On November 11, 2023
One of the most infamous drugs in pop culture since the 1980s, crack cocaine is a powerful stimulant that’s often portrayed in the media and associated with substance abuse. But aside from public image, crack is a serious addiction that can have serious risks.
Learn more about crack cocaine, its history and use, and how you can seek help for a crack addiction.
Cocaine powder is dissolved in water and simple baking soda, boiled to separate the solids, and cooled and cut to produce small pieces known as “rocks.” These pieces are white or tan pellets, similar to dry cat food. When these pieces are heated, they crackle, leading to the name “crack.”
Crack is easy and inexpensive to produce, creates an immediate and intense high, and wears off quickly, leaving the person depressed and craving more, which is why it’s so often abused. The chemicals in crack hit the brain much faster and more directly than powdered cocaine, leading to misuse in an attempt to recreate the sensation.
Smoking crack allows it to enter the bloodstream quickly, heightening the stimulant effects of cocaine. Immediately after smoking, the person may feel intensely happy, energetic, and sociable.
Despite these positive emotions, crack may cause immediate negative effects as well. People who use crack may experience panic, anxiety, and paranoia that’s short lived. The stimulant effects of crack also increase the heart rate, further compounding feelings of anxiety.
In large doses, crack may cause cocaine-induced psychosis with hallucinations, agitation, and an inability to communicate. In some cases, this is a symptom of an overdose.
With long-term use, crack affects the brain’s pathways in response to stress. People become more sensitive to feelings of stress and struggle to remain calm, leading to mood swings, irritability, paranoia, and anxiety.
Regular crack use floods the brain with an unnatural level of dopamine as well. Over time, the brain becomes less sensitive to dopamine to compensate. Normal activities lose their appeal, so crack is the only thing that makes the person feel happy and satisfied.
There are many negative health effects associated with crack, such as infertility, respiratory problems, poor appetite, malnourishment, weight loss, and heart problems. Smoking is a riskier way to consume cocaine, leading to burns on the lips, tongue, or fingers and lung cancer.
Crack has obvious signs of use, even in the short term. People who use crack will have sudden bursts of energy and stimulation, often acting excited at inappropriate times. They may talk rapidly, eat quickly (or not eat when they’ve gone without food for some time), or seem nervous and agitated. Once the effects wear off, they’ll look fatigued and may sleep for long periods.
Cycling between bursts of energy and fatigue significantly impacts behavior. People suffer sleep disturbances and miss work or school. They may have violent mood swings that can become dangerous to people around them, as well as paranoia and hallucinations. When they stop using crack for a time, they may have depression or suicidal thoughts.
Along with bursts of energy, people who use crack may be jittery and fidgety. They can’t control these feelings and sometimes seek out crack, falsely believing that it will calm them.
Crack has obvious physical signs like dilated pupils and bloodshot eyes. This is due to the drug’s effects on the way the pupils react to light and the chemical functioning of the brain. People who smoke may have burns on their lips and fingers from the crack pipe.
When crack is snorted instead of smoked, it may cause nosebleeds from damage to the nasal lining. They may have constant congestion or a runny nose. Over time, they will lose their sense of smell. Snorting also damages the lining of the throat, causing a sore throat and speech difficulties.
With its potency, availability, and intense euphoria, crack is highly addictive. Though crack and powder cocaine are nearly chemically identical, the method of consuming them can make crack seem more addictive.
The intensity of the experience with crack is short, leading people to binge the drug to chase those psychoactive effects. This can lead to a more rapid tolerance, dependence, and addiction.
Crack addiction falls under substance use disorder in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), which includes the following criteria:
Substance use disorder worsens over time. The diagnostic criteria includes a scale for severity based on how many symptoms are present. Two or three indicate a mild substance use disorder, four or five indicate a moderate substance use disorder, and six or more indicate a severe substance use disorder or addiction that needs treatment.
Crack can cause strong physiological dependence and withdrawal symptoms that can make it near impossible for someone to quit without help. The symptoms typically begin within a few hours and can last up to a month, gradually tapering off.
Some of the signs and symptoms of crack withdrawal include:
Many factors affect the intensity and severity of crack withdrawal symptoms, including:
Unlike addiction to substances like heroin, crack cocaine may not include obvious withdrawal effects like vomiting, sweating, or shaking.
Once the immediate withdrawal symptoms subside, people may experience additional symptoms for days or weeks, such as:
Because of the challenges of withdrawal, it may be best for people with crack addiction to be hospitalized and supervised to ensure their physical wellbeing and reduce the risk of relapse. In some cases, medication may be used to alleviate the physical symptoms of withdrawal.
Once detox is complete, which lasts about a week, the person can address the psychological effects of the addiction. This may be in an inpatient or outpatient program, depending on the level of support needed.
Treatment typically includes a combination of evidence-based modalities and techniques, such as cognitive behavioral therapy, group therapy, individual therapy, motivational interviewing, and experiential therapy. The treatment plan is tailored to the needs of the individual, taking their substance use, medical history, mental health history, and other factors into account.
Cocaine is the powdered form of the coca leaves that can be snorted or injected into a vein, while crack undergoes a simple conversion to convert it into small pieces that can be snorted or smoked. While both are stimulants and highly addictive, crack has an intense but short-lived high that leads people to smoke repeatedly.
Crack cocaine has many slang terms and street names that include black rock, candy, chemical, dice, gravel, grit, cookies, hail, hard rock, purple caps, rocks, nuggets, scrabble, snow coke, sleet, tornado.
Yes, crack cocaine is illegal. It’s currently a Schedule II substance under the Controlled Substances Act, along with drugs like PCP and methamphetamine that have a high potential for abuse.
Crack and powder cocaine are equally addictive and dangerous on a chemical level. The manner in which these two substances are consumed does have an effect on the intensity of the symptoms, however, which can lead someone to overuse crack cocaine more quickly than powder cocaine.
Here at Ascendant New York, we understand the importance of having access to accurate medical information you can trust, especially when you or a loved one is suffering from addiction. Find out more on our policy.
 Crack Cocaine Fast Facts. (n.d.). Retrieved from https://www.justice.gov/archive/ndic/pubs3/3978/index.htm on May 3, 2023
 U.S. Department of Health and Human Services. (2020, May 28). What are some ways that cocaine changes the brain? National Institutes of Health. Retrieved from https://nida.nih.gov/publications/research-reports/cocaine/what-are-some-ways-cocaine-changes-brain on May 3, 2023.
 A, M. N. J. A. (n.d.). Substance use screening and risk assessment in adults [internet]. National Center for Biotechnology Information. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33332063/ on May 3, 2023.