Key takeaways:

  • Crack affects the brain in a similar way to most stimulants, that is by producing an influx of dopamine, the brain chemical most closely linked to addiction
  • Most overdoses from crack cocaine occur during a ‘crack binge’. These binging sessions, where users take hits frequently to maintain a high, can result in an overdose as the symptoms are hard to distinguish from the comedown felt from crack abuse
  • Crack cocaine withdrawal symptoms are one of the toughest hurdles to overcoming a crack addiction and are one of the main reasons people fail to quit

Crack cocaine is a highly addictive form of cocaine that produces a powerful but short-lived high. Crack is cheaper to purchase than powder cocaine but is believed to be even more addictive.

Understanding crack cocaine

Crack cocaine is produced by taking the base form of cocaine, dissolving it in a combination of water and baking soda, boiling the mixture to separate out the solids, cooling the firm parts, and cutting into smaller chunks known as ‘rocks’. [1, 2]

Crack (named for the cracking noise made during the production and intake process) is snorted or most commonly smoked through a glass pipe (though sometimes through aluminum foil or other thin metals) in small amounts. This method of ingestion means the chemicals from crack reach the brain much faster than standard powder cocaine. The high from crack is instant, intense, and powerful, though it only lasts a brief time (up to around 15 minutes). [1, 2]

This relatively short but powerful high often causes the user to chase the sensation, smoking more crack in regular intervals to recapture the sensation. This makes crack an incredibly addictive drug and one that is easily abused. The repetitive and consistent nature of smoking crack makes it potentially more addictive than powdered cocaine. 

Crack affects the brain in a similar way to most stimulants, that is by producing an influx of dopamine, the brain chemical most closely linked to addiction. This surge in dopamine levels creates a sensation of pleasure and reward, causing the user to experience boosts in their mood and energy. [3]

This sensation is far stronger than can be naturally achieved through standard levels of dopamine, and taking crack can actually prevent the natural generation of the chemical. This means that taking crack can rewire the brain and cause a tolerance to the substance to form quickly. According to the Science and Practice Perspectives, the brain can become rewired from crack abuse after just one hit. [3]

Crack cocaine also goes by the slang names rock, base, kryptonite, sleet, base, candy, cookies, and of course simply ‘crack’.

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Crack cocaine symptoms of abuse

Crack is a Schedule II illicit substance under the Controlled Substance Act and therefore any use of crack is considered abuse. [1] Crack cocaine is an already extremely potent stimulant and the method of ingestion (smoking) causes the high to be felt almost instantly. This is why crack is believed to be even more addictive than cocaine, causing users to binge use it.

The effects of crack cocaine include:

  • Euphoria

  • Hyperactivity

  • Tension

  • Talkativeness

  • Confidence

As the intense pleasure felt from crack is desirable, and the effect the drug has on rewiring the brain’s chemical patterns, those who abuse crack will build a tolerance to its effects quickly. This tolerance will often eventually lead to a crack dependence forming, meaning the person using crack will require more of the drug to feel normal or to feel pleasure. Over time and with repeated use of the drug, this can lead to an addiction. [3, 4]

Crack overdose

The symptoms of a crack overdose are similar to those felt from regular cocaine. The main difference is the speed at which these symptoms present themselves. Much like the high felt from crack use, the symptoms of an overdose come on much faster than they do with regular powdered cocaine. Here are some common symptoms of a crack overdose: [1, 2]

  • Feeling feverish or otherwise hot to the touch

  • Excessive chest pain, especially around the heart

  • Rapid heartbeat even while resting

  • Uncontrollable energy, agitation, or manic behavior

  • Nausea or weakness

  • Beginning of hallucinations

Most overdoses from crack cocaine occur during a ‘crack binge’. These binging sessions, where users take hits frequently to maintain a high, can result in an overdose as the symptoms are hard to distinguish from the comedown felt from crack abuse. This can lead to a fatal overdose as the person abusing crack takes more and more on the assumption that they are coming down as opposed to overusing. The risk of crack cocaine overdose is greatly increased when the person is taking other substances, such as alcohol.

Addiction to crack cocaine

Crack cocaine abuse can often lead to someone developing an addiction, though they are not the same thing. Crack abuse will often cause negative side effects to the user, but this does not mean they are unable to quit on their own (though the high potency of crack means addiction can form even after the first time taking it). Crack cocaine addiction is more complicated and often requires help to overcome.

