression
  • hypersexuality and other changes to sex drive and sexual preferences
  • restlessness
  • mood swings
  • hallucinations
  • delusions
  • an obsessive desire to procure and smoke crack
  • altered sleeping and eating patterns
  • secrecy and deceitful and furtive behaviour
  • changes in vocabulary
  • frequent requests to borrow money
  • a loss of interest in previously valued activities
  • impaired performance in work or academia
  • loss of important relationships
  • isolation
  • self-harm
  • lack of care in appearance and hygiene
  • engagement in criminal activity

How crack cocaine affects the brain

Crack impacts upon the brain in various ways. Most prominently, cocaine binds to dopamine transporters in the brain which prevent them from performing their dopamine reuptake function, meaning that dopamine accumulates in greater and greater quantities in the synaptic cleft. This creates crack’s euphoric effect, as well as making the consumption of the drug a rewarding experience in terms of the mechanism by which addiction develops.

Cocaine is also known to affect some serotonin receptors, although how exactly this takes place is unclear. Serotonin is a chemical in the brain known to contribute to feelings of happiness and well-being. [7]

Cocaine block sodium channels in the central nervous system, which obstructs the transfer of information relating to pain, thus making it an effective local anaesthetic. Moreover, it causes the constriction of blood vessels and is known to suppress appetite, though precisely how does this is not yet fully understood.[8]

Crack cocaine psychosis

Cocaine psychosis is a psychological condition which can manifest after the use of cocaine, with symptoms tending to increase in severity and duration the more someone consumes the drug. Although it is possible to experience this in the traditional form of the drug, crack is thought to be more problematic in this regard.[9] Symptoms of cocaine psychosis can resemble those of mental health disorders such as schizophrenia and bipolar disorder, and may include:

  • hallucinations
  • delirium
  • anxiety
  • aggression
  • rage
  • paranoia
  • homicidal or suicidal thoughts
  • confusion
  • delusions

The Dangers of Crack Cocaine Addiction

Crack cocaine addiction is an extremely serious condition which has ruined countless lives worldwide. Frequent crack abuse of the sort typically occurring as a result of addiction can have devastating permanent consequences for physical and mental health, including the death of the user. Secondary health consequences can also be extremely deleterious, including injuries sustained whilst under the influence of crack cocaine or as a result of acts of violence associated with crack use or supply, and diseases including HIV/AIDS and hepatitis C resulting from risky sexual behaviour, possibly caused by crack’s aphrodisiac qualities.

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Because of the very strong cravings to consume more crack very shortly after the effects of the last dose begin to subside, some crack addicts get through a substantial quantity of the drug every day – sometimes at the cost of hundreds of pounds. This can result in crippling financial impairment, often causing very significant debt and even destitution – and requiring many addicts to take part in criminal activity. This includes theft and/or prostitution. Such behaviours can have extremely serious long-term and even permanent consequences, including a criminal record and possible imprisonment, as well as harm theirself-esteem and reputation.

Crack addicts who manage to overcome their addictions may struggle, at least in the short term, to reintegrate back into normal life. A history of crack use can have profound implications for how individuals experience pleasure in future, which could have knock-on consequences for relationships, outlook on the world, and general psychological well-being. While this is not necessarily a permanent state of affairs. Over time, individuals can regain a sense of purpose and fulfilment and can once again come to enjoy less damaging and problematic pleasures and activities. In the short term, it can make recovery more difficult, and many former users relapse as they seek to recapture the intensity of their previous experience.

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Long-term consequences of crack cocaine for the individual

Taking crack on only one or a few occasions is unlikely to have permanent health consequences. However, it is important to note that it is possible to suffer serious damage or even die after merely one instance of smoking crack cocaine. There are no circumstances in which it should be considered an absolutely safe activity. Over the long term, crack usage poses a number of substantial risks to physical and mental health.

Some of the more noteworthy health dangers associated with the consumption of crack cocaine include:

  • permanent damage to organs including the lungs, kidney and liver
  • respiratory failure
  • high blood pressure
  • heart attack
  • stroke
  • frequent chest pain
  • damage to blood vessels, including in the brain
  • malnutrition and weight loss
  • anhedonia
  • violent mood swings
  • delirium
  • cognitive impairment
  • gum disease
  • tooth decay
  • hallucinations
  • sexual dysfunction
  • infectious disease
  • psychosis
  • major depressive disorder
  • anxiety disorder
  • dependence and addiction

Detox and Withdrawal

Someone who has developed an addiction to crack cocaine and who wishes to overcome their addiction may engage in addiction treatment, the first phase which is typically detoxification (detox) and withdrawal.

