Crack cocaine was, at one time, the most widely discussed illicit drug on the market. Though opioids have taken center stage in the current drug crisis, in the 1980s and 1990s, crack saw epidemic levels of use of its own. The result wasn’t just a negative impact on public health but had societal and cultural impacts as well. The crack epidemic sparked increased crime and violence, especially in lower class inner city neighborhoods. As a response, politicians started the “Tough on Crime” movement which has lasting effects to this day.
Today, the opioid epidemic has overshadowed many of the issues coming from other drugs. However, cocaine and crack addiction remains an important issue for thousands of people. In 2014, 913,000 people met the criteria for a cocaine use disorder and over 5,000 people died in overdose deaths related to cocaine.
Crack is said to be among the most addictive drugs available and its effects can be deadly. If you or someone you know is dealing with a crack or cocaine addiction, the following information will shed light on the nature of cocaine addiction and how it can be treated.
Crack cocaine, more commonly just called crack, is a freebase form of cocaine. This is a chemistry term that refers to a chemical in its basic form rather than the salt form, which in this case is powder cocaine. Crack has a lower melting point than powder cocaine so it can be more easily smoked. This route of administration produces psychoactive effects more quickly than its salt-form counterpart. When compared to cocaine, the effects of crack are intense but short-lived and typically leave the user feeling an uncomfortable crash with deep depression.
It’s also thought to be more addictive than powder cocaine. However, this isn’t because of its chemical makeup but because of its route of administration. When a person snorts cocaine, it can take between 15 to 45 minutes to take effect, and the psychoactive effects of euphoria and the feeling of power can last for 30 minutes to an hour. Crack on the other hand starts to take effect almost immediately and creates a powerful sense of euphoria. While the stimulating effects of the drug can last for over an hour, the sense of euphoria is incredibly brief.
The intensity of the high and its short duration often leave users wanting more, especially since the after effects include anxiety, depression, and irritability.
Because the euphoric effects subside quickly, people may spend hours in a crack binge, during which they take the drug repeatedly at increasingly high doses. Crack increases dopamine activity in the brain, which causes euphoria; however, it takes time for your brain to replenish dopamine. Each successive hit produces a less potent effect, so users take heavier doses. The longer a user binges, the more they will experience adverse effects like irritability, restlessness, and paranoia. Since you are constantly stimulated during a binge, users may not sleep for as long as three days or more. A binge can result in hallucinations, psychosis, and exhaustion.
According to the Drug Enforcement Administration (DEA), a binge can cause the user to seek more of the drug before anything else. The 2017 Drugs of Abuse resource guide (PDF),states, “During heavy use, all other interests become secondary to recreating the initial euphoric rush.”
Sometimes, the only thing that stops a binge is either running out of the drug or physical exhaustion.
Crack addiction tends to gravitate toward poor inner-city neighborhoods. Some believe the spike in crack use in poor populations is because it is a cheap alternative to powder cocaine, which is sometimes called the “rich man’s drug.” However, in 1997, toward the end of the crack epidemic of the 80s and 90s, the RAND Drug Policy Research Center looked at the prices of pure crack and powder cocaine. They could not find a significant drop in the price of crack. However, crack obtained on the street may not always be pure. Additionally, cocaine’s high demand in the 80s drove up the price.
Crack often contains adulterants, or substances added to the drug to increase volume and stretch profits. Innocuous substances can be used like baby powder, flour, caffeine, and aspirin. However, potentially toxic chemicals are sometimes used. A medication called levamisole that’s intended to treat worm infestations in humans and animals is often used to cut crack. It can cause nausea, abdominal pain, headaches, and dizziness. However, it can also cause more serious side effects, most notably, levamisole-induced vasculitis syndrome (LINES). Together cocaine and levamisole can cause fever and skin necrosis.
Dealers can make a profit on cheaper adulterated crack and sell to markets that can’t afford expensive cocaine, which made crack cocaine available to the inner city.
When crack is smoked, the chemical is absorbed into the bloodstream through the lungs. Once it’s in the bloodstream, it slips past the blood-brain barrier (a membrane that filters some substances out of blood that goes to the brain) quickly. Cocaine is fat soluble, which allows it to pass through the barrier.
In the brain, crack alters normal dopamine processing. Under normal circumstances in a healthy brain, dopamine is released by nerve cells when you experience an activity that causes pleasure, like a delicious meal or a warm hug. Dopamine travels across the synapse, the space between nerve cells where messages are passed from one to the other. After the signal has been passed, the remaining dopamine is reabsorbed into the presynaptic neuron (the one that released it) in a process called reuptake.
However, cocaine stops the reuptake process and dopamine isn’t reabsorbed. The neurotransmitter stays in the synapse in excessive amounts that increases the feeling of intense euphoria. This process starts within 10 to 15 minutes when cocaine powder is snorted but only 10 to 15 seconds when crack is smoked.
After repeated use, your brain will begin to create less dopamine to level out your brain chemistry. As tolerance builds, cocaine will have less of an effect. Meanwhile, your reward center (limbic system) will learn to seek the dopamine rush that cocaine provides. Like your brain creates cravings for food when you’re hungry and a comfortable bed when you are tired, it will learn to create powerful cravings for crack.
Crack can come with a variety of physical risks, especially after long term use. When cocaine is smoked, it can cause damage to the lungs and it can worsen asthma. People that inject crack intravenously are at risk for contracting infectious diseases like HIV and hepatitis. Cocaine and crack cocaine can produce dangerous side effects in several major organs, including:
Overdose can be deadly, and it kills thousands of people every year. Crack use can lead to other psychological problems, including psychosis, or difficulty telling the difference between fantasy and reality. It can also come with irritability, restlessness, panic attacks, and paranoia.
If you have used crack and you’re worried that you may be developing a chemical or physical addiction to the drug, there are a number of signs that could point to a substance use disorder, including:
Another earmark of crack addiction is uncomfortable withdrawal symptoms that occur when you haven’t had a hit in a while. Withdrawal symptoms include depression, irritability, extreme fatigue, anxiety, and strong drug cravings. In some cases, after heavy use, withdrawal symptoms can come with psychosis.
Addiction is a chronic disease that can be treated but it may not be cured. People who go through treatment often have cravings well after they have achieved sobriety, some for the rest of their lives. According to the National Institute on Drug Addiction, addiction has relapse rates similar to other chronic diseases like hypertension and asthma. However, it can be treated with therapies that are tailored to the individual. Cognitive behavioral therapies are the most common and effective treatment modalities for addiction; however, there are a variety of options and different treatment plans will be appropriate for different people.
Though addiction is a chronic disease, you don’t have to live the rest of your life in active addiction. Crack addiction can cause serious health risks and the consequences can affect every part of your life. However, your road to recovery may just be a call away.