Crack is the No. 1 drug synonymous with the 1980s urban drug scene. During that decade and into the early 1990s, crack use had reached epidemic levels, and the surge was seen in many major U.S. cities, particularly in urban areas where crime and violence were widespread. The popular street drug first emerged on the scene in the late 1970s, when drug dealers created it to deal with the falling prices that followed the surplus of cocaine supply in the United States.

During that time, drug dealers came up with “crack,” a stimulant drug made of cocaine powder that they formed into a rock before breaking it into small chunks so it could be smoked with a glass hand pipe or water pipe. This new form of cocaine was cheaper and simpler to make, but dealers made large profits when they sold smaller quantities of this highly addictive form of cocaine.

Crack is cheaper than cocaine, so its low prices make it easier for anyone to get, including teenagers, pregnant women, and young adults. The expenses begin to pile up, however, as users try to pay for a crack-cocaine habit in which the cravings grow stronger with each use. For many people, all it takes is one time to get hooked on this drug. One hit sparks cravings for more of the drug, which all lead to addiction.

What Is Crack?

Crack is a stronger version of the stimulant drug cocaine that became popular in the mid-1980s. The rock, also called freebase cocaine, is made with baking soda or ammonia and other ingredients before it is heated. After that, users inhale the vapors for a quick, intense, euphoric high. Crack highs, however, do not last long, perhaps no more than 10 minutes. According to the National Institute on Drug Abuse (NIDA), people who use cocaine binge on it in higher doses each time so they can stay high.

The drug’s popular name “crack” refers to the crackling sound that happens when the crystal rock is heated. Rocks can appear yellow, white, or pale pink. Many users smoke crack because it produces a stronger high that hits the bloodstream faster. Some people may use crack by sprinkling it onto other drugs, such as marijuana or tobacco, and smoke it that way. However, some users may opt to dissolve it into an acidic solution, such as one containing lemon juice or vinegar, and inject it, or they may snort it. In addition to the rush feeling, users also may experience increased alertness, excitability, and increased heart rate, among other effects.

Once crack reaches the brain, it affects its dopamine levels, a neurotransmitter chemical that is linked to pleasure and part of the organ’s reward center. When crack interacts with the brain, the reward center is altered, and users will crave the drug to satisfy the brain’s demand for more crack.

Alternative names for crack include Candy, Cookies, Flake, Gravel, Nuggets, and Rock, among many others.

What Are the Signs of Crack Addiction?

If you or a loved one has a crack addiction, you may notice that you have bursts of energy that are marked by rapid talking, erratic or aggressive behavior, or anxiousness. You may also feel on high alert. Other common short-term effects of cocaine involve feeling jittery, irritable, paranoid, and a low appetite. If you are dependent on the drug, you may notice the following, which are signs of crack addiction:

  • Higher tolerance levels for crack. Prolonged use increases tolerance, which results in users taking more of the drug to achieve stronger effects.
  • Becoming focused on finding and using crack
  • Decline in school or work performance
  • Increased isolation from others to use crack
  • Withdrawal symptoms after crack’s effects wear off.

If you stop using crack after longtime or frequent use, you could experience withdrawal symptoms, such as:

  • Depression
  • Irritability
  • Extreme fatigue
  • Anxiety
  • Strong crack cravings
  • Psychosis (a mental disorder in which people lose touch with reality)

If you experience any of these symptoms along with cravings for crack, you or your loved one may have a substance abuse disorder that requires professional treatment.

What Is Involved in Crack Addiction Treatment?

Active crack users who want to end their dependence on the drug will likely need to enter an accredited rehab facility that specializes in treating people with substance use disorders. Medical detox ensures they safely end their drug use while managing uncomfortable withdrawal symptoms. The process also helps them avoid a relapse.

Medical Detox

Medical detox is traditionally the first step to take before the start of an addiction recovery program. Crack users should not quit the drug abruptly. This can be a deadly move. Instead, it is safer to get medical support for this critical recovery phase at a treatment center.

Medical professionals who conduct a 24-hour medically monitored detox understand addiction and the needs of people recovering from substance abuse. During this process, they monitor patients’ vitals, such as their heart rate and breathing rate. They may also give recovering patients medication for nausea, insomnia, and other conditions that make withdrawal uncomfortable. Currently, the U.S. Food and Drug Administration (FDA) has not approved any drugs for stimulant addiction. However, according to NIDA, researchers are testing medications that act on the brain’s dopamine D3 receptor, which affects the emotion and reward centers of the brain.


