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Crack Addiction: Effects, Treatment, and Recovery

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Medically Reviewed By: Diana Vo, LMFT

December 6, 2023

Table of Contents

Crack was a scourge throughout the eighties and nineties, but how did crack cocaine emerge? To dive deep into the dismal world of crack addiction, we first need to examine its basic raw material: cocaine.

What Is Cocaine?

Cocaine is a white powder that comes from the leaves of the coca tree, indigenous to the Andean countries of South America, notably Bolivia, Colombia, and Peru.

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Cocaine is also known by many other names including:

  • Coke
  • Blow
  • Snow
  • Rock
  • Ya-yo
  • Nose candy

The names are seemingly endless, but the product remains the same.

Coca leaves have been used by natives for millennia. Brought to Europe by the Spanish, the anesthetic and euphoric properties of cocaine were discovered in the west in around 1860.

This discovery led to other local anesthetics like Lidocaine and Novocaine being created once scientists became aware of the compounds they needed to replicate.

Cocaine as we know it is a highly addictive drug that delivers a boost of energy along with increased alertness and attention. It’s an illegal stimulant.

As well as the typical powdered form, cocaine can also be made into a solid rock crystal – the crack cocaine we’ll be highlighting right below.

Users normally snort coke through a rolled-up bill or straw. Some rub it into the gums, while others inject it. Crack users smoke the drug in a glass pipe before inhaling the smoke deep into the lungs.

Cocaine directs elevated levels of dopamine to the areas of your brain controlling pleasure. This leads to increased alertness and a sense of energized euphoria known as a high.

After mounting hysteria about cocaine use in the US, the drug was banned under 1914’s Harrison Act and 1922’s Jones-Miller Act.

Cocaine’s illegal status did little to stem the tide of the drug flooding into the country even after domestic extraction was stopped. The lengthy and porous US-Mexico border was not even policed by helicopters until the late 1970s, so the drug came into the country relatively unimpeded.

As you’ll soon see, a tightening up of this border could be said to have made the problem even worse as crack was born in response to a changing landscape.

What Is Crack Cocaine?

Crack cocaine is a hard and mineral-like substance. Crack usually has an off-white appearance. It’s also known as rocks, light, stones, or freebase.

You make crack by mixing powdered cocaine with baking soda or ammonia. The mixture is heated until it forms rocks of crack.

These rocks are smoked in a glass pipe and the user inhales the smoke deep into the lungs.

Crack can also be injected, but this is much less common than smoking, also known as freebasing.

The drug is named for the cracking, popping sound it makes when heated.

The Effects of Crack

If you smoke crack, you can expect a very intense high that’s equally short-lived. This soaring sense of euphoria is followed by the exact opposite when the high wears off. You’ll feel depressed, edgy, and craving more crack.

Habitual crack users often eat and sleep poorly. The drug often induces a sense of paranoia, even when it’s not being used.

Crack cocaine use increases the risk of stroke, seizure, heart attack, but smoking the drug also presents further health risks due the way in which it’s smoked in glass pipes. When crack burns, it gives off toxic fumes. Also, since crack pipes are usually very short and heat up quickly, they induce “crack lip” in users suffering from cracked, blistered lips.

Here’s a summary at the broad spectrum of short-term and long-term effects of cocaine you can expect if you use crack cocaine.

Short-Term Effects of Crack

  • Anxiety and paranoia
  • Bizarre, erratic, or violent behavior
  • Convulsions
  • Dilated pupils
  • Disturbed patterns of sleep
  • Increased blood pressure
  • Hallucinations
  • Hyperexcitability
  • Hyperstimulation
  • Increased rate of breathing
  • Irritability
  • Loss of appetite
  • Increased body temperature
  • Intense drug craving
  • Nausea
  • Increased heart rate
  • Panic and psychosis
  • Seizures
  • Intense euphoria
  • Severe depression
  • Sudden death
  • Tactile hallucinations

Long-Term Effects of Crack

  • Apathy
  • Auditory or tactile hallucinations
  • Delirium
  • Disorientation
  • High blood pressure leading to heart attacks or strokes
  • Infectious diseases
  • Infertility
  • Irritability
  • Liver, kidney, and lung damage
  • Malnutrition and weight loss
  • Mood disturbance
  • Severe tooth decay
  • Permanent damage to blood vessels in ears and brain
  • Psychosis
  • Severe chest pains
  • Reproductive damage
  • Risky behavior
  • Respiratory failure
  • Severe depression
  • Sexual problems
  • Tolerance

As you can see, that’s quite a comprehensive laundry list of ill-effects. Is crack really much worse than powdered cocaine, though?

Effects: Crack vs Cocaine

The effects experienced by crack users will vary according to the purity of the cocaine used to make it with.

Crack cocaine delivers similar effects to powdered cocaine, except they are even more intense. These include:

  • Decreased appetite
  • Increased heart rate
  • Dilated pupils
  • Euphoria
  • Heightened alertness
  • Intense cravings

The reason these effects are felt more quickly and intensely when cocaine is consumed in freebase form is because crack is rapidly absorbed by the membranes of your lungs. The drug then enters your bloodstream and brain in no more than 10 seconds. This intensity means the risk of overdose is heightened, with symptoms of crack overdoses including hyperventilation, rapid heartbeat, convulsions, and coma. Overdose can be fatal.

Using crack long-term will lead to pronounced mood changes, depression, anxiety, irritability, restlessness, paranoia, and hallucinations.

Developing a crack addiction is commonplace for users due to the highly addictive nature of the drug. This also means there are often severe withdrawal symptoms. These can include:

  • Agitation
  • Anxiety
  • Depression
  • Extreme fatigue
  • Intense cravings
  • Muscle pain
  • Nausea
  • Suicidal thoughts

Now you’ve seen many of the ways in which crack and cocaine are similar, how do they differ, and what does this mean for you?

Crack vs Cocaine: What Are The Differences?

The appearance of crack and powdered cocaine is different. Most powdered cocaine is white. Crack, by contrast, is usually found in rock form. While the rocks can be white, they are more commonly off-white, tan, or cream.

The two forms of cocaine are also used in different ways. Cocaine is usually snorted, while crack is usually smoked.

The nature of the high produced might be similar, but there are ways in which it’s markedly different, too. When you snort cocaine, the effects kick in after 1 to 5 minutes, peaking after about 20 minutes. Effects are fully dissipated within around 1 to 2 hours. Crack by contrast, takes hold in less than a minute, peaks in just 5 minutes, with the effects gone after no more than 1 hour. Injecting cocaine delivers effects similar to smoking crack.

Although the chemical structure of powdered cocaine and crack cocaine is almost identical, the punishment for possessing or dealing crack cocaine is far greater than that of powdered cocaine. Up until 2010, there was a sentencing disparity of 100 to 1, meaning that possessing just 5g of crack led to a 5-year mandatory minimum, while the same sentence would not be triggered unless you were in possession of 500g of cocaine, a full pound.

Even after changes to the law in 2010, there remains a sentencing disparity of 18 to 1. Resultantly, even though most crack cocaine users are white, black people in low-income areas are more likely to be convicted of crack cocaine possession.

Signs of Crack Addiction

Crack is seldom used by the uninitiated.

Often, crack users graduate to the drug after first using cocaine. Others might have used meth or other synthetic drugs before chasing an even more intense high.

Once addiction sets in, crack users find themselves needing to come up with hundreds, even thousands, of dollars each week to finance their habit. At the same time, few crack users will be in the position to hold down a full-time job. As such, many crack users turn to crime as they need to buy rock after rock after rock.

If you suspect a loved one is using crack, there are three main areas in which to look to signs:

  • Emotional signs
  • Physiological signs
  • Behavioral signs

Emotional signs

Crack interacts with the receptors in your brain and brings about neurological changes in a very short space of time. This inevitably leads to emotional and psychological changes you can spot in a loved one if they’re smoking crack.

