Table of Contents

I. The Basics

Cocaine is considered addictive and crack cocaine even more so, as the effects of smoking the drug impact the body harder and faster than snorting it. According to MedlinePlus, a publication of the U.S. National Library of Medicine, people who stop using cocaine after becoming dependent on it can still experience cravings for the drug even years after a successful recovery.

Repeated use of cocaine causes the brain to adapt, which can lead to reduced reward response. That means natural pleasures may be less pleasurable or not at all pleasurable, leading to disinterest and even depression. Other long-term impacts of cocaine use can include malnourishment and damage to organs, including the cardiovascular system.

This guide explains the effects, trends, and dangers of cocaine use, as well as an unbiased analysis of the medicinal and behavioral treatment methods for cocaine addiction based on current research and publicly available statistics. In some cases, usage statistics are derived from general cocaine use, which includes crack cocaine.

Primary Crack Cocaine Dangers

  • Addictiveness. Cocaine in any form is considered highly addictive. Nutt et. al. conducted a study in 2007 to better understand the addictiveness of 20 commonly abused substances, including cocaine. During the study, numerous experts ranked factors related to physical and psychological dependence for each drug, and cocaine scored an average 2.39 out of 3. The only drug with an overall higher score was heroin. Furthermore, cocaine scored a 3 out of 3 for pleasure and 2.8 out of 3 for psychological dependence.
  • Risk of overdose. In the same study, cocaine scored 2.33 out of 3 for the potential for physical harm. Again, only heroin scored higher. The Centers for Disease Control and Prevention noted that, from 2015 to 2016, overdose rates for cocaine increased by more than 50%. Crack cocaine comes with an especially high risk of overdose because the drug enters the body quickly and in large quantities.
  • Unintended side effects. Cocaine use can lead to a number of unpleasant or dangerous side effects, including headaches, stomach pain, loss of appetite, stroke, and heart attack.
  • Legal risks. Cocaine is a Schedule II drug, which comes with stiff penalties for nonmedical use. The penalties for possession of cocaine can vary by state but can typically range from a few months to a few years in prison. Possession of amounts of cocaine that demonstrate an intent to sell it can come with consequences of up to 20 years in prison, plus monetary fines.

Crack Cocaine Background Information

Derived FromPure cocaine mixed with a solution of water and baking soda or water and ammonia; the resulting solid that forms is removed and dried, forming rocks of crack cocaine.
Ways UsedSmoked
Scientific NameBenzoylmethylecgonine
Slang/Street Names for crack cocaineCrack, rock, white tan, mandy candy, crizack, crack rock, coco puff, bad rock, hail, grit, electric kool-aid, scrabble
How Long in Bodily SystemCocaine has a half-life in the human body of between 14 and 52 hours, which means traces of it can remain in the body for up to two or three days. Evidence of cocaine use can be found in urine samples for up to four days and in hair samples for up to 90 days after use.
Punitive Legal Measures: Using/PossessionPenalties for possession of cocaine vary by state, but commonly, they range from around six months to two years in prison and may also include some monetary fines.
Punitive Legal Measures: Selling/DistributingPenalties for selling or distributing cocaine are up to 20 years in prison for the first offense plus potential fines.
DEA Drug RatingSchedule II

II. Signs of Crack Cocaine Abuse

Behavioral Symptoms of Crack Cocaine Abuse

How crack cocaine affects the brain

Cocaine impacts how dopamine works in your brain. Dopamine is a hormone that helps regulate a number of bodily functions, including how you feel pleasure. Typically, dopamine recycles, which means your body only has a certain amount of dopamine circulating at any given time. Cocaine turns off the brain functions that recycle dopamine, which means the hormone builds up between your nerve cells and causes a disruption in communication regarding pleasure and reward.

