The crack form of cocaine was developed in the 1970s as a cheaper, more potent version of the drug. The substance’s popularity peaked in the 1980s, and although it is less popular now, crack addiction is still believed to be an epidemic.
When a person smokes crack, the chemical enters the brain and forces the release of dopamine. This leads to excited energy and a powerful euphoria as well as cravings when the sensation wears off. Although long-term use of crack cocaine causes serious health damage, it is very difficult to stop taking the drug without the right help.
The National Institute on Drug Abuse (NIDA) found, in 2013, that 6 percent of people who entered rehabilitation programs did so due to a cocaine addiction; the majority of those people, at 68 percent, smoked crack cocaine.
Medical oversight during detox is the best way to prevent relapse to crack cocaine abuse. Withdrawal symptoms are not dangerous, but they can feel very uncomfortable. A person going through withdrawal on their own is at greater risk of bingeing on the drug because of their discomfort than someone who has help managing withdrawal symptoms.Withdrawal symptoms include:
Extreme withdrawal symptoms may feel like intense depression, which can lead to suicidal thoughts.
This, in part, is why working with counselors and doctors to detox safely is important. The social support provided gives the person encouragement to persevere when they experience intense mood swings. It is also important because a doctor can use small doses of medicines like acetaminophen to manage aches and pains. Without these forms of support, the person is more likely to give in to their intense cravings and relapse. Relapse is also more likely to lead to bingeing, which can cause an overdose.
Opioid drugs have medicines, like buprenorphine, that are used as replacement therapies to taper people off the drugs. For people struggling with crack cocaine addiction, however, there are no replacement medications to ease the person off the substance. The person just has to stop taking the drug.
Some people attempt to quit using crack cocaine alone. Although a very small percentage of these people successfully stop, it is very rare. Cravings are powerful while the person goes through withdrawal because the brain has to relearn to modulate the release of dopamine without being stimulated to do so by crack. A prolonged withdrawal period, filled with intense cravings and depression after the physical symptoms end, can also lead to relapse. Because this period is psychological and emotional, working with a counselor or therapist is very helpful to understanding the ongoing symptoms. A therapist or counselor will also help their patient learn healthier behaviors, so they can avoid relapse in the future.
Fortunately, people who want to overcome crack cocaine addiction can benefit from both inpatient and outpatient programs. Research suggests that both styles of rehabilitation offer equal benefits, so the choice largely depends on whether a person wants to enter a facility fulltime or if they prefer to remain at home. The decision should be made by the individual in conjunction with their treatment team.
The two steps to ending an addiction to crack cocaine are:
Medical researchers are working to find medicines that can ease crack cocaine withdrawal symptoms. There are no drugs approved by the FDA for this part of the process, but some medicines, like naltrexone or disulfiram, may help to ease cravings and prevent relapse in the long-term. Those overcoming crack cocaine addiction may also benefit from small, controlled doses of antidepressants or anti-anxiety medicines to ease psychological symptoms and mood swings. Over-the-counter pain relief can help with physical aches and pains.
The best treatment to end crack cocaine addiction is behavioral intervention. This can come in the form of group and individual therapy, and NIDA notes that most people ending crack cocaine addiction work best with the Contingency Management or motivational styles of therapy. Positive behavioral changes are rewarded with gifts, like a voucher or prize; negative behaviors are talked through in order to understand them better. Because the brain releases dopamine when a person receives a gift they like, this therapy may replicate, in a small way, the release of dopamine caused by crack cocaine. In turn, the non-drug dopamine stimulation leads to positive association with good, nonaddictive behaviors, so they are reinforced with positive feelings later.
Some people may choose to enter therapeutic communities, like sober living homes. These communities are free from all substances of abuse, and residents support each other in remaining abstinent from substance use. A therapeutic community can be entered during treatment, as part of the rehabilitation plan, or after the rehabilitation program is completed. Regardless of the timing, these environments help many people maintain sobriety and avoid relapse because of the encouragement provided by people who are dealing with similar problems. Therapeutic communities keep people away from triggers that are found in their original environment, like former friends, traumatic memories, or specific items and places that remind them of drug use; avoiding these while working to establish a sober lifestyle in the vulnerable stage of early recovery is very important.
Ultimately, overcoming an addiction to potent drugs like crack cocaine requires assistance. Medical professionals, ranging from doctors to therapists, along with friends, family, and peers can offer those in recovery the emotional support needed to find firm footing in recovery. With the right help, individuals can go on to embrace healthy, sober lives.