Crack cocaine is derived from powdered or freebase cocaine. It comes from the coca plant, which is native to South America. Originally, pure cocaine was a medication in the United States until it was banned from over-the-counter and most prescription use by the Harrison Act in 1914.
Cocaine is still Schedule II, according to the Drug Enforcement Administration (DEA), because it can be useful in some rare surgeries as an anesthetic; however, freebase cocaine is most notorious as a club drug that rose in popularity in the 1970s and 1980s. Cocaine’s popularity in this era gave rise to crack cocaine. Its production involved a method of processing freebase cocaine to turn it into smokable, crystalline “rocks” that are less expensive and more profitable for drug dealers than more pure cocaine.
The surge in crack cocaine’s popularity in the 1980s led to a period in U.S. history called the crack epidemic. This epidemic predominantly affected impoverished urban neighborhoods, and many of the victims were young African Americans. To combat the epidemic, drug laws were toughened so more people were arrested for possession, sale, and abuse.
Between 1981 and 1985, the number of people abusing cocaine, including crack cocaine, increased by 1.6 million people. There was a fourfold increase in the number of people admitted for emergency room treatment due to crack cocaine overdose between 1984 and 1987.
Why is Crack Cocaine so Addictive?
Crack cocaine is considered more dangerous and addictive than freebase cocaine. Although crack is a less pure stimulant derived from freebase cocaine, the main reason the drug is more addictive and intoxicating is due to how it is abused. Most people who struggle with cocaine addiction snort the drug in powdered form while crack cocaine was specifically designed to be smoked.
Snorting a drug forces it along the linings of the mucous membranes in the nose and throat, so it is absorbed into the bloodstream faster than it would be if it were eaten. Smoking, however, forces the stimulant chemical into the blood faster than snorting because it enters the lungs and is absorbed, with oxygen, into the blood.
The high from smoking crack cocaine is almost immediate but lasts only 15 minutes. As the intense stimulation wears off, the person may feel uncomfortable and experience intense cravings, so they may immediately smoke more of the drug. Crack cocaine abuse can quickly lead to addiction.
There are short-term symptoms of crack abuse.
- Extreme happiness
- High physical energy
- Increased mental alertness
- Hypersensitivity to stimuli like light, sound, and touch
- Anxiety or paranoia
When the drug wears off, the person may experience negative effects.
- Ongoing paranoia
- Slow movements
- Intense cravings for the drug
Crack releases a flood of dopamine into the brain, and as the drug wears off, dopamine production slows down. Not only is there little dopamine in the brain, neurons have a hard time producing new dopamine. This neurotransmitter elevates mood and pleasure, which triggers the brain’s reward system. As crack is metabolized out, and there is less dopamine available in the brain than before, the person will compulsively smoke more crack to artificially elevate their neurotransmitter levels again. This can lead to a binge, which will increase the negative psychological and physical side effects.
Over time, binge drug use will not raise dopamine levels in the brain much because the neurons cannot produce anymore. However, binge use may lead to an overdose.
Symptoms of an Overdose
If you suspect someone may have overdosed on crack, there are specific symptoms to look for.
- Anxiety attacks or extreme panic
- Paranoia and delusions
- Sleeplessness, sometimes for days
- Extreme agitation and restlessness
- Impaired judgment
- Physical tremors
Severe overdose symptoms are associated with psychosis, which may appear like schizophrenia; individuals may attempt to harm themselves or others because they experience a break with reality. There are other effects of a deadly overdose.
- Hypertension, or very high blood pressure
- Hyperthermia, or dangerously high body temperature
- Rhabdomyolysis, when muscles break down and damage the kidneys
- Excessive bleeding with no clotting
- Kidney failure
- Deadly seizures
- Sudden death
If you see these symptoms, the person needs immediate emergency medical attention. Call 911.
How Crack Overdoses Occur
For the most part, an overdose of crack cocaine is caused by bingeing the drug. A study examining instances of crack cocaine bingeing defined the process as abusing as much crack as possible until the person runs out of the drug or physically cannot take anymore. Study participants reported that a typical binge lasted between three and four days and involved just over 40 rocks. Of the participants who binged, 47.7 percent stopped because they ran out of the drug or had no money for more crack; 52.3 percent stopped because they became physically sick and could not continue.
While many of those who became sick were likely overdosing, few reported getting treatment in a hospital setting. This can lead to serious damage to the body as well as chronic diseases like “crack lung” or heart damage. It can also cause early death.
Other causes of overdose involve abusing other drugs alongside crack, especially opioids like heroin and fentanyl. Recently, fentanyl has been found lacing crack cocaine, which can cause a devastating opioid overdose among people who do not know what they are taking. Opioid overdoses are different and primarily involve slowed, irregular, shallow, or stopped breathing. These issues also require immediate medical attention so call 911 if you see someone unconscious and barely breathing.
Because there are variable amounts of cocaine in any given crack rock, there is no way to know ahead of time what other drugs have been used to lace the rocks. In addition, everyone has a different physical tolerance to these drugs, so any amount of crack can be lethal. In fact, one hit of crack can cause sudden death from heart failure. There is no safe amount of crack that can be used, so if you struggle with crack cocaine, get treatment to overcome this addiction as soon as possible.
Treating a Crack Overdose: Hospitalization and Rehabilitation
Once the person has been admitted to the hospital, crack cocaine overdoses are treated with attempts to:
- Restore heart function from a heart attack.
- Restore blood flow to the brain after a stroke.
- Stop seizures.
There are no drugs that can reverse or temporarily stop a crack overdose, so emergency rooms will treat the symptoms until the person has stabilized. After symptoms have been addressed and the person is physically stable, a doctor may offer a brief intervention to encourage addiction treatment.