Signs and symptoms of crack addiction

Signs of crack addiction include noticeable mood changes, insomnia, and blood shot, red eyes. What else to look for in a crack addict here.

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Reviewed by: Dr. Dili Gonzalez, M.D. Dr. Juan Goecke, M.D.

ARTICLE OVERVIEW: Crack is a form of cocaine that is been changed to a free base, allowing it to be smoked.  Compared with other drugs, crack is highly addictive. Being addicted to crack produces both changes in mood and changes in behavior. Some examples include being too nervous or alert, losing weight, or being careless about personal grooming. More signs and symptoms here.


What Is Crack?

The DEA fact sheet on cocaine describes the production of crack like this: crack is made by converting cocaine hydrochloride to a chemical base by cooking it using ammonia or baking soda and water. When the substance hardens, it is placed in molds to dry and cut into chips or “rocks.” Crack is off-white in color and resembles hard shavings similar to slivers of soap or chips of cracked paint. [1]

Crack is nearly always smoked. Smoking cocaine delivers large quantities of the drug to the lungs, producing an immediate and intense euphoric effect.

How Crack Works

Crack affects the reward center of the brain. It rewires this center, so that regular users only feel good when they smoke. How does it work, exactly?

All types of reinforcing stimuli, such as food, sex, and many drugs of abuse, including cocaine, stimulate the brain’s mesolimbic dopamine system, its reward pathway. This pathway originates in a region of the midbrain called the ventral tegmental area and extends to the nucleus accumbens, one of the brain’s key reward areas. Besides reward, this circuit also regulates emotions and motivation.

In the normal communication process, dopamine is released by a neuron into the synapse (the small gap between two neurons), where it binds to specialized proteins called dopamine receptors on the neighboring neuron. By this process, dopamine acts as a chemical messenger, carrying a signal from neuron to neuron. Another specialized protein called a transporter removes dopamine from the synapse to be recycled for further use.

Drugs like cocaine can interfere with this normal communication process. Crack acts by binding to the dopamine transporter, blocking the removal of dopamine from the synapse. Dopamine then accumulates in the synapse to produce an amplified signal to the receiving neurons. This is what causes the euphoria commonly experienced immediately after taking the drug.

This diagram taken from the Surgeon General’s Facing Addiction Report of 2017 shows how cocaine affects the brain over time [2]:

Onset of Action

The high you get from crack comes on faster than cocaine but lasts for a really short amount of time: approximately 10-15 minutes, whereas the cocaine high can last up to 45 minutes. As a result, crack users seek highs with greater intensity and frequency.

How long the effects last and how intense they are depend on the method of use. Injecting or smoking cocaine produces a quicker and stronger but shorter-lasting high than snorting. The high from snorting cocaine may last 15 to 30 minutes. The high from smoking may last 5 to 10 minutes.

An illustration of how cocaine affects dopamine from the 2007 study, “Imaging the Addicted Human Brain”. [3]

Effects on the Body

The effects of crack on the body can be divided into short-term and long-term effects.

Short-term health effects of include:

  • Constricted blood vessels.
  • Dilated pupils.
  • Extreme happiness and energy.
  • Faster heartbeat.
  • Hypersensitivity to sight, sound, and touch.
  • Irritability.
  • Mental alertness.
  • Nausea.
  • Paranoia (extreme and unreasonable distrust of others).
  • Raised body temperature and blood pressure.
  • Restlessness.
  • Tremors and muscle twitches.

Some people find that cocaine helps them perform simple physical and mental tasks more quickly, although others experience the opposite effect. Large amounts of cocaine can lead to bizarre, unpredictable, and violent behavior. More health effects of crack are listed on the GAO website. [3]

Some long-term health effects depend on the method of use. For example, people involved with non-needle cocaine use, place themselves at a risk for HIV because cocaine impairs judgment, which can lead to risky sexual behavior with infected partners.

They generally include the following:

  • Over time, snorting produce loss of sense of smell, nosebleeds, frequent runny nose, and problems with swallowing.
  • Consuming cocaine by mouth can produce severe bowel decay from reduced blood flow.
  • Needle injection is associated with higher risk for contracting HIV, hepatitis C, and other blood borne diseases.

Other long-term effects of cocaine use include being malnourished, because cocaine decreases appetite, and movement disorders, including Parkinson’s disease, which may occur after many years of use.

In addition, people report irritability and restlessness resulting from cocaine binges, and some also experience severe paranoia, in which they lose touch with reality and have auditory hallucinations (hearing noises that are not real).

Is Crack Addictive?

Cocaine is a Schedule II drug under the Controlled Substances Act, meaning it has a high potential for abuse and limited medical usage. Cocaine hydrochloride solution (4% and 10%) is used primarily as a topical local anesthetic for the upper respiratory tract. It also is used to reduce bleeding of the mucous membranes in the mouth, throat, and nasal cavities. However, better products have been developed for these purposes, and cocaine is rarely used medically in the United States. [5]

According to the Manual of Adolescent Substance Abuse Treatment, it is the most addicting form of cocaine and one of the most addicting forms of any drug. Because it takes only eight seconds to reach the brain, the effects of crack are felt swiftly. This also is why dependence develops so quickly.

