Rehab 4 Addiction

Crack cocaine produces one of the most intense highs of any drug; it can also have a devastating impact on people’s lives.

In this article, we explain everything you need to know about crack cocaine, including what effect it has on the brain, how it leads to addiction, and what the best treatment options are.

What is crack cocaine?

Crack cocaine is a more potent form of cocaine. It has a similar effect to cocaine, except the high is even more extreme and the effects only last for between five and fifteen minutes.

Whereas cocaine tends to come in a powder form, crack cocaine comes in ‘rocks’. These rocks are made by dissolving cocaine in water and baking soda, boiling it, and then splitting up the resultant solid into lumps. These lumps, or rocks, can then be put into a pipe and smoked for an instant hit.

Crack cocaine goes by many names, including Cloud, Rocks, Apple Jack, Kryptonite and Base. The most commonly-used name, ‘crack’, comes from the sound the drug produces when smoked.

What happens when you smoke crack?

In scientific terms, crack cocaine causes a huge release of dopamine, which makes the user feel euphoric. It also raises the heart rate, and suppresses the appetite.

This feeling of euphoria only lasts for between five and fifteen minutes, after which the user rapidly comes down. They will then start to experience cravings for more crack.

Due to the short-lived nature of the crack high, crack users can spend huge amounts a day on their addiction. Some are driven to crime in order to fund their habit.

What are the symptoms and signs of crack use?

The most obvious sign that someone is high on crack is very high levels of energy. Crack use produces feelings of intense euphoria. Someone who is high on crack may talk very quickly, or appear agitated. After the high subsides, they will feel very tired and may fall asleep.

Doe to this oscillation between extreme energy and complete exhaustion, crack users will find it difficult to carry out daily activities such as going to work.

Furthermore, rapid mood swings can exert stress on relationships, since it is very difficult to be around someone who is irritable or violent.

When trying to stop using crack, users are likely to experience depression; long periods without crack can lead to even worse withdrawal symptoms, including hallucinations and paranoia.

Another sign of crack use, which is also common in people suffering from AUDs (Alcohol Use Disorders), is shaking or ‘tremors’. Tremors usually occur in the hands, but can also occur in other parts of the body. They may happen while someone is high on crack, or when they are sober.

Due to the illegal nature of crack, crack users will have to spend time searching for and procuring their drug of choice. They will also have to spend large amounts of money on crack, which is relatively expensive given how quickly it wears off.

Financial difficulties, and being out of the house very late at night, can therefore both be signs of crack addiction (especially if your loved one is displaying physical symptoms of crack use).

Like many drug addicts, crack users are unlikely to admit to their addiction. They may see it as a private activity which, for various reasons, they don’t want other people to know about. If you challenge someone about their crack addiction, there is a high chance that they will deny it.

Another sign of crack use is nosebleeds. These are prevalent in people who snort crack, rather than smoking it through a pipe. Though smoking crack is the more common way to take the drug, snorting is still popular.

Snorting crack is even more damaging to the nasal lining than snorting normal cocaine, since crack rock tends to be sharp and abrasive even when crushed into a powder.

Over time, someone who snorts crack may lose the ability to smell; they are also likely to have a runny nose most of the time.

The same is true of sore throats, which can occur as a result of snorting crack as well.

Finally, crack use is known to cause mydriasis, or dilated pupils and red, bloodshot eyes. If your loved one has red eyes and dilated pupils it could be a sign that they are addicted to crack.

Why is crack cocaine so addictive?

Over time, when users repeatedly abuse crack cocaine, the pleasure receptors in their brains begin to alter, such that normal activities are not as pleasurable as they once were. The brain begins to crave the effects of cocaine; this is what is known as the ‘strong reinforcing’ effect of cocaine and crack cocaine. [1]

In essence, crack cocaine is addictive because of the intense nature of the high it produces, and the unpleasantness of the withdrawal symptoms that set in rapidly after the high.

Users who have used crack find themselves very quickly coming back to reality, and the temptation to experience that extreme high once again can be overwhelming.

What are the dangers of using crack cocaine?

There are countless dangers that go hand-in-hand with using crack cocaine, but here are some of the main ones.

