Crack Cocaine Addiction: Signs, Symptoms, Risks, and Treatment Resources

What is Crack?

Sometimes called crack cocaine, this stimulant is derived from cocaine. The off-white substance is broken into small, hard chunks called “rocks.” Crack cocaine is typically smoked and, less commonly, injected.

A Schedule II drug[1], crack cocaine, is highly addictive and affects individuals, families, and communities from every geographic and socioeconomic background. According to data from the U.S. Department of Justice, an estimated 6.2 million U.S. residents[2] have tried crack cocaine at least once.

Crack Cocaine Quick Reference

Effects of Crack

Users often report an initial surge of energy, overwhelming happiness, and hyperfocus in the first ten to fifteen minutes after taking crack cocaine. This is followed by a period of depression, irritability, and extreme cravings for more of the substance.

Crack cocaine affects multiple systems in the body and brain.

What Does Crack Do To The Brain In The Short Term?

In the short term, crack cocaine causes a buildup of the neurochemical dopamine, giving users feelings of euphoria and satisfaction. It also impacts other brain areas, including the hippocampus and amygdala areas [3], memory centers that imprint the recollection of the high permanently, contributing to the strong urge to use again.

Crack can heighten the senses, amplifying the experiences of sights, scents, and touch. As a stimulant, crack cocaine can lead to feelings of intense energy, talkativeness, and in some cases, agitation, restlessness, and nervousness.

How Does Crack Affect Our Brains Over A Longer Time Period?

Crack cocaine users stop producing enough dopamine naturally, resulting in an increased reliance on the drug. This puts users at greater risk for serious mental illnesses, including psychosis. Lasting damage to the brain due to crack cocaine use also results in poor judgment, impulsiveness, and memory[4].

How Does Crack Affect The Body In The Short Term?

Crack causes an increase in heart rate, blood pressure, and temperature right after it is smoked or injected. Users may experience muscle spasms, convulsions, jitteriness, and other forms of involuntary movement. In some cases, users may experience seizures.

When crack is smoked, it causes blisters, sores, and cuts on the lips and mouths of users, putting them at an increased risk of contracting HIV and other diseases.[5] Because crack slows the pupil’s reaction to light, users often have bloodshot eyes and may experience vision problems.

What Does Crack Cocaine Do To The Body Over Time?

Long-term crack cocaine use puts immense strain on the body’s cardiovascular system, leading to an increased risk of heart attack, stroke, kidney failure, and death. Liver damage, chronic malnutrition, sexual dysfunction, and infertility. Severe tooth decay, asthma, and lung damage are also associated with smoking this substance.

How Does Crack Affect People Living With ADHD and Other Neurodiversity?

For some people, especially those living with ADHD and neurodiversity, crack cocaine can provide a calming effect and lead to greater confidence and self-control. This may lead to crack cocaine being used to self-medicate[6]  these disorders.

Crack Cocaine and Addiction

Crack cocaine is extremely addictive, often causing people to crave it again immediately after trying it out for the first time. This sparks a vicious cycle, with users chasing that initial high again and again, requiring more of the drug to achieve the same feeling and leading to crack dependency.

Crack cocaine replaces the brain’s natural ability to create dopamine. Because of this, users require more and more crack to function. Without the drug, users experience debilitating periods of depression and irritability, with or without paranoia.

Withdrawing from crack cocaine also causes physical symptoms, including severe muscle cramps, agitation, diarrhea, tremors, restlessness, and insomnia. These unpleasant sensations contribute to people continuing to use the drug.

Diagnosing Crack Cocaine Addiction

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), addiction to crack cocaine is clinically referred to as a Stimulant Use Disorder.

