Crack Addiction Symptoms and Rehab Treatment

What is Crack Cocaine?

Crack is a smokable form of cocaine that is made by processing powder cocaine with ammonia or sodium bicarbonate (baking soda) and water to form small rock crystals that crackle when heated and the vapors smoked. Smoking and inhaling the vapor or smoke into the lungs produces a faster and more intense high than snorting powder cocaine because the drug is more quickly absorbed into the bloodstream. The almost instant effects of smoking crack cocaine last for only 5 to 10 minutes before wearing off. Powder cocaine has a slower onset, and the less intense effects may last twice as long. This can lead individuals into a cycle of binge use to maintain the high.²

Cocaine is a stimulant, listed as a Schedule II substance under the Controlled Substances Act, and has a high potential for abuse, which can lead to severe psychological or physical dependence.³

Crack addiction is a cocaine addiction, which is referred to as a cocaine use disorder by the National Survey on Drug Use and Health (NSDUH). In 2022, according to the NSDUH, 1.4 million people aged 12 or older had a cocaine use disorder in the previous 12 months.⁴

What is the Difference Between Crack and Cocaine?

Crack cocaine and powder cocaine are different forms of the same drug. Both forms of cocaine produce identical effects; and as the dose is increased, so are the effects. The way the drug is taken differs based on its form, however. Crack is smoked, whereas powder is snorted, swallowed, rubbed on the gums, or injected. More intense effects are observed when the drug is smoked or injected, and the effects don’t last as long vs. snorting or swallowing, but the drug itself remains the same.²

Chronic use of cocaine can result in a variety of detrimental health effects, including addiction.²

Signs and Symptoms of Crack Addiction

Medical professionals, including doctors and licensed mental health providers, use criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose individuals with  substance use disorders, the clinical term for addiction.

An individual with a crack addiction would actually be diagnosed with a stimulant use disorder.⁵ Crack addiction means that a person compulsively uses crack despite the significant negative consequences it has on their life.⁶

While only a healthcare professional can diagnose a stimulant use disorder, it can be helpful to know the criteria. The signs and symptoms include:⁵

• Using a stimulant in larger amounts or over a longer period than was intended.
• A persistent desire or unsuccessful efforts to cut down or control stimulant use.
• Spending a great deal of time in activities necessary to obtain, use, or recover from stimulant use and its effects.
• Craving, or having a strong desire or urge to use the stimulant.
• A failure to fulfill major role obligations at work, school, or home due to recurring stimulant use.
• Continued stimulant use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the stimulant.
• Giving up or reducing important social, occupational, or recreational activities because of stimulant use.
• Recurrent stimulant use in situations in which it is physically hazardous.
• Continued stimulant use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the stimulant.
• Tolerance, meaning a need for markedly increased amounts of the stimulant to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount of the stimulant.
• Withdrawal, as manifested by either displaying a characteristic withdrawal syndrome for the stimulant, or use of the stimulant (or a closely related substance) to relieve or avoid withdrawal symptoms.

To receive a stimulant use disorder diagnosis, an individual needs to meet at least 2 of the above criteria in a 12-month period. A stimulant use disorder can vary in severity—experiencing 2-3 symptoms generally indicates mild severity, 4-5 means moderate severity, and 6 or more symptoms signals a severe addiction.⁵

Effects of Crack Use

Crack or any cocaine use can result in numerous immediate effects, which can vary from person to person.⁷ These effects can depend on how fast the drug is absorbed, how much was used, other substances in the system, and individual physical and mental health differences but may include:^7,8

Risks Associated with Long-Term Crack Use

Long-term crack or any cocaine use results in adaptations in the brain and body that can lead to a desensitization of the reward pathway in the brain. This means that people can experience a variety of adverse effects and signs of withdrawal—such as displeasure and negative moods—when not using cocaine. And as previously mentioned, this can lead to drug-seeking behavior.²

