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Crack Cocaine Withdrawal and Treatment

What Is Crack Cocaine?

Crack cocaine is a smokable, freebase form of cocaine. It is processed from the powdered cocaine hydrochloride formula, water, and ammonia or baking soda. The result is a rock crystal, which is heated to produce a vapor that is smoked and inhaled into the lungs. It is given the street name “crack” due to the crackling sound it makes when lit. Crack cocaine use first became a problem in the 1980s due to its intense and immediate euphoric effect.1,2

Over 1.5 million Americans aged 12 and older reported using cocaine in 2013.11 Cocaine is often used concurrently with alcohol or heroin, which can increase the risk of experiencing adverse effects, and it is commonly used by people with co-occurring mental health disorders such as post-traumatic stress disorder (PTSD), antisocial personality disorder, and other drug addictions.7

Crack Tolerance, Dependence, and Addiction

The crack cocaine high typically lasts only about 5-10 minutes, leading many users to binge and take several repeated doses in a short period of time to maintain the high.2 This pattern of frequent, repeated use can quickly lead to tolerance, which occurs when a person needs increasing amounts of a drug to achieve the desired effects. Chronic crack cocaine use with ever-increasing doses can lead to the development of significant physical dependence, which means that the body requires the presence of the substance to function normally. When someone who is dependent on crack cocaine suddenly stops using, unwanted withdrawal symptoms are likely to emerge. Users often will use crack cocaine to alleviate crack withdrawal symptoms, a cycle which can eventually lead to addiction. Addiction is a complex and progressive condition in which the user continues to use crack despite severe impairment in life functioning.

Am I Addicted to Crack?

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) refers to addiction as substance use disorders. Substance use disorders occur when substance use causes notable impairment and distress in a person’s life.3 It can sometimes be difficult to discern whether you or a loved one is afflicted by a crack cocaine addiction, but there are many signs and symptoms that can indicate drug use has become problematic.

According to the DSM-5, crack cocaine addiction would be classified as a stimulant use disorder. Signs and symptoms of crack cocaine addiction include:3,4

  • Experiencing crack cocaine cravings.
  • Exhibiting a difficulty in controlling use.
  • Using larger amounts of crack cocaine than originally intended.
  • Continuing use despite impairment in one’s personal and professional life.

Short-term Effects of Crack Use

People abuse crack cocaine for the euphoric high, increased energy and confidence, improved concentration, and a decreased need for sleep; however, cocaine also produces many unwanted side effects, some of which can be dangerous.

Short-term adverse effects of crack cocaine use include:1,2,7

  • Irritability.
  • Anxiety.
  • Restlessness.
  • Elevated heart rate, body temperature, and blood pressure.
  • Chest pain.
  • Irregular heart beat.
  • Muscular weakness.
  • Hypersensitivity to light and sound.
  • Nausea.
  • Anger or tension.
  • Impaired judgment.
  • Psychomotor agitation (repetitive, purposeless movements).
  • Psychomotor retardation (slowed movement and thought).
  • Vertigo.
  • Tremors.
  • Paranoia.
  • Confusion.
  • Erratic, bizarre, or violent behavior, when taken in large doses.
  • Seizures.

Some of the immediate effects of crack cocaine use are life-threatening or can lead to fatal consequences. If someone experiences a seizure, call 911 immediately, as this is a medical emergency. Remain with the person until medical personnel arrive.

Long-Term Effects of Crack Use

The longer a person uses cocaine, the higher the risk is of becoming addicted or experiencing other negative consequences. Chronic use of crack cocaine can lead to many medical complications and psychological issues. Cocaine use has been linked to many types of heart disease as well as other adverse outcomes, such as:1,2,7

  • Significant weight loss.
  • Malnutrition.
  • Severe paranoia.
  • Auditory hallucinations.
  • Mood disturbances.
  • Movement disorders, such as Parkinson’s disease.
  • Respiratory problems, such as bronchitis and pneumonitis, due to smoking.
  • Accidents or injuries from erratic behavior.
  • Risky behavior, such as prostitution, theft, and other illegal activities.
  • Pathological heart rhythms.
  • Increased risk of heart attack and stroke.
  • Increased risk of sudden death due to cardiac or respiratory arrest.

Crack cocaine addiction doesn’t have to lead to severe and debilitating physical and mental health effects. It’s never too late to find a detox or substance use treatment program that fits your individual needs. These programs can help you begin on the road to recovery, and ultimately, a happier and healthier life.