  • Health risks. Long-term use of crack cocaine can lead to problems with the lungs, brain, nervous system, reproductive organs, heart and more. The body simply is not equipped to deal with the physiological effects of crack cocaine use on a day-to-day basis, and over time, crack use will wreak huge damage on the user’s physical health. According to one addiction calculator, the life expectancy of a crack addict can be as low as 40 years
  • Poverty. Crack cocaine can cost around £10-20 per rock in the UK. [3] That doesn’t seem like much, but given that the high from crack is so short-lived, it can add up pretty quickly. Over the course of several years, or even decades of crack use, the risk of falling into poverty and homelessness is high for crack users. [4] This is partly due to the difficulty of holding down a job as a drug addict
  • Damage to relationships. It can be very hard for someone with an addiction to crack to form and maintain a relationship, due to the mood swings, poverty, mental illness and other negative consequences that come with crack use. As relationships steadily fall away, crack users may become isolated, which in turn can lead to a worsening of their addiction
  • Risky sexual behaviour and STIs. Crack users tend to be more likely to engage in risky sexual behaviour, which raises their chances of catching an STI. Serious STIs such as HIV or Hepatitis C can lead to further health problems and isolation
  • Mental illness. Long-term crack use is very likely to lead to mental illnesses, such as depression and psychosis. ‘Most clinical studies report a high psychiatric comorbidity, mainly among crack users.’ [5] Interestingly, the form of cocaine – normal or crack – is less important than the intensity of use, with severe users of cocaine and crack the most likely to develop mental health problems
  • Putting yourself in danger. The illegal status of crack cocaine means that in order to buy it, you must buy it from a drug dealer. This carries risks. You are more likely to be a victim of crime if you put yourself in these situations
  • Getting in trouble with police. Again, the possession and sale of crack cocaine are illegal, which means you have to commit a crime in order to access your drug of choice. This can have knock-on effects such as the threat of jail time

How prevalent is crack cocaine use in the UK and abroad?

While the numbers of people using crack cocaine in the UK are still relatively low – around 4,200 people entered treatment for crack use in 2017-18 in the UK – they do appear to be on the rise, with a 4.4% increase between 2014-15 and 2016-17. [2]

This suggests that the UK does have an issue with crack use. One possible explanation for the recent rise in people receiving crack treatment could be so-called ‘special offers’ on crack cocaine, with crack going down in price recently. [6]

Another is the ‘county lines’ phenomenon, where drug dealers ferry their product from large cities such as London and Manchester to smaller towns, often using children as mules.

A final explanation is the increase in purity of cocaine, with many users and scientists reporting that purer cocaine is flooding the market.

One EU study looked at cocaine use among selected dance music populations. It found the highest proportion of cocaine use among the UK sample, with 42% having used cocaine in the last 30 days, and around 75% having used cocaine during their lifetime.

By contrast, in the Netherlands, 20% of clubbers had used cocaine in the last 30 days, and 32% had used it during their lifetime. [7]

This data suggests that the UK has relatively high cocaine use compared to other European countries, although only a small proportion of this will be crack cocaine use.

What are the stages of crack addiction?

Every crack user has their own story about how they started using crack, but there are certain stages which are common to many crack users.

  • First crack experience. It all begins with the first time you take crack. One use is not enough to make you addicted, but the overwhelming euphoria that people feel when they first take crack often makes people want a repeat of that experience
  • Growing accustomed to crack. After the first experience, some decide that they never want to try crack again. Others, however, feel an urge to take more crack, and those that do enter a phase in which they rapidly familiarise themselves with the drug, and begin to develop cravings
  • Developing a habit. Once crack use becomes a regular, daily experience, a third phase has been reached. In this phase, crack use starts to become a habit. Cravings become a normal part of life, and using and procuring crack starts to take precedence over other, previously important things such as relationships with loved ones
  • Dependence becomes addiction. When crack use takes over all aspects of life, and you continue to use it despite serious negative consequences, you have developed an addiction. At this stage, proper treatment is needed in order to help you overcome your addiction safely and effectively

What happens during a crack overdose?

Due to the stressful effect which crack has on the body, people can overdose on this drug.

However, evidence from one study suggests that overdose may not be the most common cause of death among crack users. A study of crack cocaine users in Sao Paulo found that only 10% of deaths were caused by overdose. [8]

That being said, every overdose is tragic. More should be done to raise awareness among crack users of the risk of overdose, and what to do if they think they are overdosing.

What are the symptoms of an overdose?

During an overdose, crack users are likely to display convulsions and agitation. They may also experience delusions and hallucinations, and they are likely to have a high body temperature.

If you think someone is overdosing on crack, call a doctor immediately.

What are the health problems caused by crack cocaine use?

The health problems caused by crack cocaine can be both short-term and long-term.

