What is Crack and How is it Used?
Crack cocaine is a free base form of cocaine that is often processed with ammonia or baking soda. It is more potent than powdered cocaine and is typically smoked out of a pipe. It resembles rocks or crystals and is referred to as "crack" due to the crackling sound produced by heating up the drug. Some people may also smoke crack combined with tobacco or marijuana in the form of a cigarette. There have been reports of intravenous or intranasal crack cocaine use, but these methods are rare.1,2
Just like cocaine, crack is a central nervous system (CNS) stimulant that produces an intense high. The high may only last for about 5-15 minutes, which is why people commonly binge use this stimulant, meaning that they use it repeatedly in a short period of time to maintain the high and avoid a crash or the come-down.1,2
Is it Addictive?
Crack cocaine is an extremely addictive drug. Crack use increases dopamine activity in the brain by preventing the neurotransmitter from being recycled back into the neuron that releases it. Dopamine is an important neurotransmitter associated with reward, memory, and pleasure; it is released when a person engages in a pro-survival activity, such as having sex or eating food. In this way, it rewards people for activities that promote survival. Because crack use causes high amounts of dopamine to flood the synaptic space, thus rewarding the behavior, crack users are likely to experience intense cravings that reinforce crack use. Chronic crack cocaine abuse can lead to dependence, which is an adaptation to the presence of cocaine in the body. When a dependent person abruptly quits using crack, they will likely experience unpleasant withdrawal symptoms, such as:1,2
- Increased appetite.
- Slowed thinking.
- Intense crack cravings.
Oftentimes, people will continue abusing crack in efforts to alleviate or avoid these unwanted symptoms. Continued use can ultimately lead to addiction, and since people who use crack often use it in a binge pattern, this can speed up the development of an addiction.2 Addiction is often a progressive condition, which means that it tends to worsen over time as it goes untreated. The sooner you seek help from a professional rehab program, the better.
Inpatient vs. Outpatient Treatment
Because of crack cocaine's addictiveness, users often find it difficult to impossible to stop using it on their own. Fortunately, rehab is available. Crack cocaine rehab centers are generally available in two settings: inpatient and outpatient. Inpatient treatment requires that you live at the facility for the duration of the treatment program. Patients receive around-the-clock support, monitoring, and treatment in a highly-structured environment. Inpatient treatment can enhance the ability to focus on recovery because the individual is separated from the environment in which they used to use crack. Some inpatient programs offer detox services as part of their program, while others do not, so is that is something you will want to consider when deciding on the appropriate program for you. Within the inpatient setting, there are several different types of substance abuse treatment programs. Some may specialize in treating those struggling with crack cocaine addiction. Others may specialize in treating dual diagnoses, which mean that someone has both an addiction and a co-occurring mental health disorder. Since long-term cocaine abuse can lead to depression, a dual diagnosis facility may be beneficial. Other types of inpatient treatment include holistic programs, which aim to heal the mind, body, and spirit with a combination of traditional therapy approaches and complementary or alternative methods, such as meditation, yoga, acupuncture, and creative arts therapy.
Conversely, outpatient treatment does not require that you live at the recovery center during treatment. You travel to the outpatient clinic for scheduled therapy sessions then return home outside of treatment hours. This is a good option for people who don't want to experience interference in their daily lives while recovering from a crack addiction. The commitment level varies between different outpatient programs. Some programs are very intensive and involve 20-30 hours per week of treatment, while standard outpatient programs range from 2-4 hours per week. Sometimes outpatient programs are used as step-down treatment for those who complete an inpatient program but would like follow-up support or for people in long-term recovery who would like to re-engage with more formal treatment efforts.
Do I Need Inpatient Rehab?
Not everyone who struggles with a crack addiction requires inpatient treatment. Some people are able to achieve sobriety with the help of an outpatient program, while others benefit from the structure of inpatient rehab. Both types of programs can be effective in helping people make a positive change in their lives by getting clean and sober. The decision comes down to your individual needs, your specific addiction, and your treatment priorities. What works for one person may not be the best option for you. Treatment is a highly individualized experience.
Some people that may find inpatient the most beneficial include:3
- Those with a severe crack addiction and significant physical cocaine dependence.
- Those with a co-occurring mental health disorder, such as depression or anxiety.
