Cocaine is an addictive and dangerous drug that derives from the coca plant. It can be found in both rock and powder forms. The powdered form of cocaine is referred to as coke or cocaine, while the rock form is called crack or crack cocaine. Unfortunately, deaths from cocaine overdose are rising dramatically, and according to the U.S. Centers for Disease Control and Prevention (CDC), more than 16,000 people died in 2019.
Coca leaves have been chewed for thousands of years by people in South America for their stimulant effects. In the early 1900s, purified cocaine was the primary active ingredient in many elixirs and tonics developed to treat various illnesses. Cocaine was even an ingredient in the earliest formulations of Coca-Cola. Before local anesthetics, cocaine was used by surgeons to block pain.
Cocaine is considered a Schedule II drug today, meaning it has a high potential for abuse but can be administered by a medical professional for legitimate uses, such as local anesthesia for ear, eye, or throat surgeries. As a street drug, cocaine appears as a crystalline powder, but it can also come in rock form known as crack cocaine.
The base form of the drug is created by processing cocaine with sodium bicarbonate (baking soda) or ammonia, and water, then heating it to remove the hydrochloride, which produces a smokable substance. The term crack is the name given to freebase cocaine and refers to the sound you hear when the mixture is smoked. A person can become addicted to the drug after a single hit.
When a person snorts cocaine, the drug will take effect in three to five minutes and last anywhere from 15 to 30 minutes, depending on the dose and purity of the drug. A person who smokes crack will notice the effects instantly, and it only lasts five to ten minutes, which is the cycle that leads to binging and crashing and causes physical dependence. Although injecting cocaine is less common, users take advantage of its longer duration of effects. The feeling of injecting the drug can last up to an hour.
The most common effects from use include:
Withdrawal is something that occurs shortly after use, and symptoms might include:
Cocaine and crack cocaine are dangerous and can lead to overdose, which can cause convulsions, coma, or death.
Unfortunately, cocaine is seldom pure, and dealers typically cut the drug to stretch their profits. In some cases, it might be cut with something less deadly like sucrose, which is still dangerous to snort. Other impurities include glucose, talc, boric acid, strychnine, benzocaine, Ritalin, procaine, tetracaine, ephedrine, or levamisole.
The most noticeable differences between the two are the appearance. Cocaine is generally found as a white powder, while crack is found in a rock formation. It can be cream, white, tan, or light brown. The two are also used differently. Cocaine is snorted, while crack is typically smoked.
Another difference between the two is the high that’s produced. While they’re similar in nature due to their stimulant properties, crack cocaine yields a much more intense high that lasts less time. When cocaine is snorted, the effects may take longer to notice, but it results in a longer-lasting high.
Cocaine and crack cocaine produce significantly different effects in the body related to how they’re administered. When the drug is snorted, the effects occur in one to five minutes, peak in 20 to 30 minutes, and dissipate within one to two hours. Crack cocaine’s effects take hold in less than a minute, peak in three to five minutes, and last from a half-hour to an hour.
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Cocaine is an expensive drug to purchase on the streets, and crack was introduced as a cheaper alternative, making it more affordable to users. Since it’s in a lower price bracket, it’s more accessible to individuals in lower socioeconomic demographics. Someone with little means looking to get high will find crack desirable, which brought the drug to low-income and minority communities. By the ‘80s, the crack epidemic exploded in these communities.
This led public perception to associate cocaine with affluent drug users, and crack cocaine is seen for minorities and lower-income brackets. Despite the belief, a majority of crack users are caucasian.
Generally speaking, someone who wants a faster and more intense high on the cheap is attracted to crack. Some people might begin with cocaine and transition to crack when their cocaine habit becomes too expensive. Of the 1.9 million cocaine users, 359,000 of them used crack in 2008.
The effects of crack will vary because of the uncertainty when it comes to the purity of cocaine used to create it, adding to the unpredictability and seriousness of smoking crack. The most common effects of crack are similar to cocaine but much more intense. These include:
Smoking crack will cause the effects to occur quicker and be more intense than cocaine. This is because the drug is absorbed through the lungs’ membranes and reaches the brain in seconds. Overdosing on crack is common and will lead to convulsions, coma, and death—symptoms of crack overdose in hyperventilation and rapid heart rate.
Long-term effects of crack cocaine abuse include restlessness, irritability, mood changes, anxiety, depression, paranoia, and hallucinations.
Abusing cocaine for extended periods can lead to psychiatric symptoms, and you must get help immediately to stop using the drug. Although withdrawal symptoms aren’t typically fatal, they’re extremely unpredictable because of the psychiatric factor. Coming off cocaine is challenging by yourself, and checking into detox might be your last hope.
During detox, medical professionals will provide you with medications to alleviate the worst symptoms brought on by withdrawal. They’ll also monitor you around-the-clock to ensure you don’t hurt yourself or succumb to the symptoms. They’ll hold you accountable and make sure you get through the tough times. Once you finish this step, you’ll move into another level of care that will address why you started abusing the drug.
Only you can take control back of your life, and if you’re struggling with cocaine or crack cocaine addiction, you’re a phone call away from changing your life forever.
According to the National Institute on Drug Abuse (NIDA), an estimated six percent of all admissions into treatment were from cocaine. An estimated 68 percent who sought treatment for cocaine admitted to smoking crack and were more likely to be polydrug users, indicating they use more than one substance at a time.
Those who provide treatment for cocaine abuse need to understand that addiction is a complex disease that involves changes in the brain, as well as a broad range of familial, social, and other environmental factors. With that said, treating cocaine addiction must address co-occurring mental disorders that may be contributing to the drug abuse.
Although there isn’t a medication approved to treat cocaine addiction, researchers continue looking for various neurobiological targets. Past research has focused on the changes in dopamine, but cocaine use causes havoc on serotonin and gamma-aminobutyric acid (GABA), and glutamate. Current research in animals has looked at medications that act as serotonin receptors.
Besides medication, behavioral treatments for cocaine and crack addiction have shown useful in both residential and outpatient settings. Behavioral therapies are typically the only available and effective treatments for stimulant addiction. Contingency management (CM), also known as motivational incentives, is a program that uses vouchers or prize-based systems to reward clients who abstain from cocaine or other drugs.
It encourages healthy living, such as motive tickets, gym memberships, or dinner at a local restaurant. It’s beneficial for helping a client achieve initial abstinence from the drug and stay in treatment longer. It has been implemented in community treatment programs nationwide and is something you should speak to an addiction specialist about.
NCBI (August 1999) Cocaine and Psychiatric Symptoms. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181074/
NSDUH (2013) Substance Use and Mental Health Estimates From 2013. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-SR200-RecoveryMonth-2014/NSDUH-SR200-RecoveryMonth-2014.htm
FDA (N.D.) Ritalin. Retrieved from https://www.fda.gov/media/72922/download
CDC (N.D.) Provisional Drug Overdose Death Counts. Retrieved from https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
NIDA (January 2021) What is Cocaine? Retrieved from https://www.drugabuse.gov/publications/research-reports/cocaine/what-cocaine
NIDA (N.D.) How Is Cocaine Addiction Treated? From from https://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers