The Basics of Crack Cocaine Rehabilitation

Crack cocaine rehabilitation typically begins when an individual recognizes he or she has an addiction and reaches out for professional help. In some cases, individuals may be deemed unable to make this determination for themselves, in which case a court might order them to attend rehab if they have been determined to be a danger to themselves or others.

Within the treatment program, whether inpatient or outpatient, an initial assessment is conducted. Clinical and therapy professionals work with the individual to create a treatment plan to meet his or her sobriety goals.

As of late 2019, the FDA had not approved any medications specifically for cocaine rehabilitation. However, within an inpatient or residential environment, clinical staff members may provide some medical interventions to help treat symptoms of cocaine withdrawal — for example, providing options to reduce nausea or vomiting.

Cognitive behavioral therapy and other therapies may begin immediately in inpatient or outpatient programs and may increase as a person continues through the detoxification process. Depending on the treatment program, users might engage in individual and group therapy, recreational therapy, exercise and nutrition education, and other activities. Treatment staff also work with clients to plan appropriate aftercare and therapy after being discharged from any program, as successful recovery and relapse prevention may require ongoing intervention.

the four steps of rehab process

What Makes Crack Cocaine Rehabilitation Difficult?

Cocaine, and thus crack cocaine, is a Schedule II substance under the Controlled Substances Act. Schedule II substances are considered to be those with limited medical use that also have a high potential to be abused and create addiction. Cocaine in crack form doesn’t have medicinal use, but cocaine itself does, which is why this illicit drug falls under the Schedule II category. According to data from the United Nations Office on Drugs and Crime’s World Drug Report, cocaine use is prevalent in most nations on four continents: North and South America, Europe, and Australia. It’s also prevalent in certain areas of Africa, specifically South Africa, Nigeria, and Kenya.

Crack cocaine addiction can be difficult from which to recover, due in part to how the drug interacts with the body and brain. Cocaine changes the way the brain manages dopamine, which is a hormone that causes you to feel pleasure. Normally, the body recycles dopamine to keep it at appropriate levels, given natural responses to the environment and situation. However, cocaine turns off the processes that manage this recycling, so dopamine builds up in the system, creating unnatural and intense pleasure responses.

The human body is designed, in part, on a risk and reward system. The brain and body have a natural tendency to keep doing things that feel good. In a healthy situation, that might be exercise, eating right, or engaging in appropriate social interactions. For individuals addicted to crack cocaine, however, what feels good is using more of the drug, and the brain and body may no longer feel natural pleasures related to other activities.

The Unique Struggle of Crack Cocaine Addicts
Crack cocaine…
  • Delivers a fast, strong, yet short-lasting high, leading users to abuse the drug repeatedly, which can result in a faster track to addiction
  • Alters the way pleasure hormones in a user’s brain and body work, resulting in drug-seeking behavior
  • Short circuits the body’s reward system, resulting in a user requiring more of the drug to feel the same high, which leads to increased usage and dosage
  • May increase performance with short-term activities because it speeds up physical and mental responses, leading to users becoming emotionally and psychologically dependent on the drug

Crack Cocaine Rehabilitation Statistics

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that in 2015:

  • 9,035,000 individuals age 12 and older — around 2.8% of the population — reported using crack cocaine at least once in their lifetime
  • Crack cocaine represented 63% of all treatment admissions for cocaine addiction
  • 65,108 people age 12 and older admitted into addiction treatment facilities reported crack cocaine as one of their drugs of choice

Cocaine Treatment Admissions by Gender

59.4% Male
40.6% Female

Demographics of Individuals Seeking Treatment for Cocaine Addiction

According to a 2017 SAMHSA report that charts admissions to and discharges from publicly-funded substance use treatment facilities, men are considerably more likely to seek treatment for crack cocaine abuse. The gender breakdown of treatment admissions for smoked cocaine was 59.4% male and 40.6% female. While crack cocaine addiction occurs in most age groups, individuals aged 50 to 54 was the most common age group admitted to a treatment facility for smoked cocaine use, with 44 being the average age of all individuals from all age groups seeking rehabilitation.

