Before opioid addiction started to spread across the United States at epidemic levels, another drug was wreaking havoc across the country. Cocaine was the biggest threat to public health in the 1980s and 1990s and killed people by the thousands each year. According to the National Institute on Drug Abuse, more than 12 million people used cocaine in 1985, a number that would drop by 50 percent by 1990.
Cocaine, and its processed version crack, had a significant impact on health and culture as addiction and overdose started to escalate.
But what is crack and why does it still represent a significant addiction problem to this day? Learn more about crack addiction, dependence, and withdrawal symptoms.
Crack and cocaine are the same drug that’s derived from the coca plant that’s indigenous to South America. The plant was used as a traditional medicine by native people groups for thousands of years. When the leaves of the plant are chewed, it can deliver stimulating effects, increased wakefulness, and a numbing sensation in the mouth. The active ingredient in the drug was isolated in 1855 and began to be used for medical purposes in the 1870s.
Cocaine also delivers powerful stimulating effects, euphoria, and a feeling of empowerment, which makes it popular as a recreational drug.
However, it also causes itching, increased heart rate, hallucinations, and paranoid delusions. High doses can induce a condition called stimulant psychosis, which is when a stimulant produces psychotic symptoms often associated with schizophrenia. During an overdose, cocaine can cause tremors, fever, cardiac arrest, arrhythmia, and sudden cardiac death.
Cocaine is also powerfully addictive and can lead to chemical dependency and severe substance use disorders. Dependency can also lead to uncomfortable withdrawal symptoms as the effects of the drug wear off.
Crack is a version of cocaine that goes through an extra process that converts it to its freebase form. Cocaine is difficult to burn, so it is usually insufflated (snorted) as its main means of intake. Crack cocaine burns more easily and can be smoked, leading to a faster high. Crack highs are short but intense, causing a quick sense of euphoria before an uncomfortable comedown. Because the high is short-lived but powerful, the drug often encourages users to binge on it. Crack works in the brain by blocking the reuptake process of dopamine and serotonin.
In other words, the naturally occurring chemicals that cause excitement and motivation are prevented from being removed and recycled, causing a buildup in your brain. However, during a crack binge, your brain will release dopamine and need time to produce more, so each hit in a binge will be weaker than the last.
Binging can lead to psychological and physical consequences like addiction and psychosis. Stimulant psychosis is often associated with people who binge for long periods without sleep. Once you become chemically dependent on a drug, you’ll experience withdrawal symptoms when you try to stop.
Crack cocaine affects chemicals in your brain that are closely tied to motivation and reward. Dopamine, in particular, can cause feelings of excitement, empowerment, alertness, and focus.
When you take crack for a long time or in heavy doses, your brain may become used to these psychoactive effects, adapting your normal brain chemistry to rely on crack and elevated levels of dopamine. When you stop using crack, your brain chemistry will become unbalanced until it adjusts to normal levels.
Because crack affects chemicals that primarily affect your mood and energy levels, the most common effects of withdrawal manifest in psychological symptoms but nausea, extreme fatigue, and muscle pain may also occur. Some users report that a comedown from crack may be more intense and unpleasant than typical powder cocaine. Since the effects of crack can be powerful but wear off quickly, the comedown may be more jarring. Users also report more intense physical symptoms like discomfort, aches and pain, and tremors. Other common symptoms of withdrawal include:
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Crack cocaine withdrawal symptoms aren’t typically life-threatening, though they may be extremely uncomfortable. However, going through withdrawal on your own may be risky. A crack binge can take a toll on your mental and physical health, especially if it lasts for days. If a person stays awake for days on crack, they may develop extreme fatigue and psychosis that may need medical attention.
Crack can also cause extreme depression and thoughts of suicide. If you experience extremely negative emotions after stopping crack use, it’s important to recognize that your brain is going through a chemical readjustment that may cause emotional turmoil. Speak to a professional if you have thoughts of suicide or severe depression.
The timeline on which you experience crack cocaine withdrawal will depend on factors such as the size of your usual dose and the amount you used last. However, the withdrawal timeline typically follows a common pattern. Here’s what you might be able to expect:
Crack withdrawal symptoms can begin in as little as one hour, and they usually start to manifest within the first 12 hours of your last hit. This is the comedown phase and can include symptoms like increased appetite, agitation, paranoia, exhaustion, insomnia, anxiety, and depression. This phase can last several days, though some symptoms will peak a and then subside after 24 hours.
After your initial crash phase starts to subside, you may still experience psychological symptoms like anxiety and depression. You may also start experiencing powerful drug cravings as your brain feels the effects of a lack of the chemical it had gotten used to. Psychological symptoms may subside after a week to 10 days, but they may linger for longer without treatment.
Without treatment cravings and psychological symptoms can last for a long time. Addiction treatment can help examine the underlying issues that may contribute to your substance use problems like mental health issues. You can also learn to cope with drug cravings and triggers without using.
Crack withdrawal can be treated in a medical detox facility or a hospital detox setting. In medical detox, you will be monitored at all hours of the day and treated with medications to alleviate symptoms. The goal of medical detox is to ensure your safety and to avoid any potential medical complications. Your symptoms will also be alleviated as much as possible. In medical detox, any other mental or physical health issues can be addressed while you go through detox.
After you complete detoxification, clinicians can connect you to the next level of care that would be appropriate for your needs. If you’ve developed a severe cocaine use disorder, you may need more than just detoxification to address your addiction effectively. You may still experience psychological symptoms and cravings for a long time after your brain chemistry has returned to normal.
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