Crack Abuse

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Key Facts About Crack Abuse

What Is Crack?

What does crack look and smell like?

If you’re worried that your teenager is doing crack, it’s helpful to know what to look for. Shaped in irregular white chunks of varying sizes sometimes gives crack the nickname “rock”. Though the drug itself doesn’t carry a distinct smell, the method it’s taken—typically smoked—produces a burning or smoke odor.

Crack cocaine is the freebase form of cocaine. Crack’s popularity, in part, was due to its appeal for drug users seeking an inexpensive, ultra-potent, fast acting high.1,4 The name crack actually comes from the sound that is produced from burning the rock-shaped chunks.2 Other names for the substance include:3

  • Nuggets.
  • Jelly beans.
  • Gravel.
  • Dice.
  • Candy.
  • Rocks.
  • Base.
  • Cookies.

As a powerful stimulant, crack use can elicit a rapid, euphoric high.1 Its stimulant effect on the body means that it will speed up various mental and physical processes, serving to increase energy and give you a sense of control.2 As a smoked form of cocaine, crack cocaine use results in near-immediate effects because the drug is inhaled into the lungs, where it is then absorbed into the bloodstream quickly.4 The effects are quick to be felt, peak quickly, and then end after only 2-20 minutes.1 Because the high is so short-lived, users often abuse crack in a binges.1 The binge and crash cycle of use adds to the risk of tolerance, dependence, and addiction.

Why Do People Use Crack? 

Those who use crack do so to achieve a “high” that includes:4,5

  • An intense euphoric feeling.
  • Inflated sense of self and increased self-importance.
  • Increased alertness.
  • Hyperstimulation.
  • Decreased appetite.

As with other drugs, with persistent use, the desired effects quickly become replaced with negatives.

Signs and Symptoms

Crack is a very dangerous substance. It is very unlikely that someone can use crack cocaine in a casual or recreational way for any significant duration, due to its powerfully addictive nature.4 Any crack use must be taken seriously. Symptoms of crack abuse may be both physical and psychological.

Crack is addictive because it causes an intense euphoric rush that fades quickly, leaving the user wanting more.1 The brain’s reward centers are activated by crack stimulation, reinforcing continued use of the drug.3,4

When the high wears off, the user feels a need to smoke more crack because he or she becomes agitated, restless, paranoid, or anxious.4,5

Parents or others close to a individual potentially addicted to crack may benefit from knowing what some of the warning signs or such an addiction are. Physical signs include:4,5

  • Dilated pupils.
  • Reduced sleep.
  • Increased heart rate.
  • Hypertension (raised blood pressure).
  • Suppressed appetite and weight loss.
  • Fasciculations / twitching of the muscles.
  • Nosebleeds.

Psychological signs may arise that may indicate a person is abusing crack cocaine. These signs may include the following:4,5,6

  • Aggression and volatile mood swings.
  • Psychotic symptoms, such as hallucinations and paranoia.
  • Persistent thoughts about smoking crack/strong cravings.
  • Inability to stop despite a strong desire to do so.
  • Tendency to put a high priority on obtaining the drug.
  • Smoking crack at the expense of your finances, your relationships, or other important aspects of your life.

Other Signs: Tolerance and Withdrawal

Addiction is likely present when someone will engage in risky, dangerous, or problematic behaviors to continue receiving and using the substance.

Someone who persistently engages in crack use can easily build a tolerance to the drug. Tolerance occurs when your body adapts to the crack in your system and requires greater amounts of it to have the same effect. If you are no longer satisfied with a small amount of crack and feel a need for larger and larger amounts, you have built a tolerance.4

Once tolerance has manifested, and increasing amounts of drug are used to overcome it, addiction to the substance may follow soon thereafter. Addiction is likely present when someone will engage in risky, dangerous, or problematic behaviors to continue receiving and using the substance.7

In the throes of an addiction, someone will be less rational and logical. It will likely be increasingly challenging to maintain a relationship due to the influence of the substance.

The phenomenon of withdrawal is another sign of crack abuse. As tolerance develops, a physical dependence may also develop, meaning the brain comes to rely on the drug. Without it, the person may experience withdrawal symptoms such as:5

  • Depression.
  • Increased anxiety.
  • Being highly irritable and easily agitated.
  • Intense cravings for more crack.

