Crack Cocaine Rehabilitation and Treatment

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.

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 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

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.

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.

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.

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.

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.

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 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.