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Crack Withdrawal

Crack cocaine, usually shortened just to “crack,” is a central nervous system stimulant and a highly concentrated, much more potent form of cocaine and gets its name from the crackling sound it makes when being smoked.  

Crack is made by taking cocaine in its powdered form, combining it with water and baking soda, and then boiling it until the substance becomes solid, after which it is broken up into pieces. Because smoking crack changes the way it is absorbed into the body, even though it is chemically the same as cocaine, the high is much more powerful and poses a higher risk of addiction than the powdered form of cocaine. 

Crack is classified by the DEA as a Schedule II Drug, which means it has an extremely high potential for both abuse and addiction, but also a limited degree of medicinal use. This label is due to the fact that, according to the DEA, cocaine and crack are considered to be the same substance, even though once in the form of crack, it has none of the medical usefulness that can be applied to cocaine. 

Crack rose to notoriety during the 1980s, with crack abuse running rampant in cities like Los Angeles and Miami within only a few years. In recent years; however, there has been a significant drop off in use, with methamphetamines becoming the drug of choice for illicit stimulant use. 

Still, crack remains a threat based on the fact that it’s possible for someone to become addicted to it in as little as one use. As of 2015, just under about half a million people in the United States reported regularly abusing crack or otherwise being dependent on it. 

How Does Crack Work?

Like cocaine and other central nervous system stimulants, crack is what’s known as a “reuptake inhibitor,” and it works by blocking the brain from reabsorbing a neurotransmitter called dopamine. Dopamine is a brain chemical that is responsible for regulating emotions, cognition, and the brain’s motivation and reward system. It is often referred to as the “pleasure center” of the brain. 

Typically, the brain will naturally produce dopamine in response to stimuli, such as finding pleasure in an activity or anticipating a reward. Once the dopamine is no longer required, it is reabsorbed until the next time dopamine production is triggered in a process called “reuptake.”

So what crack does is increase the levels of dopamine in the brain’s synapses not by increasing dopamine production like other stimulants such as amphetamines do, but by blocking the reabsorption process and letting dopamine linger and build up way past what the brain could ever produce on its own. 

This excessive amount of dopamine is how both cocaine and crack use causes a huge spike in feelings of euphoria, alertness, and intense energy as well as paranoia, confusion and sometimes suicidal thoughts and behavior.

Since crack is essentially just a more concentrated form of cocaine, it has a much more powerful high that comes on faster than cocaine, generally in five minutes or less, and lasts for a much shorter time as well, hitting its peak in around 10 minutes, as opposed to cocaine’s half-hour high. 

Because the high from crack is so much stronger as well as more brief, people who abuse crack tend to do so in the form of a binge where they use dangerously large amounts in a short window of time. This rapidly forms the inextricable link in the brain between crack use and the “reward” of dopamine, which is the beginnings of dependence and addiction.

But since crack does not actually stimulate the production of more dopamine, each subsequent high becomes less intense than the last one, because dopamine can take a long time to replenish itself. This means that even before someone has become dependent on crack to the point where they have built up a tolerance to it, they have to take bigger and bigger doses of it to achieve the same effects, increasing the risk of overdosing as well as suffering from total psychosis due to having toxic levels of crack in their system.    

What Are the Symptoms of Crack Withdrawal?

Like cocaine, the high from crack is usually followed by a “crash” as the dopamine is reabsorbed and the feelings of euphoria and energy rapidly leave the body, leaving behind cravings for more crack as well as withdrawal symptoms. 

The symptoms of crack withdrawal do share similarities with those of cocaine, as you might expect. However, while cocaine withdrawal symptoms are almost entirely mood-based and psychological in nature, crack withdrawal has more of the physical, flu-like symptoms common in other substance withdrawals.

Some Common Symptoms Of Crack Withdrawal Include:

  • Nausea
  • Insomnia
  • Suicidal thoughts and behavior
  • Unstable moods
  • Muscle pain
  • Tremors
  • Inability to concentrate
  • Anxiety and panic attacks
  • Intense exhaustion and fatigue
  • Severe depression
  • Vivid nightmares or other sleep disturbances
  • Increase in appetite (in response to the appetite suppression effects associated with stimulants)

Some extra points worth noting that also differentiate crack withdrawal from cocaine withdrawal is that the withdrawal symptoms from crack will generally be more intense and uncomfortable than those from cocaine because of how highly concentrated crack is, which creates much more severe addictions much faster. 

Also, because drug manufacturers will often cut the cocaine they use to make crack with other substances, including toxic poisons, to make it both cheaper to produce and more potent, the purity levels and chemical makeup of any given dose of crack is almost impossible to predict. This means that someone undergoing crack detox is highly likely to experience other, possibly more dangerous symptoms that are not as commonly associated with crack withdrawal. 

Can Crack Withdrawal Kill You?

Again, as with cocaine, withdrawal from crack is almost never a life-threatening situation. That does not; however, mean that it is necessarily safe to undergo a crack detox without some kind of medical intervention, whether in the form of an inpatient or outpatient detox. 

