Crack Cocaine Addiction and Abuse

Crack cocaine is a solid off-white substance with properties similar to minerals. Crack cocaine is formed by blending baking soda or ammonia into the powdered-version of cocaine and heating the mixture until it hardens into ‘rocks.’

Crack is a highly concentrated version of cocaine, making this a very potent drug. Crack is most often vaporized in glass pipes, called the stem or rose, and inhaled. However, it is also the norm for certain individuals to use soda cans or aluminum foils to heat it and inject it directly.

Crack cocaine gets its name mainly from the cracking or popping sound it generates when heating. This drug is also referred to as rock, base, candy, cookies, kryptonite, sleet, hard, or crack.

Crack and cocaine are distinct from each other in terms of color, appearance, and properties. Cocaine is mostly available in white, while crack comes in off-white, cream, tan, or light brown. Crack is found in rock form, while cocaine is mainly available in powdered form.

The effects of crack are generated instantly and intensely but are short-lived. The effects of cocaine take longer to settle in, but the high lasts longer. Crack was initially developed to provide a cheaper alternative to cocaine. This made it highly accessible to all demographics, especially to those who fall within the lower socioeconomic bracket.

This epidemic in the 1980s led to a widespread notion that cocaine is associated with the affluent, while crack is related to lower-income or minority communities. However, this notion was proved false when it was identified in 1991 that most crack users were Caucasian. It was further analyzed that most crack users were previous cocaine users who alternated to crack due to the high costs associated with cocaine purchase.

Similar to most illicit substances, any amount of crack intake is considered abuse. However, the effects of crack tend to differ from one person to another due to the fluctuations in the substance’s purity.

According to the analysis of a clinical pharmacist, the effects of cocaine when snorted can take root within one to five minutes and peak at 20 to 30 minutes. The effects taper off usually within one to two hours. However, with crack cocaine, the effects take root within one minute and peak at three to five minutes. The intense effects generally dissipate within thirty to sixty minutes.

Since the euphoric highs generated by crack cocaine are short-lived, individuals are highly likely to take more and more of the substance to sustain the effects. This behavior can make an individual highly susceptible to addiction and overdose.

Crack addiction can form rapidly, with some even developing it overnight or the very first time they experiment with it. As the euphoric high generated by crack is very intense, an individual might inhale or inject more and more of the substance frequently, resulting in the development of addiction. Due to its highly addictive nature, the abrupt cease of consumption will result in severe and dangerous withdrawal systems.

The effects of crack, both physical and psychological, can increase in severity when a person smokes more and more of the substance. Some of the immediate effects of crack abuse are:

• Immediate and immediate euphoria
• Hyperactivity and excitability
• Talkativeness
• Tension
• Over-confidence
• Irritability
• Aggression
• Restlessness
• Anxiety
• Paranoia
• High alertness
• Seizures
• Increased blood pressure or heartbeat
• Dilated eyes
• Loss of appetite
• Difficulties in sleeping
• Stroke
• Heart failure
• Eccentric behaviors
• Hallucinations about bugs crawling under one’s skin
• Intense cravings for the substance
• Nausea
• Increased body temperature
• Contracted blood vessels

Crack abuse should not be taken lightly. Although there are a considerable number of people who abuse different types of drugs in private, this is rarely the case with crack addicts. It is quite challenging for crack addicts to keep their abuse/addiction a secret.

The mental obsession with crack is also a significant indicator of abuse/addiction. Crack addicts tend to prioritize their substance use above all other obligations in life. These individuals could also have rifts with the law and get into legal troubles. As per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), here are a few signs of addiction to look out for:

• Forming a tolerance to the substance
• Experiencing withdrawal symptoms after quitting the substance use
• Neglecting work and personal obligations
• Using more of the substance than intended

Any individual exhibiting the above symptoms are clinically known to have a crack cocaine addiction and may require immediate medical intervention.

Here are a few signs of crack cocaine abuse and addiction:

• Unaccounted disappearance
• Dilated pupils
• Aggressiveness
• Restlessness
• Irresponsible behaviors that are not characteristic to the individual
• Burning sensation on the fingers
• Labored breathing
• Cracked or blistered lips due to smoking out of a hot pipe

It is universally accepted that the use of illicit substances, such as crack and heroin, can be detrimental for an individual in the long-run. Crack abuse damages vital organs such as the liver, kidneys, and heart while also making the individual more susceptible to various infections. Few other effects of long-term crack use are:

• Depression
• High blood pressure
• Abscesses
• Malnutrition
• Tooth decay
• Damages to the blood vessels
• Problems with reproduction or fertility
• Disorientation
• Apathy
• Sexual dysfunction
• Exhaustion
• Irritability
• Risky behaviors
• Delirium
• Psychosis
• Paranoia
• Respiratory failure
• Stroke
• Heart attack
• Death

One of the most apparent dangers of crack is its addictive property. Crack releases an excessive amount of dopamine, a neurotransmitter that poses control over the brain’s pleasure and rewards systems. Therefore, as soon as one consumes crack, the brain will rewire itself to the pleasure generated through it and start depending on the substance to function normally.

The short-lived, intense effects and it’s highly addictive characteristics make crack cocaine users highly susceptible to overdose. An overdose is easily identified by the following signs.

• Anxiety
• Aggression
• Seizures
• Rapid heartbeat
• Sweating
• Dilated pupils
• Chest pains
• Nausea
• Hallucinations
• Stroke

It is noteworthy that the possibilities of a fatal overdose are higher in individuals who have a history of kidney problems or high blood pressures.

Individuals who frequently abuse crack tend to invite harm to themselves and others around them, mainly due to their uncontrollable drug-seeking behaviors. A few behavioral risks of crack abuse are:

• Crack has been observed to intensify sexual desires and remove self-awareness resulting in unprotected sex or sex with multiple partners, exposing them to the risks of contracting sexually transmitted diseases. Certain individuals desperate for a shot can also exchange sexual favors in return for crack.
• Crack increases the tendency to violence by intensifying anger and rage. As such, individuals high on crack can be dangerous to themselves and to those around them.
• Individuals are highly likely to enter risky neighborhoods or undertake dangerous and unlawful activities to obtain the drug.
• Individuals are likely to steal from their own family and friends to help fuel their addiction.

Statistics on crack abuse are quite sparse. The below estimates are based on the information that is openly available.

• Crack is used extensively in the US, Italy, Australia, and South American countries such as Chile and Argentina
• With over 178,475 admissions to addiction treatment, crack cocaine was one of the main types of abuse that was reported in 2006. It accounted for more than 71 percent of all cocaine admissions to treatment the same year.
• As per a survey in 2004, around 7,840,000 people have confessed to using crack at one point in their lives. In 2006, this increased to 8.6 million, amongst which about 6.9 percent have also reported using cocaine previously.
• Those who have used crack during the last 30 days account for 0.2 percent of the total population.
• In 2007, the US Federal courts sentenced 5,477 people guilty of crimes that were directly or indirectly associated with crack cocaine use. More than 90 percent of these convicts were engaged in illegal crack cocaine trafficking
• Monitoring the Future survey conducted by the US has identified that around 3.2 percent of twelfth graders had used crack cocaine at some point in their lives.
• The situation is drastically different in Europe. The European Monitoring Center for Drugs and Drug Addiction (EMCDDA) has reported that crack addiction is only limited to minority communities in larger cities who have issues with unemployment and poor living conditions.
• In 2006, about 20 European countries analyzed that those addicted to crack accounted for only 2 percent of the total addicts enrolling in rehabs or treatment centers. Most of these individuals are from the United Kingdom.

Crack cocaine addiction implies that an individual has developed a physical and psychological dependence to crack and might encounter distressing withdrawal symptoms when quitting.

Crack’s potency causes significant changes to the brain and nervous system. As such, when someone quits taking it for some time, the body might need time to rewire the brain back into functioning without the drug in the system. This phase is referred to as withdrawal.

