Crack Addiction and Abuse

Last updated on May 5th, 2021

  • What is Crack?
  • What Causes Crack Addiction?
  • Signs and Symptoms of Crack Abuse
  • Treatment for Crack Abuse
  • Find Out If Your Insurance Plan Covers Crack Rehab

Crack cocaine abuse and addiction is a serious problem for many people in the United States. According to the 2019 National Survey on Drug Use and Health, around 5.5 million Americans reported using cocaine (which includes crack) in the past year, with 778,000 of those people using crack.1 Not only can crack use cause significant psychological and physical health consequences, but it can be deadly.

Crack is an addictive and dangerous form of cocaine, but it doesn’t have to control your life. If you think that you or someone you care about may have a problem with crack, it’s important to know that treatment is available so that people can overcome their addiction. This article will help you understand crack addiction, symptoms, and explain the treatment and support available for someone with a crack addiction.2

What is Crack?

Cocaine is a white powdery drug obtained from the South American coca plant that is typically snorted or mixed with water and injected.2,3 It is a stimulant, which means it enhances activity in the body’s central nervous system, including in the brain, resulting in feelings of euphoria, energy, and alertness, but it also can cause paranoia, irritability, and anger, especially when its effects wear off.2-4 When cocaine salt is processed into cocaine base it takes the form of small hard rocks, known as crack, which people smoke in glass pipes to achieve a rapid high.3 The term crack comes from the crackling sound it makes when the substance is heated.4

The main difference between cocaine and crack is their physical properties which favor different routes of administration, but they are chemically nearly identical substances. Crack cocaine and cocaine that is injected appear to have a greater potential for dependence compared with snorting powder cocaine, and people who smoke crack also have a greater risk of negative health consequences.5 All forms of cocaine are classified as Schedule II substances under the Controlled Substances Act. Schedule II drugs are defined as having a high potential for abuse, potentially leading to severe  physiological dependence.2

A substance use disorder (SUD) is the general diagnostic term given to people suffering from addiction to drugs or alcohol. Crack cocaine addiction falls under the category of a stimulant use disorder. For a person to receive this diagnosis, they must meet at least 2 of the following criteria, which includes:6

  • Using crack in higher quantities or amounts than they originally intended.
  • Being unable to cut back or control their crack use.
  • Spending a lot of time trying to obtain crack or recover from its effects.
  • Cravings, which means having a strong physical or psychological desire to use the drug.
  • Being unable to meet responsibilities at work, home, or school due to crack use.
  • Continuing to use crack even though substance use causes problems in the person’s social life and relationships.
  • Giving up or stopping activities they used to enjoy to use crack.
  • Using crack in situations where it’s physically dangerous to do so (such as while driving).
  • Continuing crack use even though they are aware that they have a physical or psychological problem that is caused by drug use.
  • Tolerance, which means needing to use more crack to experience its effects.
  • Dependence, which causes withdrawal symptoms when a person tries to stop using crack.

Dependence means that your body has adapted to the presence of the drug and needs it to function normally.7 Withdrawal symptoms can be uncomfortable and unpleasant that you may keep using crack to avoid withdrawal symptoms, which can include:6

  • Low, depressed mood (known as dysphoria).
  • Fatigue.
  • Sleeping too much but experiencing poor sleep quality.
  • Increased appetite.
  • Psychomotor impairment or agitation (slowed or faster speech and physical movements).

A person who is dependent on a drug isn’t necessarily addicted; dependence is just one component of addiction.7

CNS depressant drugs, such as alcohol, benzodiazepines, opioids, and marijuana, are often used following cocaine use to temper some of the more unpleasant effects (e.g., anxiety, paranoia, restlessness) and/or to relieve symptoms of cocaine withdrawal.16

What Causes Crack Addiction?

Addiction is a chronic, relapsing disease where a person uncontrollably and compulsively uses substances despite the negative consequences.7 Many people mistakenly assume that addiction is a matter of willpower, and if a person wants to stop using drugs badly enough, they’ll be able to do so. But the fact is that addiction causes changes in the brain that affect the way the brain works and how a person behaves. Chronic administration of crack blocks the normal recycling of dopamine, resulting in a buildup of dopamine, your brain’s “feel-good” reward and reinforcement chemical. Dopamine is responsible for emotional regulation and motivation and influences people to participate in important life-sustaining activities like eating and socialization.8

Your brain adapts to the  dopamine buildup and can result in developing tolerance, which means you need more crack to experience a high. Long-term abuse of crack can also affect your ability to learn, make decisions, remember things, and use good judgment. Despite these negative consequences, people often continue to use, which is a defining characteristic of addiction.8

Not everyone who uses a drug becomes addicted. The exact reasons for addiction are not fully understood, but scientists believe it involves a complex interplay of several different factors. Specific risk factors that can impact your chances of addiction include:8,9

  • Your genes are responsible for about half of your risk of addiction, but you should know that your genes are not necessarily your destiny. Other biological factors that can influence the risk of addiction include ethnicity, gender, and having other mental health disorders.
  • This factor involves many influences, such as the area where you live, stress, your socioeconomic status, peer pressure, exposure to abuse or trauma, and the amount of parental guidance and support you received while growing up.
  • Your risk for addiction is affected by the way your biology and environment interact with important developmental stages. The younger you are when you start using drugs or alcohol, the greater your chances of drug use progressing to addiction. This is because your brain continues to develop throughout adolescence, and important areas that aren’t quite fully developed, like decision-making and judgment, can be negatively impacted by substance use.