The impact of this dopamine flood is two-fold. First, it provides intense pleasure that reinforces the use of the drug. In short, the brain releases all of the signals it normally reserves for healthy behaviors like eating and exercise. Second, the brain eventually adapts to a state of high dopamine, which means that it can’t function appropriately when presented with normal levels of the hormone. As a result, you can become unable to experience and enjoy normal pleasures and experience withdrawal symptoms if you don’t take in cocaine.

Behavioral signs of crack cocaine usage and abuse

The behavioral signs of the extra dopamine can manifest in a number of ways. First, individuals might seem to “speed up” as the excitement and energy puts their body and mind into overdrive. They may talk faster, rush to complete tasks, or seem to jump from one task to another in an illogical manner. They may also engage in activities that don’t make sense.

Crack cocaine can also drive a user to anger, paranoia, or other highly emotional states or impulsive behaviors. Individuals often lose control of themselves and may have fewer inhibitions because of the stimulant in their system. Individuals who are abusing cocaine may also demonstrate drug-seeking behavior, including lying or engaging in risky or illegal activities so they can obtain more of the drug. This is especially true with crack cocaine because the high is hard and fast, but it wears off quickly.

Physical Symptoms of Crack Cocaine Abuse

How crack cocaine affects the body

Cocaine affects more than the dopamine function in your brain. It can lead to a variety of issues throughout your body, including increased heart rate and blood pressure, rapid breathing, and dilated pupils. Long-term use of cocaine can decrease your appetite and even lead to malnourishment, in part because the normal reward and pleasure response that helps regulate how you eat no longer works correctly. Long-term impacts of crack cocaine use can include depression, paranoia, heart attack, stroke, and sexual dysfunction.

Early physical effects of crack cocaine

Because crack cocaine is smoked, drawing a large amount of the drug into the lungs, the early physical effects and euphoric high are almost immediate. Crack cocaine effects can impact the body just minutes after use begins, but they may only last up to 10 minutes.

This table illustrates the possible short-term physical effects associated with crack cocaine.
Short-Term Physical Symptoms
Initial (direct effects of drug, 30 – 60 min.)Fast euphoric effect that wears off quickly
Feeling as if you’re moving or thinking quickly
Increased energy and excitement
Lingering (within an hour of taking the drug)Dilated pupils
Increased blood pressure
Increased heart rate
Potential panic attacks
Post-Use (several hours to days after use)Restlessness
Anxiety
Irritability
Vertigo
Tremors
Muscle twitching
Drug cravings

Severe and long-term physical effects of crack cocaine

Long-term abuse of crack cocaine can lead to serious health complications. In particular, it can lead to 600% higher risk for stroke than nondrug users experience, and cocaine is also associated with an increased risk of mental disorders, according to the National Institute of Mental Health.

Other long-term physical effects of crack cocaine can include damage to organs, including the heart and various parts of both the neurological and cardiovascular systems. Crack cocaine users are also at risk for developing poor relationships with food and nutrition, which can lead to malnourishment and all of the physical complications that come with this condition. This is due to the fact that users may seek drugs over other activities meant to provide natural pleasure and reward, such as eating. Smoking crack also damages the lungs, which can lead to respiratory distress and illness.

This table illustrates the possible long-term physical effects associated with crack cocaine.
Long-Term Physical Symptoms
CasualDecreased pleasure in normal activities
Anxiety or irritability
Changes in eating or sleeping habits
Illogical or scattered thoughts
Increased heart rate
Increased blood pressure
Chronic

Including all of the above effects for casual use

Anger
Paranoia
Hallucinations
Organ damage
Difficulty breathing
Cardiovascular issues
Neurological issues
Depression
Mental health disorders, such as schizophrenia
Sexual dysfunction
WithdrawalDifficulty with concentration
Fatigue or exhaustion
Restlessness or irritability
Feeling as if you’re moving or thinking slowly
Chills and tremors
Muscle aches
Lack of sexual arousal
Decreased pleasure in normal activities
Unpleasant dreams
Changes in appetite or sleep
Drug cravings

Further Resources

Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on both the symptoms and treatment of prescription stimulant addiction.