During the withdrawal phase, the user will undergo many unpleasant symptoms, such as depression, agitation, anxiety, fatigue, paranoia, mood swings, restlessness, and nightmares. These symptoms can vary in intensity based on factors such as the user’s tolerance, length of addiction, frequency of drug use, the severity of the addiction, and the presence of any co-occurring mental disorders.

Overcoming one’s dependency to crack cocaine can be quite challenging. Due to its adverse withdrawal symptom, many find it hard to stop. Withdrawal symptoms can be divided into two main stages:

• Acute withdrawal: Acute withdrawal refers to the immediate symptoms that follow the cessation of drug use
• Protracted withdrawal or Post-acute Withdrawal Syndrome (PAWS): Protracted withdrawal is the psychological symptoms that appear several weeks or months after ceasing the drug habit.

The characteristics of acute withdrawal symptoms are:

• Anxiety
• Exhaustion
• Difficulties in concentrating
• Irritability
• Mood swings
• Unpleasant dreams

The commonly occurring protracted withdrawal symptoms are:

• Depression
• Anxiety
• Agitation
• Intense cravings
• Sleep disorder
• Frequent emotional outbursts
• Lack of motivation
• Inability to experience pleasure

Withdrawal is accompanied by certain health risks such as heart attacks, strokes, seizures, and neurological problems. However, these risks can be controlled to a great extent during medical detox.

The withdrawal duration typically depends on a number of factors, including the user’s body chemistry, drug tolerance, severity, and length of addiction.

Withdrawal can begin as soon as 30 minutes or 72 hours after the last dose. The physical symptoms that appear during withdrawal can stay around for one to three months, although there is no precise timeframe to it.

Any withdrawal symptoms that persist for more than three weeks are termed as Post-Acute Withdrawal Syndrome (PAWS). Psychological symptoms, such as intense cravings, vivid dreams, and strong obsession with the drug, can remain for a longer time, with some even lingering around for more than six months.

Users are highly advised to treat their addiction in a medical treatment facility to help prevent any episodes of relapse.

The withdrawal symptoms and timeline can vary from one person to another. But, a typical withdrawal phase goes through the below–mentioned timeline.

Crack addicts stand the best chance at recovery while detoxing at a drug addiction treatment facility. These programs are performed by therapists and physicians who customize treatment and recovery plans based on the specific needs of each patient.

After the successful completion of the detox program, most patients will be transferred or referred to a residential or outpatient rehab center to continue on with their treatment programs, therapies, and counseling. Treatment at these rehabs focus mostly on the psychological aspects of the individual’s addiction and can last anywhere between 30 days to one year.

Most of the treatment programs use a range of therapeutic techniques, including psychoeducational groups, process groups, support groups, individual psychotherapy, cognitive-behavioral therapy, motivational interviewing, and dialectical behavioral therapy. These techniques equip patients with healthy relapse prevention skills and help them in identifying and changing behaviors and thought processes that led them to addiction in the first place.

Researchers have found out that the most challenging part of addiction recovery is overcoming the social aspect of crack use; hence, why a successful recovery should start by moving the individual into a positive surrounding and associating with people who only have good intentions for you.

Crack addiction is easier to treat when the addict is welcomed into a surrounding or social structure that they were never a part of before. This approach focuses more on habilitation than rehabilitation.

The support groups and relationships established within the treatment centers are vital components in helping an addict through their journey to recovery.

Detox is the preliminary stage to most drug addiction treatments and is most often customized as per the severity of the addiction, treatment needs, medical history, and body chemistry of the crack user. It is an effective process, if done in a highly controlled environment, can safely remove the drugs from the body and help cope with the depression that typically follows crack abuse. The process will be constantly supervised by doctors for any emergencies.