Crack Withdrawal Symptoms

Common crack cocaine withdrawal symptoms include:2,3,5,7

  • Irritability and agitation.
  • Anxiety.
  • Lack of pleasure.
  • Fatigue.
  • Sleep problems.
  • Depression.
  • Suicidal thoughts.
  • General discomfort.
  • Vivid and frightening dreams.
  • Psychomotor retardation (slowed movement and thought).
  • Increased appetite.
  • Powerful cravings for crack cocaine.

How Long Does Crack Withdrawal Last?

Everyone experiences crack cocaine withdrawal in different ways. The length and severity of your withdrawal experience may not necessarily be the same as those of someone else who is going through withdrawal. The symptoms you encounter can vary based on factors, such as:

  • Your length of crack use.
  • The amount of crack used.
  • The frequency of crack use.
  • Your physiological makeup.
  • Your age.
  • Your overall physical and mental health.
  • Whether you use other substances.

Crack cocaine levels in the blood drop rather quickly post-intoxication, meaning that a rapid crash tends to occur, particularly in those who engage in crack cocaine binges. Generally speaking, crack withdrawal symptoms emerge within a few hours after the most recent dose. Withdrawal symptoms may increase in intensity for about 2-4 days before resolving. These symptoms often resolve within 1-2 weeks.7,8,9

 Crack Cocaine Detox

doctor talking to patient about crack detox treatmentCrack cocaine detox can occur in a variety of settings. Since every person is unique, different levels of detox treatment may be more appropriate for different people. Common settings that may be beneficial for those struggling with crack cocaine withdrawal include:

  • Inpatient detox center: Inpatient detox centers provide care and supervision 24/7 until a person completes detoxification and is substance-free. This is a suitable option for those with severe addictions who may have trouble resisting cravings and coping with withdrawal symptoms outside of the treatment environment.
  • Outpatient detox center: Outpatient detox centers provide detox treatment on an outpatient basis while the patient continues to reside at home. This provides people with the freedom to still attend work or school while detoxing from crack cocaine.

What Happens During Detox?

The goal of professional detox is to help people safely withdraw from drugs through the use of medical intervention and supervision. Detox typically involves three steps:6

  1. Evaluation: Detox begins with a comprehensive assessment of your current psychological, medical, and social condition. You will be screened for co-occurring mental and physical health conditions. The severity of addiction will be assessed and your blood will be tested for substances.
  2. Stabilization: The stabilization phase is what most people imagine when they think of professional detox. During this phase, medical support personnel provide you with psychosocial support and medical intervention, if necessary, to assist you as you progress through the crack cocaine withdrawal period.
  3. Fostering the patient’s entry into treatment: The last phase helps prepare you for the transition into a professional addiction treatment program. It is important to remember that crack cocaine detox is only the first step on the continuum of addiction treatment care. Detox center staff will stress the importance of following up with comprehensive substance use treatment in order to address the underlying issues that led to crack cocaine addiction in the first place.

Crack Cocaine Addiction Treatment

After cocaine detox, your treatment team will work with you to create a treatment plan to help you learn coping skills to deal with stress, cravings, and triggers, as well as relapse prevention skills to help maintain sobriety over time.

Crack cocaine addiction treatment options include:

  • Inpatient rehab: Inpatient rehab consists of 24/7 care in a residential facility for a specific amount of time (ranging on average from 30-90 days). Inpatient treatment typically includes a combination of individual and group counseling, support groups, and medical care for any co-occurring physical conditions.
  • Outpatient rehab: Outpatient rehab consists of similar treatment modalities as inpatient treatment centers except that care takes place on a part-time basis while the patient continues to reside at home and may remain active in personal and professional duties outside the treatment environment.
  • Narcotics Anonymous is a global 12-step program that offers peer support in addiction recovery by following the traditional 12 steps established by Alcoholics Anonymous.
  • Non-12-step programs: Secular support groups can be beneficial for people struggling with cocaine addiction and abuse. Some popular programs include SMART Recovery and LifeRing Secular Recovery.

Each form of addiction treatment has its own strengths and weaknesses. What works for one person may not work for another. Collaborating with your detox treatment team can help you explore all of the options and choose the treatment program that is best suited for you. Make a list of what is most important to you when selecting a treatment program so that you can find a program that is well aligned with your unique beliefs, values, philosophies, and treatment needs.


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