There are several elements of crack withdrawal that, if attempted unsupervised, can place someone in a dangerous situation that could have severe consequences. The most obvious example is the high risk of relapsing due to the discomfort of the symptoms of crack withdrawal and the intensity of the cravings. In order to relieve these symptoms, many people will relapse and take a larger amount of crack than usual, which can lead to a fatal overdose.  

There is also a risk presented by the psychological symptoms such as depression, anxiety, and suicidal thoughts, which can put someone going through crack detox in a frame of mind where they might harm themselves or worse. 

Finally, as we previously stated, there is no way for someone to know how much crack they’re using is actually cocaine or what might be mixed in with it, which can lead to atypical withdrawal symptoms that could potentially be deadly without the aid of a medical professional. 

What Are the Stages of the Crack Withdrawal Timeline?

While in theory, the crack withdrawal timeline follows the cocaine withdrawal timeline very closely, it is difficult to ascertain exactly how long a given individual’s crack withdrawal period will last due to a number of different factors that will be unique from person to person, as well as reasons specific to crack use itself.

Some common individual-based factors include:

  • How much crack someone was taking
  • How long they were abusing crack
  • If they have a history of addiction
  • If they have a mental illness or other co-occurring disorder
  • The current state of their health in general
  • If they are attempting to quit crack “cold turkey”
  • If they were taking crack at the same time as alcohol or other drugs

Expanding on the last factor, crack is very frequently used in combination with other substances, including marijuana, heroin, amphetamines, and even PCP, any of which has the potential to significantly impact the timeline for withdrawal from crack. 

Generally, the form and manner in which someone uses a substance are also important in determining how long a withdrawal period will be. Though since crack is nearly always smoked, this is usually not worth considering in the case of crack withdrawal.  

With these facts in mind, the established timeline for crack withdrawal can be separated into three main stages and will typically go as follows:


As we mentioned before, since the high from crack peaks so much faster than cocaine, its half-life is equally short, and so it’s possible for someone to start feeling the symptoms of crack withdrawal as soon as an hour after their last dose. Early symptoms associated with the crash period include intense feelings of paranoia, irritability, and a sudden increase in appetite.

The first stage can last anywhere from 24 hours to several days, depending on how much crack someone was using and how severe their dependency is. Over the course of the crash stage, the symptoms of fatigue, insomnia, anxiety, and depression will appear and reach their peak strength, making this the stage during which people are typically most vulnerable to relapse. 


After the crash stage comes the craving stage. At this point, the majority of the physical symptoms should have run their course, and the psychological symptoms, while still present, should have greatly diminished. In their place will be extremely intense crack cravings, along with feelings of general restlessness and difficulty concentrating.

Unfortunately, even with the general established timeline of crack withdrawal, the craving stage can last anywhere between one week and several months. If someone was abusing very large amounts of crack multiple times a day over an extended period, they have a much higher likelihood of having a protracted craving stage. 


However long the craving stage does end up lasting, it will then be followed by what’s known as the extinction stage, wherein the symptoms of crack withdrawal should have either dissipated or, if still present, be much weaker and easier to manage. 

Even though this is the final stage of crack withdrawal, even once past it, an individual can still experience random intermittent cravings for crack as well as mild feelings of depression, which can sometimes remain for as long as six months. 

Why Should I Do a Medical Crack Detox?

Like cocaine detox, crack detox can be done on an outpatient basis if the addiction is not as severe or the individual has not been dependent on crack for very long. However, because crack withdrawal can be more intense with symptoms that are difficult to predict, medical detoxification may be necessary to avoid the previously mentioned dangers associated with withdrawal from crack. 

Crack rocks being picked up by forceps

If someone tries to stop using crack all at once or “cold turkey,” there is also a greater risk of complications and more severe withdrawal symptoms. Engaging in regular crack binges throws off the dopamine levels in the brain to such an extreme degree that the crash becomes much more intense and harder to handle, especially for someone trying to do a crack detox alone. 

At a medical detox facility, the possibility of relapse due to being unable to deal with the symptoms of crack withdrawal can be avoided through the administration of different medications to help alleviate any unnecessary discomfort. And should any complications arise, they can be handled without the situation becoming dangerous or life-threatening.

What Is the Next Treatment Step?

After someone has successfully completed their crack detox, the next step in crack withdrawal treatment should be checking into an addiction recovery treatment program. Even if it is just on an informal, outpatient basis, if detox is not followed up with aftercare, relapse is likely and sooner rather than later, especially when considering how long cravings for crack can remain even after finishing detox. 

An addiction rehabilitation treatment program can provide the tools, resources, and support to get to the root of someone’s issues with addiction and help them make positive, lasting changes to their behavior so that they are more likely to remain sober and avoid using again. 

At most treatment facilities, an individual will work with their therapist or counselor to create a customized treatment plan that will be most effective for them and might include group therapy, individualized counseling, holistic therapy, and more. 

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