Like most forms of addiction, a person with a crack cocaine use disorder will be diagnosed by a licensed professional using these 11 criteria, outlined by the DSM-5: [4]

  1. Hazardous use: You have used the substance in ways that are dangerous to yourself and/or others, i.e., overdosed, driven while under the influence, or blacked out.

  2. Social or interpersonal problems related to use: Substance use has caused relationship problems or conflicts with others.

  3. Neglected major roles to use: You have failed to meet your responsibilities at work, school, or home because of substance use.

  4. Withdrawal: When you stop using the substance, you experience withdrawal symptoms.

  5. Tolerance: You have built up a tolerance to the substance so that you have to use more to get the same effect.

  6. Used larger amounts/longer: You have started to use larger amounts or use the substance for longer amounts of time.

  7. Repeated attempts to control use or quit: You've tried to cut back or quit entirely, but haven't been successful.

  8. Much time spent using: You spend a lot of your time using the substance.

  9. Physical or psychological problems related to use: Your substance use has led to physical health problems, such as liver damage or lung cancer, or psychological issues, such as depression or anxiety.

  10. Activities given up to use: You have skipped activities or stopped doing activities you once enjoyed in order to use the substance.

  11. Craving: You have experienced an intense craving for the substance.

These criteria are measured by the negative impact the substance has on a person's life; including physical, psychological, and behavioral measures, and are classified as mild, moderate, and severe. The criteria are measured against the previous 12 months of substance use and a score of 2-3 is considered mild, 3-5 moderate, and 6 or more severe. [4] Even severe crack cocaine addictions can be treated and overcome.

Crack withdrawal symptoms

Crack cocaine addiction manifests with both a psychological and physical dependence which can appear as early as the first time of using. This makes crack very hard to overcome. Many people who are addicted to crack find it is easier to start their recovery in an inpatient setting, where there is more structure and fewer chances of being triggered or relapsing. This can be especially important for people in the first week of sobriety when withdrawals and cravings tend to be the most severe. This is called the acute withdrawal phase. [5]

Some of the most common acute withdrawal symptoms from crack include:[5]

  • Anxiety/paranoia

  • Exhaustion

  • Increased appetite

  • Bad dreams

  • Lack of concentration

  • Irritability

  • Mood changes/depression

  • Cravings 

After a week, the drug has left the person’s system and the worst of the withdrawals are over. However, a small number of people will go on to experience post-acute withdrawal symptoms (PAWS), which include less severe symptoms of withdrawal that can last for months or even a year or more after a person stops smoking crack. PAWS usually involves psychological distress rather than physical symptoms experienced during the acute phase.[5]

Protracted withdrawal symptoms may include:[5]

  • Depression

  • Anxiety/agitation

  • Poor sleep patterns

  • Lack of motivation

  • Inability to feel pleasure

  • Emotional instability

Crack cocaine withdrawal symptoms are one of the toughest hurdles to overcoming a crack addiction and are one of the main reasons people fail to quit. By detoxing in an inpatient treatment facility, people often find it much easier to establish their sobriety and make it through the early withdrawals without relapsing.

Detox medication for crack addiction

Unlike detoxing from other drugs, such as opioid prescription medications, there is no tapering process for crack cocaine detox. This is because, unlike some other substances, cocaine and crack are not dangerous to withdraw from, and for most people, the worst symptoms will resolve in a few days to a week on their own. Still, to help people through this process, medication will often be administered to help the person feel more comfortable during this process of detox.

Drugs that may be used during crack detox and what they treat:

Clonidine - High blood pressure and anxiety reduction

Gabapentin - Seizures, restless leg syndrome, anxiety, and insomnia

Propranolol - Anxiety

Trazodone - Sleep

Seroquel - Sleep

Vigabatrin - Anxiety

Vistaril - Anxiety

After the initial detox stage, the next phase of treatment can begin.

Treatment for crack cocaine addiction

Crack addiction can be powerful and devastating to someone's way of life, but help is available and there are plenty of treatment centers that can help people overcome their addiction and regain control over their lives. If you or someone you know is suffering from a crack cocaine use disorder, contact a treatment center today to learn more about your options.