Look for dramatic mood swings and chronic irritability. Exhibitions of paranoia also point to a problem with crack cocaine.

If a loved one is becoming addicted to crack, they will be emotionally disrupted by the experience. This will be very hard for them to conceal in interpersonal relationships with you and others.

If your friend or family member tries to stop using crack cocaine, you will also notice some marked emotional changes as they become restless, irritable, and depressed without that excess of dopamine flooding the brain.

Physiological signs

Look out, too, for some of these common physiological signs that could point toward crack cocaine use:

  • Appetite changes
  • Dilated pupils
  • Elevated heart rate
  • High blood pressure (hypertension)
  • Increased breathing rate
  • Insomnia
  • Nosebleeds
  • Twitching of muscles

Withdrawing from crack cocaine triggers the opposite effects to those induced by the drug. Users who abstain will likely sleep for lengthy periods, exhibit extreme fatigue, shakiness, and tremors.

You might also notice burned fingers and blistered lips.

Behavioral signs

Most crack users will betray their drug use by the way they behave.

Look out for any of the following behavioral signs that could indicate crack cocaine abuse:

  • Aggression
  • Deteriorating interpersonal relationships
  • Engaging in risky behaviors
  • Failing to attend social appointments
  • Focusing on crack use while forfeiting other responsibilities
  • Intense discomfort if use is discontinued
  • Not meeting obligations
  • Volatile mood swings

The Birth of Crack

With the US-Mexico land border controls tightening, cocaine importers needed new routes. Traffickers started shipping coke to Miami instead via the Bahamas and the Caribbean.

Also, the CIA was alleged to have turned a blind eye to the Contra rebels in Nicaragua exporting large quantities of cocaine. This further fueled the influx of coke hitting American shores from Colombia.

As a result of this sudden glut of cocaine, prices dipped, and dealers started bulking the cocaine out with bicarbonate of soda or ammonia.

By 1981, small batches of crack started cropping up in major American cities. To begin with, the police didn’t recognize this new material in rock form. Once chemically analyzed, crack was revealed to be cocaine freebase as opposed to cocaine hydrochloride.

Large-scale crack production was taking place in Los Angeles by 1984. Gangs seized control of the street-level crack trade with bloody turf wars breaking out.

Where most cocaine bought on American streets is cut with at least 45% filler, crack cocaine is typically 80% pure.

With crack rocks available for $10, cocaine was no longer the preserve of the rich and famous. Indeed, the ease of access meant that crack was soon leaving a trail of devastation in poor, inner-city areas. With users becoming rapidly addicted and prepared to do almost anything to get hold of more money for the drug, crime rates rose significantly in the mid-1980s with homicides more than doubling.

The crack epidemic continued to wreak havoc across the US for almost 20 years.

Unfortunately, with officers on task forces becoming incentivized for drug busts, there was a sharp uptick in arrests for possession and other nonviolent crimes. To tackle the crack problem effectively, it’s essential to address the root cause of addiction.

What Is Crack Addiction?

Crack addiction is formally known as substance use disorder, specifically stimulant use disorder.

According to NIDA (the National Institute on Drug Abuse), crack addiction is a chronic and relapsing brain disorder. Once addicted to crack, you become physiologically dependent on the substance. You will continue to use crack compulsively, despite an array of negative outcomes.

The chronic use of stimulants like crack cocaine can lead to permanently altered brain structure, as well as triggering emotional, cognitive, and neurological impairment.

While there are no FDA-approved medications for the treatment of crack addiction, stimulant disorders often respond favorably to behavioral interventions like counseling and psychotherapy.

What Causes Crack Addiction?

Crack, just like powdered cocaine, is a powerful stimulant that causes increased energy levels and euphoria.