After a patient regains stability, the next step is to enter a recovery program. People recovering from moderate-to-severe crack use likely will need more time at a treatment facility to start healing from the physical and psychological effects of their addiction. If they stay on-site for 30 or more days at an inpatient/residential facility, they will start their healing in a structured, monitored environment that promotes a full-time focus on sobriety. Research shows that treatment that lasts a minimum of 90 days, or three months, is the most effective for significantly reducing or stopping drug use.

During the time in residential treatment, patients will learn more about addiction and participate in therapies tailored to their program. These can include cognitive behavioral therapy (CBT), which teaches recovering users how thoughts, beliefs, and attitudes affect behavior, and/or dialectical behavior therapy (DBT), a form of CBT that focuses on self-acceptance and managing negative thinking and behavior with coping techniques, such as mindfulness. Life skills and healthy relapse prevention strategies are also taught in recovery treatment programs. Patients may be able to participate in group therapy, family therapy, and a 12-step program.

Partial Hospitalization (PHP)

People who have finished treatment in an inpatient/residential program can continue their recovery in a less-restrictive environment called partial hospitalization (PHP). This level of care may also be called partial care or a partial day program. This form of outpatient treatment requires at least 20 to 25 hours a week of intensive therapy and counseling. Patients usually can care for themselves without 24-hour supervision.

People with a substance use disorder and a mental health disorder can benefit from PHP as well as those who need relapse prevention support. PHP continues CBT and DBT therapies as well as a focus on addiction education, life skills, 12 steps, relapse prevention, and more. A person can live at home or transitional housing while in PHP.

Intensive Outpatient/Outpatient

After PHP, recovery substance users can continue getting addiction treatment in an intensive outpatient (IOP) or outpatient program (OP). Which one they choose will largely depend on how much therapy they need at this point. IOP patients will have therapies and services for nine or more hours a week, while OP patients will have fewer than nine hours a week. Both options allow patients to return home after they receive services for the day. These treatment settings offer the programs and services listed above, but patients are responsible for getting to the facility and back. They also must keep their home environment free of influences that can derail their recovery progress.


People new to recovery should not return to the outside world without support. Aftercare programs ensure they get the care they need to make recovery attainable. Some facilities help their graduates find resources that help them make a smooth transition from treatment. This could involve helping them find employment, housing, support groups, 12-step programs, or life skills training opportunities. Graduates also gain a recovery community they can turn to when they need help, encouragement, motivation, or just someone who understands their challenges as they work toward fulfilling their sobriety goals. Managing addiction is a lifelong process, and aftercare programs keep people on the track to living the fulfilling life they have worked to have.

How Dangerous Is Crack or a Crack Overdose?

Crack is a purer form of cocaine, and therefore, it is the riskiest to use. The stimulant affects the central nervous system and strains the body, which only worsens with each use. Not getting help for a crack addiction could very well mean dealing with health problems during one’s use, with many of them being life-threatening.

Users who smoke the drug repeatedly to chase the highs they felt when they started using the drug are also developing a higher tolerance for the drug, which means they need more of it to achieve the desired effects. Increased drug use is risky and can lead to overdose and death. Users are on a slippery slope as they continue to use the drug to avoid uncomfortable withdrawal symptoms. Use can lead to overdose, and overdose can lead to death.

Prolonged crack addiction can result in many physical and mental health complications for users. Chronic users may also experience respiratory failure, stroke, heart attack, and heart disease. They also are at risk of developing “crack lung,” an injury that comes from smoking crack long-term. Fever and respiratory failure are signs of this condition. NIDA shares more of cocaine’s physical and psychological long-term effects, which you can read about here.

Relapse is a real possibility, even for people who have done the work, to stay away from it. According to NIDA, the memory of using the drug can trigger strong cravings for it, which can make one seek it out to use it again.

Crack Abuse Statistics

  • In 2020, of the 10.3 million people aged 12 or older who misused central nervous system stimulants, about a third (3.3 million) misused cocaine. (Source: 2020 National Survey on Drug Use and Health (NSDUH))
  • Only 84.7% of people aged 12 or older in 2020 perceived once- or twice-weekly cocaine use as a great risk. (Source: 2020 National Survey on Drug Use and Health (NSDUH))
  • Cocaine ranked fifth among the drugs involved in past-year illicit drug use among people aged 12 or older in 2020. Marijuana was No.1, followed by prescription pain reliever misuse, hallucinogens, and prescription tranquilizer or sedative misuse. (Source: 2020 National Survey on Drug Use and Health (NSDUH))
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