Crack withdrawal syndrome can manifest when someone who has developed a dependence to crack suddenly stops taking the drug, sparking a period of abnormal functioning in the brain and body while their system readjusts to the absence of crack and re-normalises. Withdrawal can occur during the detox phase as part of addiction treatment, or in an unmanaged manner if a crack addict is obliged to stop smoking crack for any reason.

Although crack is not typically viewed as causing serious physical dependence, various problematic psychological withdrawal symptoms [10] can manifest, including:

  • strong cravings
  • agitation
  • fatigue
  • depression
  • tremors
  • mood swings
  • anxiety
  • insomnia
  • anhedonia
  • sexual dysfunction
  • problems concentrating
  • weight loss
  • suicidal ideation

What happens when you detox?

During detox, withdrawal can be monitored and managed by medical professionals for the safety and comfort of the withdrawing addict. Because withdrawal is typically a serious condition, many addicts find it all but unbearable. Some even resort to self-harm as a means of distracting themselves from or escaping the reality of withdrawal.As a result, even though it is not considered directly physically dangerous in the same way as alcohol and/or benzodiazepine withdrawal, withdrawal from crack cocaine is nevertheless a perilous condition and should not be undergone without medical assistance.

It is somewhat problematic think of addiction of any kind as a condition with a possible “cure”: addiction can certainly be overcome, and abstinence achieved and sustained, but recovery is typically a long-term – even lifelong – process, and should be viewed as such.

With that in mind, with professional help, it is certainly possible to beat a crack cocaine addiction and to resume a happy and healthy life free of substance abuse.

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Get Help for Crack Cocaine Addiction

If you are addicted to crack cocaine, you have a very serious condition which can be life-threatening, and which can certainly cause permanent impairment to your physical and mental health and to your overall life prospects. It is vital that you take steps to overcome your addiction as soon as you can. Fortunately, there are now a number of different treatment options, and addiction treatment facilities, which can help you tackle your condition.

No matter how serious or long-lasting your crack cocaine addiction, the sooner you can reach out for the help you need, the sooner you can start to receive it – so contact your GP and/or an addiction specialist today to discuss your condition and the treatment options that might be available to you. Making that call could be your first step out of addiction and onto the path back to the happy, healthy, successful life you want and deserve.

Crack cocaine rehab

Addiction treatment is frequently provided in residential rehabilitation (rehab). In rehab, holistic addiction treatment programmes are provided. Treatment will begin with detox and withdrawal, followed by the therapy phases and augmented by various other elements including dietary and fitness plans.

Inpatient stays in rehab typically last for between 30 and 90 days (though shorter and more intensive programmes are sometimes provided, as are longer stays for individuals with particular problematic addictions). Clients are able to take advantage of secure, friendly, pleasant, relaxing and confidential settings in which to focus on their treatment and recovery.

Rehab can also be attended on an outpatient basis in some instances, which may be more appropriate for addicts who feel unable to take the time out from responsibilities including work and family which an inpatient stay would entail. However, outpatient treatment is sometimes considered far from ideal as it does not take the addict out from the environment of substance abuse in which addiction has developed.

Pharmacological approaches

There are no pharmaceutical “cures” for crack cocaine addiction. However, it is possible to use certain medications to ease some of the more problematic symptoms of withdrawal during and following the detoxification phase. For example, some benzodiazepines may be prescribed to ease anxiety and reduce the likelihood of seizures, while antidepressants may be provided in the short or long term to counter the potentially damaging effects of depression.

Behavioural interventions

Therapy lies at the core of addiction treatment. A great variety of different therapeutic models and methodologies may be provided in rehab, in both group and one-to-one settings. Therapy models such as cognitive behavioural therapy (CBT) and motivational interviewing (MI) allow clients to address and understand the psychological causes of their addictions and to remediate the problematic behaviours which have led them to their current situations. Therapy can also provide addicts with defence mechanisms against relapse for when they leave the facility and re-enter life in the outside world to begin the maintenance phase of recovery.

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