Crack Addiction

Crack is the street name given to the freebase form of cocaine that has been processed from the powdered cocaine hydrochloride form to a smokable substance. The term “crack” refers to the crackling sound heard when the mixture is smoked. Crack cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water, and heated to remove the hydrochloride.

Because crack is smoked, the user experiences a high in less than 10 seconds. This rather immediate and euphoric effect is one of the reasons that crack became enormously popular in the mid 1980s. Another reason is that crack is inexpensive both to produce and to buy.

Cocaine, like all CNS stimulants, increases the level of dopamine in the brain when introduced into the bloodstream. The release of dopamine is the brain’s reward system by creating feelings of pleasure for achieving a certain ‘mood’ or brain frequency. Dopamine is a neurotransmitter that is naturally released by the brain, and then is retrieved by a receiving neuron where the dopamine cycle begins again. The presence of cocaine averts dopamine from reaching the receiving neurons, causing excess amounts of dopamine to build up and therefore disrupts normal transmission. This excess buildup amplifies the feelings of pleasure, known as a state of euphoria or ‘high.’ After repeated cocaine use, this neurological interference can create long-term changes in the brain’s reward system, such as building tolerance to cocaine’s toxic effects. This requires the user to take more frequent or larger amounts of cocaine to achieve the same high. These changes developed from habitual use often lead to addiction. Crack cocaine addiction is both a physical and psychological disorder since the body and brain become dependent on the presence of cocaine.

In 2000, an estimated 1.2 million Americans were current cocaine users. This represents 0.5 percent of the population aged 12 and older. The estimated number of current crack users in 2000 is 265,000.

Like any form of substance addiction, cocaine addiction is a multifaceted disease that causes problems behaviorally, socially, occupationally, biologically, neurologically, and psychologically. Cocaine is highly addictive; repeated use leads to tolerance, dependence, withdrawal after abstinence, and addiction. In 2006, the 71 percent of individuals seeking treatment for cocaine abuse smoke crack and are likely to abuse more than one substance.

Treatment for crack cocaine must be all-encompassing to address the coexisting medical, neurobiological, and mental disorders.