What Is a Crack Addiction?

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What Is Crack?

Cocaine is a stimulant drug that is extracted from the leaves of the coca plant. The purified form of the extract, which looks like fine, white, powdered crystals, was initially used for medicinal purposes. 

Cocaine is currently classified as a Schedule II drug. It can be legally used for certain medical purposes, including local anesthesia for some ear, throat, and eye surgeries. However, it has high potential for abuse. People rub cocaine in their gums, snort it through their nose, or dissolve it and inject it into their veins.

"Crack is a form of cocaine that people smoke. The term ‘crack’ refers to the crackling sound the crystal makes when it is being heated to smoke,” says Jeanette Tetrault, MD, an addiction medicine specialist at Yale Medicine.

Crack is a freebase form of cocaine that is processed using water and either ammonia or baking soda, until it forms a rock crystal that can be smoked. Crack cocaine is also known as “rock,” because it looks like small, hard shards of rock. People typically smoke crack by heating it in a glass pipe; however, they may also add it to tobacco cigarettes or marijuana joints.

What Is a Crack Addiction?

Crack addiction refers to a substance use disorder where an individual is physiologically dependent on the substance; they lose control over their use and continue to use the substance despite negative consequences, says Dr. Tetrault.

Substance use is recognized as a brain disorder. People who are addicted to crack have a chronic medical condition that requires treatment. It’s often not as simple as expecting a person to stop using it on their own, or thinking they'll be better if they stop using it for a few days.

Approximately 1.3 million people in the United States over the age of 12 have a cocaine use disorder, which means they use cocaine or crack.

Causes of a Crack Addiction

Cocaine and crack are powerful stimulants that give users a euphoric feeling and increased energy, says Dr. Tetrault. Using these substances floods the brain with dopamine, a natural chemical that is part of the brain’s reward system; it stimulates the brain, numbs pain, and helps us feel pleasure.

Smoking crack can cause the drug to reach the brain faster than snorting powdered cocaine. The high is stronger but only lasts five to 10 minutes. As a result, the person experiences an intense rush, followed by a hard crash that can feel depressing and lead to intense cravings for more of the drug. Crack is therefore associated with stronger cravings and greater risk of addiction than inhaled cocaine.

Dr. Tetrault explains that repeatedly using crack or cocaine can cause changes in the brain’s reward circuitry, which can make people use it compulsively, despite the harm it causes. This is because repeated use of the drug causes the reward circuit of the brain to adapt and become less sensitive to its effects. People therefore need to take more of the drug and do it more often, in order to achieve the same high and prevent withdrawal symptoms.

Effects of Crack Cocaine Use

While using crack or cocaine, people may experience a high that is characterized by:

  • A surge of energy
  • Extreme happiness
  • Mental alertness
  • Sensitivity to sound, light, and touch
  • Irritability
  • Paranoia
  • Strange, unpredictable or even violent behavior

The high is also accompanied by physiological changes, such as:

  • Dilated pupils
  • Nausea
  • Raised blood pressure
  • Increased body temperature
  • Rapid or irregular heartbeat
  • Muscle tremors or twitches
  • Restlessness  

However, using crack cocaine can damage the person’s heart, brain, or other vital organs, says Dr. Tetrault. She says it is particularly harmful for people with heart problems. These are some of the side effects of frequent crack cocaine use:

  • Brain seizures
  • Sudden cardiac death
  • Heart attack
  • Stroke
  • Coma
  • Elevated blood pressure
  • Sexual dysfunction 
  • Depression
  • Respiratory conditions such as cough, asthma, bronchitis, and pneumonia

A person may also overdose on crack cocaine, especially if they mix it with alcohol or heroin. Dr. Tetrault explains that cocaine is sometimes adulterated with other drugs such as amphetamines or synthetic opioids like fentanyl, which can make it particularly dangerous. A person can overdose the first time they use crack cocaine, or any time thereafter.

Using crack cocaine can cause an overdose or other serious or life-threatening side effects. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Signs and Symptoms of a Crack Addiction

These are some of the signs and symptoms of a crack cocaine addiction, according to Dr. Tetrault:

  • Experiencing intense cravings for the drug
  • Needing to take the drug to feel “normal”
  • Using more of the drug to achieve the same effect
  • Losing control over one’s drug consumption 
  • Continuing to use the drug despite the harm it causes
  • Willing to do anything to get more of the drug
  • Experiencing withdrawal symptoms, such as fatigue, irritability, sluggishness, increased appetite, depression, and insomnia when the high wears off

Additionally, people who are addicted to crack cocaine may also experience the following:

  • Severe depression
  • Weight loss
  • Insomnia 
  • Lack of interest in their work, friends, and family
  • Lack of attention to personal hygiene
  • Negative consequences to their job, relationships, and daily life
  • Loss of control over their life
  • Considerable expenditure to fund their habit 

Diagnosing a Crack Addiction

Crack addiction is diagnosed by clinicians, says Dr. Tetrault. She explains that the diagnostic process could involve:

  • A physical examination
  • A detailed medical history
  • A series of screening questions

The clinician will evaluate whether the person meets the criteria listed for addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a guiding manual published by the American Psychiatric Association.

Treating a Crack Addiction

Treating a crack addiction may involve detoxification and therapy. Treatment may occur in hospitals, in therapeutic communities, or in clinical settings.


The treatment process often begins with detox, where the person is not allowed to consume crack and may experience severe withdrawal symptoms as a result.

The physical symptoms of withdrawal can start shortly after the person’s last use of the drug and continue for up to a week. Working through the emotional challenges that accompany addiction can take a lot longer.


Several evidence-based counseling options have been shown to treat crack addictions, says Dr. Tetrault. These can include:

  • Cognitive behavior therapy (CBT): CBT involves challenging negative thought processes that lead to unhealthy behaviors, such as using drugs.
  • Contingency management: Also known as motivational incentive, this form of therapy involves rewarding people for not using drugs.
  • Community-based treatment: This can include support groups or 12-step programs.


There are no medications currently available to treat cocaine use disorder or cravings associated with crack cocaine, says Dr. Tetrault.

However, she says that if the person is experiencing an opioid overdose that is caused by using cocaine adulterated by high-potency opioids, the drug naloxone can help reverse the overdose.

A Word From Verywell

A crack addiction can put a person at risk for serious health consequences, including death. Preventing the use of this drug is critical, because even a single instance of use can lead to addiction or death in some people. 

If someone in your life has a crack addiction, Dr. Tetrault says it’s important to support them and help them find evidence-based treatment that works for them.

6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Johns Hopkins Medicine. Substance abuse.

  2. National Institute on Drug Abuse. What is the scope of cocaine use in the United States?

  3. Harvard Medical School. Dopamine: the pathway to pleasure. Harvard Health Publishing.

  4. Garza-Villarreal EA, Chakravarty M, Hansen B, et al. The effect of crack cocaine addiction and age on the microstructure and morphology of the human striatum and thalamus using shape analysis and fast diffusion kurtosis imaging. Transl Psychiatry.2017;7(5):e1122. doi:10.1038/tp.2017.92

  5. Havakuk O, Rezkalla S, Kloner R. The cardiovascular effects of cocaine. Journal of the American College of Cardiology. 2017;70(1):101-113. doi:10.1016/j.jacc.2017.05.014

  6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.

Additional Reading

By Sanjana Gupta
Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.