Smoking crack cocaine floods your brain with dopamine. This natural chemical is part of your brain’s reward system, performing the following roles:

  • Numbing pain
  • Stimulating the brain
  • Helping you feel pleasure

The effects of crack hit the brain more rapidly than powdered cocaine due to the method of delivery – crack is typically smoked in a glass pipe rather than snorted. While the high experienced is more potent, effects last for no more than five or ten minutes. The crack high is followed by a hard crash, prompting feelings of depression and intense cravings for crack cocaine. Research indicates that crack cocaine is associated with more intense cravings and a higher risk of addiction than inhaled cocaine in powder form.

Using crack cocaine on an ongoing basis will cause the reward circuitry of your brain to adapt, becoming less sensitive to the effects of the substance. As tolerance builds, you will need more crack to get the same results, further worsening the problem.

How Is Crack Addiction Diagnosed?

Like all substance use disorders, stimulant use disorder in the form of crack addiction is diagnosed using the criteria in DSM-5. DSM-5 is the fifth edition of the APA’s benchmark diagnostic tool used by mental health professionals worldwide.

You will be asked variations on the following eleven questions to determine whether you have stimulant use disorder:

  1. Have you smoked more crack than intended or used crack for longer periods than planned?
  2. Do you get powerful cravings for crack when the effects of the drug wear off?
  3. Have you tried and failed to stop using crack?
  4. Are you spending a great deal of time obtaining and using crack, as well as recovering from the effects of crack abuse?
  5. Are you giving up important engagements due to crack use?
  6. Are you encountering problems at home, work, or school due to your use of crack?
  7. Do you require more crack to get the same effects as tolerance builds?
  8. Have you experienced withdrawal symptoms in the absence of crack cocaine?
  9. Do you continue to use crack despite negative consequences in your closest relationships?
  10. Do you continue to use crack even though it is inflaming a physical or psychological condition?
  11. Do you repeatedly use crack cocaine in dangerous situations?

Crack addiction is diagnosed as follows:

  • Mild crack addiction: 2 or 3 of the above symptoms.
  • Moderate crack addiction: 4 or 5 of the above symptoms.
  • Severe crack addiction: 6 or more of the above symptoms.

Treatment for Crack Addiction

OK, now you have a solid overview of what crack is and what effects it brings about, it’s time to underscore just how dangerous this stuff is.

Crack is much more potent than powdered cocaine, and it’s resultantly much more addictive, too. While it’s not always true that first-time users become instantly addicted to the drug, that scenario is not uncommon either. The crack high is so intense and so fleeting that most users feel immediately compelled to recreate the experience. Unfortunately, the user never seems to regain this initial euphoria, and ends up chasing something that’s never delivered. By the time addiction and dependence set in, typically quite quickly, you need to use crack simply to feel normal.

Tolerance rapidly builds causing users to need more of the drug to generate the same effects.

Withdrawal symptoms will rapidly manifest if crack use is discontinued. Using crack, as outlined above, triggers the creation of excess amounts of dopamine, a feel-good chemical in the brain. The brain’s natural production of dopamine diminishes with habitual crack use.

Due to strong cravings for the drug combined with a desire to avoid unpleasant withdrawal symptoms, crack users find themselves caught in the unrelenting grip of drug fixation.

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Crack Cocaine Rehab At Renaissance Recovery

Now you’ve seen what crack cocaine addiction can do, here’s the good news…

Recovering from crack cocaine addiction is possible, as long as you commit to the right treatment program, and you’re prepared for some challenging times on your road to a full recovery.

Due to the seriously addictive nature of the drug and the severity of withdrawal symptoms, most crack addicts benefit from detoxing in a controlled medical setting. This ensures that qualified medical staff are on hand around-the-clock to mitigate withdrawal symptoms, if necessary using prescription medication to lessen any discomfort. At minimum, someone withdrawing from crack cocaine should do so in a controlled setting with help on hand.

If you’re ready to take the first step, or you need to seek help for a loved one addicted to crack cocaine, get in touch with the friendly team here at Renaissance Recovery and get started at our cocaine rehab in California. Call us today at 866.330.9449 and we’ll help you get back on track.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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