Signs and Symptoms of Crack Abuse

It may not always be easy to identify when someone is struggling with crack cocaine abuse. However, people who are using crack cocaine may display some of the following behaviors and signs, which can include:10-12

  • Jitteriness.
  • Talking or moving faster than normal.
  • Shaking or twitching.
  • Changes in their sleeping or eating habits.
  • Paranoid or suspicious behavior.
  • Mood changes, like being irritable, aggressive, or angry for no apparent reason.
  • Experiencing a “crash” after they’ve used crack, which can cause symptoms like fatigue and sadness.

Physical Effects of Crack

Crack use can cause a range of short and long-term physical effects. The short-term physical effects of crack use include:4,11,13

  • Increased energy, mental alertness, and sociability.
  • Sweating.
  • Appetite loss.
  • Being hypersensitive to things you see, hear, or feel.
  • Dilated pupils.
  • Increased body temperature and blood pressure.
  • Restlessness and irritability.
  • Nausea.
  • Insomnia.
  • Tremors or muscle twitches.
  • Fast or irregular heartbeat.
  • Heart attacks.
  • Seizure.
  • Stroke.
  • Coma.

The long-term physical effects of chronic crack use include:4,13,14

  • Lung damage.
  • Worsening of asthma.
  • Significant weight loss and malnourishment.
  • Inflammation to your heart or aortic ruptures.
  • Chronic cough.
  • Higher risk of infections such as pneumonia.
  • Respiratory distress.
  • Intracerebral hemorrhage, or brain bleeding.
  • Neurological problems, like Parkinson’s disease.
  • Impaired cognitive functioning, such as memory loss, inability to pay attention and difficulty controlling inhibition.

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Treatment for Crack Abuse

Calling a crack addiction hotline can be a helpful first step to help you understand your treatment options. Effective treatment is available to help people abstain from crack use and learn ways to avoid relapse.15

Treatment can take place on an inpatient basis at a residential treatment facility, in which you live at a rehab for the duration of treatment, or outpatient treatment facilities, in which you live at home and travel at least once a week to a nearby facility for treatment. Regardless of the setting, it’s important that you receive an individualized treatment plan based on your unique needs, and that it is adjusted throughout the duration of treatment as necessary.15

Common therapies that are usually offered at both inpatient and outpatient rehabs include:4,13,15,17

  • Behavioral therapies, like cognitive-behavioral therapy (CBT) or the Matrix Model, which are offered as a part of individual counseling or group therapy sessions.
  • Treatment for any co-occurring mental health disorders, such as depression, anxiety, or bipolar disorder.
  • Although there are no currently approved FDA medications for crack cocaine addiction, research into different medications is ongoing; you may also receive medication to treat symptoms of co-occurring disorders.
  • Long-term follow-up and relapse prevention care. This may include ongoing counseling, living in a therapeutic community (drug-free residences to help people in recovery), or participation in mutual-help groups like Narcotics Anonymous or SMART Recovery.

Find Out If Your Insurance Plan Covers Crack Rehab

American Addiction Centers can improve treatment outcomes for those in recovery for crack addiction and stimulant use disorder. To find out if your insurance covers treatment at an American Addiction Centers facility, click here or fill out the form below. Your information is kept 100% confidential.


  1. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  2. National Drug Intelligence Center. (n.d.). Crack Cocaine Fast Facts.
  3. U.S. National Library of Medicine. (2020). MedlinePlus: Cocaine.
  4. National Institute on Drug Abuse. (2021). Cocaine DrugFacts.
  5. Hatsukami, D. K. & Fischman, M. W. (1996). Crack cocaine and cocaine hydrochloride. Are the differences myth or reality? JAMA: The Journal of the American Medical Association, 276(19), 1580–1588.
  6. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  7. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Is there a difference between physical dependence and addiction?
  8. National Institute on Drug Abuse. (2018). Understanding Drug Use and Addiction DrugFacts.
  9. U.S. National Library of Medicine. (2021). Substance use disorder.
  10. National Institute on Drug Abuse. (n.d.). Signs of Cocaine Use.
  11. National Institute on Drug Abuse. (n.d.). Effects of Cocaine on Brains and Bodies.
  12. U.S. National Library of Medicine. (2021). MedlinePlus: Substance use – cocaine.
  13. National Institute on Drug Abuse. (2020). Commonly Used Drugs Charts.
  14. National Institute on Drug Abuse. (2016). Cocaine Research Report: What are the long-term effects of cocaine use?
  15. National Institute on Drug Abuse. (2019). DrugFacts: Treatment Approaches for Drug Addiction DrugFacts.
  16. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  17. National Institute on Drug Abuse. (2016). Cocaine Research Report: How is cocaine addiction treated?

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