Short-term health risks include:

  • Seizures
  • Paranoia
  • Unusual behaviour
  • Nausea
  • High blood pressure
  • Hallucinations
  • Elevated body temperature
  • Delusional thinking
  • Panic and anxiety
  • Accelerated heart rate and respiration

Longer-term health risks include:

  • Long-lasting psychotic symptoms
  • Significant cognitive decline
  • Malnutrition
  • Depression, anxiety, and irritability
  • Kidney and/or liver complications
  • Cardiovascular problems such as stroke, heart attack, and damaged blood vessels
  • Damage to the lips, mouth, teeth

Treatment for crack addiction (including a detox timeline)

Crack addiction is typically treated with a medically assisted detox and rehab. During the detox, you will go through various stages:

  • 0-24 hours after last dose. During the first day after your last hit, you will start to crash. You will feel completely exhausted. You will also experience some cravings
  • 2-5 days after last dose. Sometimes known as the ‘honeymoon stage’, crack users may feel surprisingly happy and confident during this period. Cravings tend to disappear for a few days
  • 5-14 days. Cravings come back. Still low on dopamine and serotonin, your body craves crack in order to help it produce more of these chemicals. Withdrawal symptoms may also intensify. These can include anxiety, fever, depression, diarrhoea, and muscle pain
  • 14-28 days. Emotional withdrawal symptoms intensify. During this stage, you will experience an uptick in symptoms such as anxiety and depression, as well as mood swings, nightmares, and irritability
  • 28 days onwards. After the first month, you will have got through most of the acute withdrawal symptoms associated with crack detox. You may still experience some prolonged withdrawal symptoms. You will also have to learn to manage triggers and stressors which tempt you to relapse. All of this can be achieved with sufficient help and support

A full detox should be followed by rehab. A detox on its own will help rid you of all traces of toxins, but it won’t help you to understand why you became addicted to crack in the first place.

Knowing what caused your addiction is of the utmost importance if you want to stay abstinent in the future.

What are the main therapies used in crack cocaine rehab?

Crack cocaine addiction is often treated using behavioural therapies, such as Contingency Management. Contingency Management incentivises abstinence by awarding people in recovery with prizes and vouchers when they are able to produce drug-free samples of urine.

This encourages users not to relapse. It also provides tangible, real-life consequences for abstinence – and for relapse.

This helps people in recovery to think about their sobriety as something more meaningful. Studies have shown that CM is effective in some populations. [9][10]

Another behavioural therapy that is often used to treat crack addiction is Cognitive Behavioural Therapy.

CBT helps patients to identify the thought patterns and triggers which tend to lead to their relapse. CBT has a wealth of evidence behind it, too. [11]

Finally, for those who can afford a longer stay in rehab, Therapeutic Communities can be helpful for crack cocaine users. In TCs, patients stay in rehab for between six and 12 months.

In a TC, more emphasis is placed on vocational things, such as helping addicts to learn key skills which will stand them in good stead once they leave rehab. [12]

Long-term recovery from crack addiction

Long-term recovery from crack addiction is all about managing your triggers and stressors, maintaining good relationships, and staying connected with other people in recovery.

One good way to keep up with other people in recovery is to join a 12-step group. Cocaine Anonymous is the branch of Alcoholics Anonymous which is specifically for cocaine addicts. They have meetings in most major cities.

Final thoughts

Crack cocaine addiction is a terrible addiction, but it can be overcome.

We hope you’ve learned something useful from this article. If you or a loved one are going crack addiction, we wish you a successful recovery.

References

[1] https://www.emcdda.europa.eu/publications/drug-profiles/cocaine_en

[2] https://publichealthmatters.blog.gov.uk/2019/03/25/what-the-latest-estimates-on-opiate-and-crack-use-tell-us/

[3] https://www.drugwise.org.uk/how-much-do-drugs-cost/

[4] https://www.homeless.org.uk/connect/news/2015/aug/05/homeless-health-data-finds-heroin-and-cocaine-dependency-more-prevalent

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414771/

[6] https://www.theguardian.com/society/2019/mar/25/special-offers-on-crack-cocaine-fuelling-big-rise-in-use-in-england

[7] https://www.emcdda.europa.eu/system/files/publications/445/TDSI07002ENC_84864.pdf

[8] https://pubmed.ncbi.nlm.nih.gov/17063219/

[9] Schierenberg A, van Amsterdam J, van den Brink W, Goudriaan AE. Efficacy of contingency management for cocaine dependence treatment: a review of the evidence. Curr Drug Abuse Rev. 2012;5(4):320-331.

[10] Petry NM, Alessi SM, Rash CJ. Contingency management treatments decrease psychiatric symptoms. J Consult Clin Psychol. 2013;81(5):926-931. doi:10.1037/a0032499.

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/

[12] Vanderplasschen W, Colpaert K, Autrique M, et al. Therapeutic communities for addictions: a review of their effectiveness from a recovery-oriented perspective. Sci World J. 2013;2013, 2013:e427817. doi:10.1155/2013/427817.