III. Crack Cocaine Usage

Global cocaine manufacturing on the rise

According to the World Health Organization, the manufacture of illicit cocaine is on the rise throughout the globe. Statistics indicate it reached a historic high in 2017, with 1,976 tons of illegal cocaine produced throughout the world, an increase of 25% from just the previous year. Global seizures of the illegal substance were 13% higher year-over-year from 2016 to 2017.

Cocaine makes up a large percentage of illegal stimulant drug seizures globally

In the Americas and Europe, cocaine accounted for the bulk of the illegal stimulant seizures in 2017, and in the Oceania region (which includes Australia and parts of Southeast Asia), cocaine accounted for just under 25% of stimulant seizures. In Africa, the drug accounted for slightly under half of stimulate seizures, and it was a small percent of seizures in Asia, where methamphetamines made up the bulk of seizures.

Crack Cocaine Use Throughout the World
HighestSecondThird
Countries with the highest number of cocaine users per capitaUnited StatesThe NetherlandsPoland
Regions where cocaine is the highest percentage of illegal stimulant drug seizuresAmericasEuropeAfrica

Crack Cocaine Usage Demographics in the U.S.

Cocaine-related overdose deaths in the United States are rising

The United States has the highest number of per capita cocaine use in the world, according to the United Nations Office on Drugs and Crime. The National Institute on Drug Abuse notes that overdose deaths from cocaine use have been on the rise since 2012, increasing from just under 5,000 that year to more than 13,000 in 2017. The increase from 2015 to 2016 alone was almost 40%.

Furthermore, according to Jeremy Barnett, a Credentialed Alcoholism and Substance Abuse Counselor, “There is a strong misconception about crack cocaine that its primary user base is poor individuals. While this was true in the 1980s, as crack was a cheaper form of cocaine, it is no longer the case and is abused by people of all demographics. This creates a powerful stigma, forming a barrier for those who want support but may be unwilling to reach out due to the strong judgments attached to crack cocaine use.”

Use of crack cocaine among older adolescents is trending down

According to the 2018 Monitoring the Future Survey, the prevalence of crack cocaine use among high school seniors trended down in 2018 after a concerning bump between 2016 and 2017. In 2017, 1% of 12th graders reported using crack cocaine in the last year; in 2018, that percentage dropped to 0.9%. The percentage of 12th graders who reported using crack cocaine in their lifetime dropped from 1.7% to 1.5% during the same time period, and the percentage who reported abusing the drug in the past month dropped from 0.6% to 0.5%.

Demographics of Crack Cocaine Usage
Past Year (2018)Lifetime
8th grade (14-15 yo)0.4%0.9%
10th grade (15-16 yo)0.6%1%
12th grade (17-18 yo)0.9%1.5%

Source: 2018 Monitoring the Future Survey

IV. How to Find Help

Crack cocaine can be extremely addicting. The high obtained from smoking this form of cocaine can impact the body within minutes, but it doesn’t last long, which can lead someone to smoke crack again right away. Regular and constant use builds up even more tolerance in the body, leading to increased drug use. Additionally, the fact that cocaine alters the body’s internal pleasure and reward systems can mean that individuals addicted to the substance are no longer able to enjoy the normal pleasures of life, creating psychological dependence in addition to physical dependence.

Because of this vicious circle, treating crack cocaine addiction can be a multi-step process. First, an addict completes the detoxification process and then the initial withdrawal period, which can last for several days or weeks. Next, treatment strives to identify the triggers for drug abuse and help an addict develop the coping mechanisms required to stay drug-free when stress, triggers, and cravings for cocaine threaten long-term recovery.

To learn more about the treatment process, read the Crack Cocaine rehabilitation guide, which provides a comprehensive resource for starting treatment.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention

1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.

V. Sources