With regular crack cocaine use, individuals may require increasing amounts, more frequent doses, or both to experience previous effects. This is known as tolerance. It’s also possible to become sensitized to crack, meaning it requires less crack to produce anxiety, convulsions, and other signs of toxicity. Both tolerance and sensitization can increase the risk of overdose.²

Additionally, lung injuries relate to the toxicities of smoking more than the direct stimulant effects of cocaine.² Thus, smoking crack cocaine can increase the risk of certain long-term health effects including:^2,9

•   Lung damage.
•   Worsened asthma.
•   Cough.
•   Blackened sputum (mucus).
•   Chest pain.
•   Reduced lung function.
•   Impaired ability to force air out.
•   Abnormal collection of gas between the lungs and chest wall.
•   Air present between the two lungs in the chest.
•   Muscle necrosis (severe tissue infection).
•   Neurological problems such as seizures and brain hemorrhages.

Withdrawal From Crack

Individuals who chronically use crack cocaine and then suddenly stop or drastically reduce their use of cocaine risk experiencing withdrawal symptoms. Additionally, individuals who use crack in high-dose, short-term binges can also develop acute cocaine withdrawal symptoms.^2,5

Withdrawal symptoms from chronic crack cocaine use occur due to physiological adaptations that take place due to the ongoing presence of cocaine in the body.⁷ When cocaine use is suddenly reduced or is stopped after a period of prolonged use, unpleasant and uncomfortable withdrawal symptoms can surface.⁵

Unlike withdrawal syndromes from substances like alcohol, benzodiazepines, and opioids, cocaine withdrawal is not typically dangerous or life-threatening. Symptoms may include:⁸

•   Depression.
•   Fatigue.
•   Increased appetite.
•   Insomnia.
•   Vivid unpleasant dreams.
•   Slowed thinking and movement.
•   Restlessness.

Due to the intense discomfort, cravings, and distress associated with stimulant withdrawal, individuals may continue crack use as a way of avoiding withdrawal symptoms. This can fuel the cycle of addiction and make it very hard for someone to stop using crack without professional help.¹⁰

Crack Addiction Treatment and Rehab

Unlike other substances, the U.S. Food and Drug Administration (FDA) has not approved any medications for the treatment of cocaine addiction.² Treatment for stimulant use disorders generally involves different interventions, including behavioral therapies, participation in mutual-help groups such as Narcotics Anonymous or Cocaine Anonymous, and residing in a sober living home.^2,7,11

Additionally, individuals with stimulant use disorders may also have co-occurring mental health disorders, such as depression or anxiety, and should receive integrated treatment that addresses both disorders simultaneously.⁶ Research shows that people who receive integrated treatment that focuses on both the addiction and the mental health disorder can experience improved outcomes.¹²

Treatment for cocaine addiction may take place in a variety of settings:

• Inpatient treatment means you live onsite at a rehab facility for the duration of treatment. There, you receive 24/7 care and monitoring, and you can fully focus on your recovery without outside distractions and exposure to potential triggers.¹³
• Outpatient treatment are programs that can take place with different levels of intensity—depending on your needs—but involves living at home or in a sober living anvironment and traveling to a rehab for scheduled treatment sessions.¹³

In either setting, treatment looks similar and includes a combination of counseling and behavioral therapies. Those utilized in the treatment for cocaine addiction generally include:²

• Cognitive-behavioral therapy (CBT). CBT helps you examine your thoughts and behaviors related to crack use and develop    skills that are required to achieve long-term abstinence.
• Contingency management (CM). CM provides rewards, or positive incentives when you achieve a desired behavioral outcome, like abstinence.

After completing a formal treatment program, people with stimulant use disorders can benefit from different forms of aftercare, also known as continuing care. Aftercare programs may include ongoing participation in mutual-help groups or recovery housing, which allows you to live in a safe, supportive, substance-free setting with others who are also in recovery.^2,11

If you or a loved one struggle with controlling crack use or cocaine addiction, we’re here to help. Please contact American Addiction Centers (AAC) to speak to a caring admissions navigator about your rehab options and let us help you begin your journey to recovery.

Frequently Asked Questions