Unlike detox of other highly addictive drugs, crack is not tapered down during the detox program. Instead, users are encouraged to quit the substance cold turkey and take medications to combat the powerful withdrawal symptoms that can follow. Drugs that are used during a crack detox program are:

• Gabapentin– This medication is generally used to treat seizures, hot flashes, neuropathic pain, and restless leg syndromes. However, under a crack detox program, they are used to relieve symptoms such as seizures, insomnia, and anxiety.
• Vigabatrin– This is an anti-epileptic drug that is primarily used to prevent relapses by controlling anxiety during detox.
• Clonidine – This drug reduces high blood pressure and anxiety.
• Propranolol and Vistaril – These medications treat anxiety.
• Trazodone and Seroquel – These drugs treat sleeping difficulties.

Recovery is definitely hard, and the withdrawal symptoms will make relapse inevitable. However, a few relapses do not mean immediate failure.

Certain rehabs treat only a specific type of addiction, for example, opioid addiction or alcohol addiction. Enrolling into a rehab that specializes in crack addiction treatment could greatly improve one‘s chances of a full recovery.

Inpatient treatment requires patients to reside at the facility to receive around-the-clock support, supervision, and treatment in a highly-structured treatment atmosphere. Inpatient rehabs provide the ideal environment to focus solely on the treatment, as the patient is systematically detached from the environment that encourages addiction.

Certain inpatient rehabs offer detox services in addition to the standard programs, while some do not. Inpatient rehabs generally include a range of substance abuse treatment programs. While some inpatient rehabs only specialize in treating crack cocaine addiction, others can treat both the addiction and any other related mental disorders. Since long-term crack abuse can lead to depression, enrolling in a facility that treats both the addiction and co-occurring disorders can be promising. It is essential to take this into consideration when choosing the right rehab for you.

Inpatient rehabs can also include holistic programs, such as yoga, meditation, acupuncture, and creative arts therapy, that focus on healing the mind, body, and spirit, in addition to other traditional therapies or alternative methods.

Outpatient rehabs do not require patients to reside within the premises while receiving treatments. Patients are offered the flexibility to travel to the clinic for scheduled therapy sessions. This treatment option is the go-to choice of many individuals who prefer to keep their personal and professional life uninterrupted from addiction recovery treatment.

The programs offered by outpatient rehabs can vary. Some rehabs may provide patients with treatment for 20-30 hours per week, while others may provide treatment for 2-4 hours per week.

Outpatient rehabs can also be attended by patients who have just completed an inpatient program but would like to get off the treatment gradually or would like some extended support in the form of outpatient rehabs.

It is not necessary for all crack cocaine addicts to enroll in inpatient rehabs. Only a few could benefit from inpatient rehabs, while the others can benefit the most from outpatient rehabs to establish sobriety.

Both facilities are effective in their own ways to sustain recovery. However, the decision to enroll in a specific rehab is rooted down to a patient’s needs, addiction, and treatment preferences. Since addiction treatment is an individualized experience, what works best for one may not work for another. Individuals who could benefit the most from inpatient rehabs are:

• Individuals with a very severe or crippling addiction to crack.
• Individuals with co-occurring mental disorders.
• Individuals who are abusing both crack and other illicit or addictive substances.
• Individuals who have quit addiction treatment abruptly or without notice in the past.
• Individuals who lack a strong support system.
• Individuals without reliable access to outpatient rehabs.
• Individuals with suicidal or violent thoughts and behaviors.

The most effective way to figure out the best treatment program is to seek the guidance of a physician or an addiction treatment professional. These professionals will first assess one’s addiction, mental and physical health, and other aspects before reaching a conclusion on what treatment suits best.

Many addicts refrain from seeking treatment due to the fear of reprisal from law enforcement or humiliation at work or society. However, it is crucial to note that since drug rehabs classify as medical facilities, they are bound by the Health Insurance Portability and Accountability Act to remain confidential with regards to patients’ information. The act also covers regulations on how health information of a patient should be disclosed.

Crack addiction recovery can require continuous intensive counseling, as adjusting to a life without a drug that was once a major part of life could be challenging. Certain rehabs also include vocational training to equip addicts with the necessary skills to blend back into society.

Establishing long-lasting ties with the many support groups within the community, which consist of people who keep you away from temptations and support you through your recovery, is a vital part of long-lasting recovery.