What is crack cocaine?

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Crack cocaine is derived from powdered cocaine and is converted using a very simple conversion process to produce crack. This first emerged in the USA in the 1980's and is abused because, unlike powdered cocaine, produces an immediate high. It is manufactured by mixing ordinary Cocaine with baking soda or ammonia and water then boiling  it. It got the name crack due to the popping sound it makes when it is heated by the end user in a "bong" (see the image above). Due to the ease in which Cocaine can be converted, it is cheap and easy to produce.

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What does it look like?

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After the cooking process it forms rocks and it is sold as such. These are invariably white or off white and vary in both size and shape.

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How is it taken?

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Crack cocaine is either smoked using a "bong" or it is crushed and injected, often with other drugs which is known as speed balling.

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What are the risks?

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In any form, Cocaine is a powerful, addictive drug. When it is smoked as crack the addiction forms much more quickly than ordinary powdered cocaine.  In addition to the usual considerations when taking cocaine in it's original powdered form.  Powdered cocaine presents with following potential health problems:

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* increased temperature

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* increased heart rate

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* rise in blood pressure

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* risk of cardiac arrest

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* seizures

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With crack there are added complications:

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* persistent coughing

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* shortness of breath

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* lung trauma

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* internal bleeding

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* paranoia

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* aggressive behavior

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Symptoms of Withdrawal

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As with powdered cocaine, crack is both psychologically and physically  addictive. There is no recognized medical detox  for crack as it is a very short acting drug.  There are three recognized stages of cocaine withdrawal

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Stage One: The Crash

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This commonly sets in within the first day after last use. Users will, typically, experience very significant fatigue and a major change in appetite which would have been suppressed by cocaine. This change in appetite can last from 7 2hours to two weeks. Of course, the length and severity of the crash phase depends largely on how much crack was being used and how long it was being used for.  Ordinarily, the acute withdrawal phase need  not be life threatening but needs close medical monitoring. In any event, one aspect is a rapid and significant lowering of mood which can lead to suicidal thoughts.

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Stage Two: withdrawal

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This occurs, normally, within three to fourteen days after last use and can last for anything between three and six months.  Symptoms can include:

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* lack of interest in work/social/family activities

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* poor sleep

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* inability to concentrate

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* short term memory loss

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Unfortunately, it is during this second phase when people are most likely to relapse. This is due to the intense psychological  symptoms such as mood swings, inability to sleep and episodes of extreme panic. This is known as Post Acute Withdrawal Syndrome.

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Stage Three: Extinction

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This is the final phase and can be identified as such due to the decreased frequency of withdrawal symptoms. That is not to say that there are not sporadic and or intense cravings during this phase , they tend to be sporadic or isolated around a particular triggering event. This is the time that coping strategies learned in treatment are invaluable.

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What help is available?

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As explained above, there is no "detox" for cocaine. However, many centers will offer, if clinically appropriate, adjunctive medication to assist with the symptoms of withdrawal. That said, the most important element of treatment for cocaine, as with any substance of abuse, is a comprehensive programme of intense therapy. All centers run on either a 12 STEP programme, a SMART programme or an eclectic mix of the two. These programmes run seven days a week meaning that someone can enter treatment on any day of the week, if necessary Christmas day. 

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As soon as someone is physically able to do so, they are expected to attend all therapy sessions which are often augmented with additional therapies such as:

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* music therapy

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* yoga

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art therapy

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* gentle exercise and group walks

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* mindfulness

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* individual therapy sessions (for those staying for more than one week)

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Close medical monitoring is important for the first few days and it may be necessary to share information (with consent) between the client in treatment and their GP surgery. However, a medical summary can be requested from a GP surgery and they are not entitled to know what it is for or who the intended audience is.

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As with any effective period of treatment , effective discharge planning starts from the pre-admission assessment. This needs to be done by an experienced clinician in a collaborative fashion working with the users treatment goals in mind. While there are some centers that will admit clients for a week in cases of cocaine addiction, most will not and a week is not much time to get to grips with the therapy programme or to build up the psychological tools and techniques to prevent relapse.

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The centre will, not only provide at least twelve months aftercare, will also link the user in with local support groups: both voluntary and statutory (if applicable).

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Not all centers are the best fit for every person seeking treatment. While bolt on therapies are useful, they may not be necessary, in every case. As such, it may be possible to keep costs down by making an informed choice about the centre someone is going to be receiving treatment in. All centers must be registered with the Care Quality Commission (CQC). It is imperative that the registration of any centre you are proposing to use is checked, on the CQC website or by calling them:directly.  If a centre has been open for a period of time there may be  inspection reports published on the CQC website. Centers, if they have a website, are legally required to post the inspection reports within twenty one days of it's publication by the CQC.

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For impartial, free and confidential advice from a clinician with many years experience of prescribing for and treating those caught up in the madness of addiction, call Paul on:  01252 412 064

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