Smoked (Crack) Cocaine Treatment Admissions Percentages by Age Group, 2017
Age at the Time of Treatment Admission Percentage of Cocaine Treatment Admissions
12-17 0.1%
18-24 4.2%
25 – 34 18.1%
35 – 44 22.3%
45-54 36.6%
55-64 17.5%
65+ 0.2%

Crack Cocaine Detoxification & Withdrawal Process

Because crack cocaine impacts the way the brain functions and can cause a physical dependency, the first step for many individuals in recovery is detoxification. The first phase of detox focuses on managing the most difficult and uncomfortable withdrawal symptoms, which can last for a few days to a week.

The second phase of the withdrawal process for cocaine addiction can last several months, with users experiencing mild to moderate symptoms intermittently — particularly cravings for the drug.

Withdrawal symptoms lasting longer than two weeks are called post-acute withdrawal symptoms. Because addiction is a chronic disorder and not something that can be cured, some users may experience post-acute symptoms for a long time after use. Cravings for cocaine can come and go throughout the rest of the individual’s life, although strong coping skills and recovery tools can help users deal with cravings to remain drug-free. Typically, the length of the first stages of detox depends on a variety of factors, including the person’s overall health, history of drug use, and how much crack cocaine they had to use to experience a high.

Crack Cocaine Withdrawal Symptoms

Body Mind
Short-Term Symptoms Stomach pain/digestive distress
Drug cravings
Loss of appetite and weight
Difficulty sleeping
Physical restlessness
Sadness and depression
Mental desire for the effect of the drug
Slowed thinking process
Long-Term Symptoms Drug cravings
Changes to appetite and sleep
Desire for the drug

Suspicion can make crack cocaine detox more difficult

The changes cocaine makes in the body alter the way the brain functions. As a result, paranoia and suspicion of others can be common withdrawal symptoms. Since cognitive behavioral therapy — one of the recommended best practices for treating drug addiction — and other treatment options often depend on patients developing a trust relationship with providers or counselors, this withdrawal symptom can be a barrier that needs to be addressed.

Mood changes and mental health struggles can occur

Cocaine alters the chemistry of the brain. Brain chemistry is partly responsible for dictating moods and approaches to certain situations and emotions. In the weeks after users stop taking cocaine, their bodies goes through a period where the brain works to return their brain chemistry to normal. During that time, users can experience severe mood swings and other mental health distress.

Cognitive challenges or a perception of cognitive challenges can be present

Some individuals start or continue taking cocaine for the “speed up” effect it has on the brain. It can increase the speed of mental processes and, in some cases, make users feel as if they are moving or thinking faster. Consequently, some users feel as if they slow down or are moving or thinking too slowly when they stop taking cocaine. It can take a few hours or weeks for brain and body functioning to recalibrate to normal, causing some frustration in the meantime.

Crack Cocaine Detoxification Medications

There are no FDA-approved medications specifically for crack cocaine detoxification, though research is being done in this arena. Some medications have shown promise in being able to reduce cocaine use or dependence. Meanwhile, clinical treatment providers may provide other medication interventions, such as over-the-counter medications meant to address certain specific withdrawal symptoms.

For more information about withdrawal, read our guide on crack cocaine addiction.

Treatment for Crack Cocaine Addiction

While the FDA doesn’t currently approve any medications to treat cocaine addiction, some clinical trials are using medications approved for treating alcohol addiction or dependency on other drugs. Researchers are also working on a potential vaccine that may be able to reduce an individual’s likelihood for cocaine relapse.

As of December 2019, the primary treatments for cocaine addiction in use among providers in the United States are behavioral in nature. They include, but aren’t limited to, cognitive behavioral therapy, time in therapeutic communities, and group therapy.

Crack Cocaine Rehabilitation Settings

Within either an inpatient or outpatient setting, treatments such as detoxification services, behavioral therapies, and medication-assisted treatment are offered for varying lengths of time.