- Those simultaneously addicted to crack and another drug.
- Those who have dropped out of rehab previously.
- Those who do not have a strong and sober support system.
- Those without reliable transportation to outpatient treatment.
- Those with suicidal or violent behaviors.
That being said, the best way to determine which program is right for you is to receive a professional evaluation from your physician or other addiction treatment professional. Your doctor can conduct an assessment of your substance abuse, mental health, physical health, and more, then use this information to refer you to the appropriate level of crack addiction treatment.
Are Crack Cocaine Rehabs Confidential?
Many people who use crack cocaine do not seek treatment because they fear reprisal from law enforcement or they're nervous that their employer may find out about their condition. Drug rehab is classified as medical treatment and as such is required to remain completely confidential under the Health Insurance Portability and Accountability Act (HIPAA). This privacy rule requires that health agencies and facilities protect the privacy of your personal health information. It also sets limits on how patient information can be disclosed and to whom. None of your medical records or treatment information may be discussed with other parties without your direct permission.4
Having a private room during treatment is a high priority for many people seeking treatment for a crack cocaine addiction. Not all facilities offer private rooms; some require that people share a room, so it's important to ask each program what their rooming policy is before enrolling in that program.
If you or someone you love is having a hard time quitting crack use, you might want to consider a 28-day or 30-day drug rehab. One-month rehab centers give you a chance to get and stay clean without requiring a long-term commitment. Read More
How Long Does Treatment Last?
There may not always be a pre-determined treatment duration for cocaine rehab; it happens at the pace that is necessary for each individual. Some cocaine rehab centers may offer inpatient or residential treatment programs that run for a certain interval of time and may then prescribe longer-term treatment via outpatient therapy. Drug treatment programs tend to last anywhere from one to three months. Severe addictions may require longer treatment. It all depends on your individual needs, preferences, and recovery progress. Research indicates that longer bouts of treatment are associated with better treatment outcomes. According to research, rehab programs that are shorter than 90 days may have more limited effectiveness.5
What is the Treatment Process Like?
Like many formal substance abuse treatment protocols, crack cocaine rehab centers may operate under a similar general timeline and procedure to get patients through treatment. The intake process is the start; it consists of getting patients oriented with the facility and a mental health or addiction professional performing a thorough assessment. The assessment measures a person's addiction severity, mental health status, physical health, risk of withdrawal complications, special medical considerations (such as pregnancy), financial status, home life, etc. The treatment team uses this information to create an individualized treatment plan based on the person's specific situation. If necessary and if the treatment center provides a formal detox period, a person may undergo detox before beginning treatment. Withdrawal from crack cocaine isn't typically life-threatening (unlike alcohol or sedatives), but the withdrawal symptoms still may be distressing enough that a crack-dependent individual would benefit from detox support.3
Professional medical detox uses medical supervision and therapeutic and emotional support to manage withdrawal and help the recovering individual achieve medical stability. Once you're stable and ready to focus on recovery work, you'll participate in several treatment types, which may include individual therapy, group counseling, family therapy, support meetings, and any other treatment approaches the rehab may offer. Every person's treatment process will vary, depending on their unique needs. Throughout recovery, the treatment team will re-evaluate your treatment plan and the effectiveness of the interventions they're using; they may adjust your treatment plan if necessary. Therapy is a crucial part of addiction treatment; it is designed to help the patient address and deal with the underlying causes of his or her crack abuse. Additional specialized care may be implemented if other conditions coexist with the drug abuse.
Specific treatment interventions may be used for crack cocaine addiction. For example, The Matrix Model was designed specifically to treat an addiction to stimulants, namely methamphetamine and cocaine. The therapist in this model acts as both a counselor and a teacher, empowering the addicted individual and reinforcing positive behaviors. Therapy sessions promote self-worth, dignity, and self-esteem. Matrix Model treatment components include:6
- Relapse prevention tactics.
- Group and family therapy sessions.
- Self-help meetings.
- Drug education.
- Family education groups.
- Urine testing.
- 12-step programs.
- Relapse analysis.
- Early recovery skills groups.
Regardless of the type of treatment program someone chooses, it is crucial that they engage in some form of aftercare once they complete their program.
What Happens After?