The main addictive mechanism of crack is that it stimulates key pleasure centers within the brain and causes extremely heightened euphoria. Compulsive use develops soon after the person starts using, because the substance can be smoked repeatedly as it exits the blood stream rapidly. A tolerance develops quickly, a person soon fails to achieve the same high experienced earlier from the same amount of crack cocaine…leading to heightened frequency of use or searching for more potent forms.

Crack Addiction Signs

The symptoms and signs of crack addiction are very noticeable. Often, a person who becomes addicted with display abnormal behavior as their physical appearance deteriorates. Here is a list of the most common symptoms of addiction that are noticeable shortly after a person starts using crack regularly:

  • Being nervous and alert all the time.
  • Carelessness about personal appearance.
  • Constantly requiring money.
  • Denial of a problem.
  • Frequent sniffing.
  • Insomnia.
  • Looking tired.
  • Loss of interest in family, friends, school or other once-pleasurable activities.
  • Lying.
  • Noticeable mood changes.
  • Red eyes.
  • Runny nose.
  • Sudden loss of weight.


Those who seek NIDA-supported treatment for cocaine use should recognize that drug addiction is a complex disease involving changes in the brain as well as a wide range of social, familial, and other environmental factors; therefore, treatment of cocaine addiction must address this broad context as well as any other co-occurring mental disorders that require additional behavioral or pharmacological interventions. [6]

There are no medications approved by the Food and Drug Administration to treat cocaine addiction, though researchers are exploring a variety of neurobiological targets. [7]
Many behavioral treatments for cocaine addiction have proven to be effective in both residential and outpatient settings. Indeed, behavioral therapies are often the only available and effective treatments for many drug problems, including stimulant addictions. However, the integration of behavioral and pharmacological treatments may ultimately prove to be the most effective approach.

One form of behavioral therapy that is showing positive results in people with cocaine use disorders is contingency management, also called motivational incentives. Programs use a voucher or prize-based system that rewards persons who abstain from cocaine and other drugs. Based on drug-free urine tests, the persons earn points, or chips, which can be exchanged for items that encourage healthy living, such as a gym membership, movie tickets, or dinner at a local restaurant. These may be particularly useful for helping persons achieve initial abstinence from cocaine and stay in treatment. [8]

Cognitive-behavioral therapy is an effective approach for preventing relapse. This approach helps persons develop critical skills that support long-term abstinence, including the ability to recognize the situations in which they are most likely to use cocaine, avoid these situations, and cope more effectively with a range of problems associated with drug use. This therapy can also be used in conjunction with other treatments, thereby maximizing the benefits of both.

Therapeutic communities of drug-free residences, in which people in recovery from substance use disorders help each other to understand and change their behaviors, can be an effective treatment for people who use drugs, including cocaine. These therapy require a 6- to 12-month stay and can include onsite vocational rehabilitation and other supportive services that focus on successful re-integration of the person into society.

Community-based recovery groups, such as Cocaine Anonymous, that use a 12-step program can also be helpful in maintaining abstinence. Participants may benefit from the supportive fellowship and from sharing with those experiencing common problems and issues.

How To Get Help?

If you suspect that yourself or your loved one is showing addiction signs, there is much that you can do. First, addiction specialists such as psychotherapists, doctors, and psychiatrists (in addition to your own love and support) can help people recover from addiction. So, you can seek professional help from any of these professionals:

  • Find a therapist, American Psychological Association [9]
  • Find a psychiatrist, American Psychiatry Association [10]
  • Find an addiction specialist, ASAM [11]

One of the most common ways to get person into treatment is to hold a family intervention. An intervention can be casual or professional. During an intervention, the addict’s friends and family confront the addict about substance abuse with the goal of getting him to agree to attend drug rehab treatment.

There is a way out!

Addiction is a medical condition. It is treated medically.

Or, consider giving us a call. Our hotline is listed on this page.

Your Questions

Still have questions about addiction? Please ask us now. Leave your questions in the comments section at the end. We respond to questions or comments personally.

References Sources: [1] DEA: Cocaine
[2] NCBI: Facing Addiction In America: The Surgeon General’s Report On Alcohol, Drugs, And Health
[3] NCBI: Imaging The Addicted Human Brain
[4] GAO: The Crack Cocaine Epidemic: Health Consequences And Treatment
[5] PUMCHEM: Cocaine HCL
[6] NIH: Cocaine
[7] NCBI: New Medications for the Treatment of Cocaine Dependence
[8] NIH: Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)
[9] APA: How do I find a Good Therapist?
[10] APA: Find a Psychiatrist
[11] ASAM: What is an Addiction Specialist
MEDLINE PLUS: Cocaine Withdrawal
NDIC: Crack Cocaine Fast Facts
NIDA: Cocaine
NYC HEALTH: Cocaine Abuse & Addiction
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
Medical Reviewers
Dr. Dili Gonzalez, M.D. is a general surgeon practicing women's focused medici...
Dr. Goecke is a medical doctor and general surgeon with personal experience of...