Inpatient treatment involves living full-time (including overnight) at a treatment facility for a set period of time. Outpatient treatment involves scheduled appointments at a facility in which you are free to come and go. Within each category, there are several distinctions.

Crack Cocaine Treatment Programs
Setting Type of Treatment Description Duration Time Commitment
Inpatient Short-Term Residential Intensive treatment, sometimes in a hospital setting. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 14-30 days Hours Per Day:


Days Per Week:


Long-Term Residential Intensive treatment in a non-hospital setting, most often a therapeutic community with other patients. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 3-12 months Hours Per Day:


Days Per Week:


Partial Hospitalization Intensive treatment in a hospital setting. Patients do not stay overnight. Considered inpatient due to the hospital setting. Extensive services are provided and require a near full-time commitment every week. Medication-assisted treatment is available to those who qualify. 14-30 days Hours Per Day:


Days Per Week:


Outpatient Intensive Day Treatment Extensive services of an inpatient program but patients return home each day following treatment. After completion, patients often transition to less intensive counseling. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 3-4 months Hours Per Day:


Days Per Week:


Counseling Both individual counseling and group counseling focus on short-term behavioral goals to develop coping strategies. Therapies offered are moderate. Medication-assisted treatment is not available. As long as desired Hours Per Day:


Days Per Week:


Support Groups Support groups center on maintaining abstinence after another form of treatment. Typically meet one day a week for 1-2 hours. As long as desired Hours Per Day:


Days Per Week:


Crack Cocaine Behavioral Therapies

Behavioral therapy for substance addiction seeks to identify and manage addictive behaviors that lead to use and prevent relapse. Behavioral therapy is based on the concept that all behavior is learned, and unhealthy behavior can be changed through learning coping skills and increasing awareness of negative thoughts and beliefs that contribute to substance abuse.

Behavioral Therapies for Crack Cocaine Addiction
Type of Therapy Definition
Cognitive Behavioral Therapy

Further reading:

Cognitive behavioral therapy is a form of psychotherapy, which is talk therapy. CBT works on the knowledge that thoughts, behaviors, and feelings are all interconnected. Changing the way you behave often means learning about and realigning negative thought patterns.

CBT has been shown to be an option for treating many types of drug dependency. Through the therapy, individuals unlearn negative behaviors and develop healthier coping mechanisms to support long-term sobriety.

Community Reinforcement Approach

Further reading:

This intensive outpatient therapy approach is often an option for treating addiction to cocaine, as well as dependency on alcohol or opioids. CRA integrates family, social, recreational, and vocational aspects into treatment to help demonstrate that a sober lifestyle is more rewarding long-term than a life with drug use. In some cases, CRA is used alongside a voucher system to reward people for behavior that supports sobriety.
The Matrix Model

Further reading:

While the Matrix Model is typically used to treat stimulant addiction, it can be a viable method for treating cocaine abuse. Often, the struggles faced by individuals dealing with cocaine addiction are similar to someone who has been abusing stimulants, especially in regard to the mental and physical withdrawal symptoms.

The Matrix Model combines therapies such as cognitive-behavioral therapy, drug education, relapse prevention, early recovery skills therapy, family and group therapies, social support groups, and 12-Step facilitation therapy. This is also a model that is facilitated in an intensive outpatient program.

How to Find Help

Finding a Rehabilitation Center for Crack Cocaine Addiction

When looking for a rehab center for crack cocaine addiction treatment, it’s important to find one that matches the user’s needs and preferences while also delivering proven therapeutic treatment options. Users should begin by considering whether they need an inpatient or outpatient facility, which isn’t a decision they need to make on their own. Treatment professionals can help addicts understand their options.

Because cocaine addiction treatment tends to be heavily based on behavioral methods, users may want to look for centers that offer cognitive behavioral therapy or other methods. Facilities that are staffed by clinical, licensed social workers and addiction counselors are also an option to consider.

Our Directory

Our directory of rehab programs includes a comprehensive list of available treatment centers and programs as provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). In the directory, you will find tools to filter the programs by setting, price, and location.