Risks of Crack Abuse

Oftentimes, those who abuse crack place themselves and others in harm’s way because of dangerous compulsive drug seeking behaviors. Crack abusers tend to engage in the following behaviors:


  • Risky sexual behaviors. Crack intensifies sexual desire and removes inhibitions. Those high on crack might be more likely to have sex with multiple partners and are also more likely to have unprotected sex. In addition to risky sexual behaviors while under the influence of crack, some people may choose exchange sex for the drug.7
  • Increased tendencies towards violence. Crack cocaine intensifies emotional experiences, including anger and rage. People who are high on crack may be violent toward others. They may also harm themselves intentionally or unintentionally.4,8
  • Getting into risky situations in order to obtain crack. Crack users often enter dangerous neighborhoods or agree to do risky things in order to obtain the substance. Crack addiction is a powerful motivator, and many individuals ensnared by it are willing to do almost anything in exchange for some more of the substance.
  • Neglecting their other responsibilities. People in active crack addiction will prioritize drug use over responsibilities like paying their bills, attending work, maintaining relationships with family members, or even caring for their children.6
  • Breaking the law. Many addicted to crack may steal to support their habit. They also may commit robberies or engage in other illegal activity to gain money to buy crack. In addition, crack possession itself is illegal, so some will face legal trouble for using it even if they don’t engage in these behaviors.8

Credit: Howcast

Effects of Crack Abuse

In both the short- and long-term, crack abuse can give rise to a number of side effects that can drastically compromise your health.

Short-term health risks of crack abuse include:4,5

  • Cardiovascular risks including higher heart rate, blood pressure, and body temperature.
  • Higher breathing rates.
  • Nausea.
  • Odd or bizarre behaviors.
  • Delusional thinking.
  • Paranoia.
  • Anxiety and panic.

The above negative effects of the substance can occur after only one use at a high dose.

Crack’s Long-Term Effects

Long-term effects can occur after days, weeks, months, and years of consistent abuse. They include:4,5,9

  • Long-lasting cardiovascular issues that may include heart attack, stroke, and heart disease.
  • Malnutrition due to significant weight loss.
  • Marked cognitive decline.
  • Confusion / delirium.
  • Psychosis.
  • Hallucinations (seeing, hearing, or feeling things that are not present).
  • Damage to the lips, mouth, and teeth.
  • Major depression, anxiety, and irritability.
  • Seizures.

Don’t wait until crack use has caused numerous debilitating physical and mental health effects to pile up before beginning your recovery.

Crack Abuse Treatment

You can live a better life with treatment. Learn how.

Treatment for crack abuse may begin with detoxification. This is a controlled withdrawal from crack cocaine that is usually performed at a detox center. Doctors are able to monitor patients for severe physical symptoms of crack withdrawal. Patients may  experience intense psychological effects such as mood swings, agitation, depression, and anxiety during the withdrawal period.5 This period varies in duration based on the amount of use and the time the substance was abused. Withdrawal can be more severe if the patient has used crack at high doses for an extended duration. Some users may experience what is known as a post-acute withdrawal syndrome, in which symptoms can extend well past the acute detoxification phase.5

After finishing detox, many patients transition to a residential rehab center or other form of structured addiction treatment. Rehab programs are generally inpatient, which means patients live at the rehab center while getting treatment. Treatment focuses on the psychological aspects of addiction—patients receive individual and group therapy and may attend ongoing support groups (such as 12-step groups like Narcotics Anonymous). These residential programs may last anywhere from 30 days to 1 year.

An inpatient or residential rehab stay is typically followed by a period of ongoing aftercare, in which patients return to their daily lives but continue to visit the treatment center (or a pre-arranged aftercare clinic or clinician) on a regular basis to receive continuing therapy and other needed treatment. Some patients transition back to their normal lives by living in a halfway house or sober living facility. These facilities are run like regular apartments, but residents must follow house rules such as curfews and must submit to regular drug tests to prove they are clean.

Some people may elect to enroll in or undergo addiction treatment in an outpatient setting. In outpatient treatment, someone in recovery from crack might meet with a mental health or addiction therapist weekly on an ongoing basis. Someone in recovery will also benefit from community supports like sober activities and meetings and will be encouraged or required to participate in some sort of support group setting.

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Eric Patterson, MSCP, NCC, LPC, is a professional counselor who has been working for over a decade to help children, adolescents, and adults in western Pennsylvania reach their goals and improve their well-being.

Along the way, Eric worked as a collaborating investigator for the field trials of the DSM-5 and completed an agreement to provide mental health treatment to underserved communities with the National Health Service Corp.

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