As you near the end of your treatment program, your treatment team will help you formulate an individualized aftercare plan. Aftercare includes ongoing support to help you maintain abstinence and avoid relapse following your rehab program. Depending on what type of environment and support you require, aftercare or follow-up treatment may include:
- Alumni program participation.
- Individual counseling.
- Group therapy.
- 12-step meetings, such as Cocaine Anonymous.
- Sober living arrangements.
Through your active aftercare efforts, you can continue to build upon the coping skills you learned in rehab, receive support and encouragement from people in recovery, work on your sober social skills, and more.
Crack cocaine rehab treatment can cost thousands of dollars—often $20,000 or more for a 30-day treatment program. This includes the costs of food, housing, and treatment. Of course, not many people have the resources to pay upfront. Insurance can help; health insurance plans often cover detox and provide at least partial coverage for substance abuse treatment. Read over your insurance plan if you have any questions, or call your insurance provider to learn more about the details of your specific coverage. You may have to pay a portion of the cost yourself to get your insurance to cover the rest.
If you don't have insurance, there are plenty of ways to finance your crack abuse treatment program. For instance, you could purchase affordable insurance on the healthcare exchange marketplace. You could also look for rehabs that offer scholarships or grants for people who can't afford treatment on their own. Likewise, many cocaine addiction treatment programs offer sliding scale options, in which the price is reduced according to a person's financial status. Some programs also allow people to finance treatment using payment plans in which they pay off the cost of treatment in affordable installments. Other options include opening a healthcare credit card, taking out a healthcare loan, using your savings, or crowdfunding on a platform, such as GoFundMe.
Should I Travel or Stay Close to Home?
The decision to choose a treatment facility near home or to travel elsewhere depends on personal preference and costs. On the one hand, being near home gives your family and friends easy access to act as a support network. Traveling, however, can remove you from a triggering environment. Neither option is inherently more effective than the other; it truly depends on your needs and priorities. If you'd prefer to separate yourself from drug-using friends, family, and triggers, some rehabs may offer to pay for your travel to get to the facility.
Learn More About:
- Interventions. People who are addicted to crack cocaine often find it hard to admit it or seek help on their own. An intervention occurs when friends and family get together and to share with the addicted person how they have been impacted by their crack cocaine abuse. It's important that those holding the intervention avoid confrontation, as that may drive the addicted individual away or cause them to reactive in a defensive or aggressive manner. Instead, approach your loved one with compassion, empathy, and a nonjudgmental attitude. If they are receptive to your intervention, you may suggest that the person seek professional treatment and then go from there. If they are in denial or are resistant to your feedback, it may be best to back off for a while and respect the person's space and decision. It is likely that they may come to you when they are ready after they've considered the impact of their drug abuse on those close to them.
- Assessment. A thorough assessment prior to substance abuse treatment will consist of a physical checkup, mental health evaluation, and a substance use history to evaluate methods and of patterns of past and current substance abuse. Particular attention may be paid to any significant health issues to arise in connection from your substance use that will require attention throughout treatment. Although it can seem invasive, a detailed evaluation, complete with health histories and physical examination, is necessary to determine the best course of treatment in a crack cocaine rehab facility.
- Detox/withdrawal. Detox and withdrawal from crack cocaine, while rarely presenting significant physical risks, may be uncomfortable. Symptoms may include depression, anxiety, and lethargy, which may all be managed through the support and intervention of your treatment team.
- Sober living. Many people transition into a sober living home (sometimes referred to as halfway homes) after completing treatment. These environments are drug-free and require that residents attend support group meetings, do chores, and remain abstinent. Residents are typically subject to urine testing to ensure that they are sober while living there. Some sober living homes may provide people with occupational counseling and will help them get a job.
Turn Your Life Around
Although crack cocaine addiction may seem to take over your life, it is never too late to get help. Crack cocaine rehab centers treat people of all ages and demographics. There is a program out there for everyone.
1. National Institute on Drug Abuse. (2018). Cocaine.
2. Center for Substance Abuse Research. (2013). Crack Cocaine.
3. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment, Treatment Improvement Protocol (TIP), 45.
4. U.S. Department of Health & Human Services. (2015). The HIPAA Privacy Rule.
5. National Institute on Drug Abuse. (2018). How long does drug addiction treatment last?
6. National Institute on Drug Abuse. (2018). The Matrix Model.