Stimulant use disorder is present if a person meets 2 or more of the following criteria in the last 12 months:

1. The stimulant is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control stimulant use.
3. Much time is spent on activities necessary to obtain the stimulant, use it, or recover from its effects.
4. Craving, or a strong desire or urge to use the stimulant.
5. Recurrent stimulant use results in a failure to fulfill major role obligations at work, school, or home.
6. Continued stimulant use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the stimulant
7. Important social, occupational, or recreational activities are given up or reduced because of stimulant use.
8. Recurrent stimulant use in situations in which it is physically hazardous.
9. Stimulant use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the stimulant.
10. Tolerance, as defined by either of the following:
    1.  A need for markedly increased amounts of the stimulant to achieve intoxication or desired effect.
    2. A markedly diminished effect with continued use of the same amount of the stimulant.

If you suspect that you or someone you care about is experiencing Stimulant Use Disorder, speak to your medical provider about treatment options.

Can You Overdose on Crack?

Yes, it is possible to overdose on crack cocaine. Symptoms of a crack cocaine overdose may include an excessively rapid heart rate, hyperthermia (elevated body temperature), chest pain, seizures, delirium, paranoia, and severe agitation or anxiety. In case of a potential crack cocaine overdose, call 9-1-1.

The likelihood a user will overdose increases with the length of their addiction as the person continues to take bigger and bigger doses in search of the same high.

Additionally, the illegal nature of crack cocaine makes it more likely that it will be cut with dangerous additives, including fentanyl, levamisole, and lidocaine, increasing the risk of overdose and death.

According to data, overdose deaths in Tennessee involving stimulants, including cocaine, significantly increased by 245% from 2017 to 2021, with 620 specific deaths attributed to cocaine in 2021.[7] However, the state of Tennessee is working hard to change this through education and life-saving interventions.

From the fall of 2017 to the spring of 2023, over 60,000 lives were saved from drug overdoses in our state, as reported by the Regional Overdose Prevention Specialists (ROPS).[8]

Is It Possible To Recover From A Crack Cocaine Addiction?

Recovery from crack cocaine is possible and becomes more likely with the support of family, friends, and medical professionals. It also requires the crack cocaine user to want to recover. Recovery takes the form of three stages — withdrawal, treatment, and lifestyle maintenance.

Crack Cocaine Withdrawal

Detoxing from crack cocaine is the first step in recovering from this addiction. Unfortunately, the symptoms of withdrawal from crack cocaine can be very severe. It’s best to undergo this process wherever possible while supervised by medical professionals, including your family doctor, an additional treatment specialist, or a rehabilitation center.

When stopping crack cocaine, people are likely to experience psychological symptoms, including extreme depression, anxiety, irritability, mood swings, and intense, painful cravings for the drug.

Physical symptoms range from restlessness and muscle pain to diarrhea, tremors, and a marked increase in appetite. These symptoms are most pronounced during the first 14 days and should begin to taper out by the 21-day point. It is advisable to consult with a healthcare professional who can assess and potentially prescribe medications to help manage withdrawal symptoms safely.

Crack Cocaine Addiction Treatment

After the physical detox is over, the next stage of treatment for crack cocaine addiction begins. During this time, medical professionals, including doctors, therapists, and social workers, help address the underlying causes of addiction, for example, depression or anxiety, and set up this individual for long-term sobriety and success.

This treatment may take place through inpatient or outpatient programs. These treatment models typically involve individual psychotherapy, support groups, dialectical behavioral therapy (DBT), cognitive behavioral therapy (otherwise known CBT for addiction), Rational Emotive Behavioral therapy (also known as REBT therapy for addiction) and social and life skills training.

Lifestyle Changes to Prevent Crack Cocaine Relapses

Once someone has experienced crack cocaine addiction, they always need to be vigilant in avoiding a return to old habits.

According to researchers, lasting recovery from substance use disorder can be supported by six key elements[9]:

1. Nutritious and appealing diets
2. Individualized physical activity plans
3. Improving and maintaining good sleep
4. Managing stress through healthy coping strategies
5. Building and fostering strong social relationships
6. Stopping tobacco smoking.

Recovery is an ongoing journey, but adding some or all of these building blocks can help transform this challenge into a meaningful and hopeful lifestyle.