All of the information on this page has been reviewed and verified by a licensed medical professional.


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  1. Hi my partner has been smoking crack for nearly a year on top of methadone and occasional heroin use too. He’s being verbally and occasionally physically abusive and disappears for weeks on end. He keeps saying he’s able to stop whenever he likes but he’s lost so much weight and behaves so erratically. I’m slightly confused though as he still nods as if he’s on heroin but I thought crack made people alert?
    He’s driving around with his child in the car and the mother is ok with this. I’ve just had to walk away from him as he has no concern for my feelings at all and has gone from
    A quite reliable man to my worst nightmare. Is this to be expected?

  2. I need to know how can I go about doing a intervention cuse my fiance has been on it for the last 10 years we also have two small kids and I really need help to get him off he is not the same person that he used to be please help me

  3. My loved one is on crack cociane I believe I found like pen pipes all over the bathroom once I bought it up to him he only got more upset only thing I have to do is pray to god that he gets better. I love him so very much

  4. Hello .Im in Africa and I’ve been smoking for four months now.pls help me I want to stop . How can I quit from home??

    1. Hi Patricia. If you’ve been using crack for more than a month or so, it’s pretty hard to just stop taking it. You’ll need to be prepared for the emergence of withdrawal symptoms once you quit or lower your dose. This is because you’ve developed a physical dependence to crack, meaning that your body has adjusted to the presence of the drug and has modified the normal production of neurotransmitters. To stop taking crack, you should start by consulting a medical professional: a doctor, a psychiatrist, or psychologist. Seek help from people who have experience in addiction medicine.

    1. Hi Josh. It depends on the type of probation you’re on and how your Parole Officer is, it could land you back in court where you could have your probation modified or revoked. At a minimum, if you test positive, your PO will document it and should you land in court later for a hearing in front of the judge. Every judge has a particular way they look at probation violations. Some consider a failed drug test more serious than other violations. If your drug test is positive, it’s possible the judge will extend your probation, add some additional sanctions (community service) or counseling. A probation violation is serious business, and you must have a good lawyer with you to avoid going to a jail.

  5. Does it make you have tummy pain an do you throw up from time to time I’m asking because I think my best friend is use in again she use to smoke long ago but now I think she back on it because of the new people she is around smokes

  6. Is convulsions and bsd coughing a sign that a cracking addicts health is in mortal danger.
    Can you die from longterm crack addiction.

  7. Can crack cause my boyfriend to be abusive to me. I want to find out how to get an intervention seems like I’m the only one that cares.

  8. My boyfriend is addictive to crack started from coke to beans and now crack…I love him with all my heart but he told me he quit but he is not wanting to get help almost 20 hours now sents he stopped the use of it. He comes from a family of both parents using Auntie uses oldest brother sold drugs to parents… Please don’t call the cops on him. His mental impairment has changed greatly

  9. please help me i am a crack addict but i am agoraphobic and it is hard for me to leave my house how can i stop smoking crack on my own

  10. My Ex just died (April 9, 2016) of suicide because he was using this drug. He said a girl he was fulling around with gave him a turbo (joint with crack inside) but he thought it was a regular joint. He said after that one hit, it was over and he was hooked. Get your loved one help (rehab or prayer) and never give up because if they die, you will always ask yourself, did I do enough to help them.

    1. Hi, Daniel. If you have questions about addiction treatment and your options, call our free hotline to speak with a trusted treatment provider.

  11. Hello I don’t how I start this evil thing crack it massing my life up I always think of no one here to support me i go to dash but it’s just getting my mofdone I don’t get any other support my family think I can just stop it like that instand of help I get told off I know my doing worng I start its 9month now I lost so much Wight not eating I need help help where do I go help me if any advice to stop this evil drug hate my self I cry my self all I do talk to my self I don’t have nobody to tell my feeling I m married living wife she hate it so much won’t listen to me atall it’s just a big problems where do I go I think of doing many things about harming but I can’t I have kids and love them to bits will do anything to come of it plz help

    1. Hello Ally. I suggest you to consider an addiction treatment. You can call the helpline number displayed on our site to get in touch with our trusted treatment providers who can help you access adequate treatment program.

    1. Hello Nikki. Your friend should seek help immediately, because in any case, she might loose her children. Addiction affects every member of the family. Also, I suggest your friend call the helpline number displayed on our site to get in touch with our trusted treatment providers who can help you access adequate treatment program.

  12. We are regular readers of this blog and @Cari we agree with @Addiction blog. Addiction is a sign of an underlying pshycological problem and that problem should be addressed while getting the user off their drug of choice. Substituting one drug for another is by no means addressing the issue at hand

  13. Hi Cari. Addiction is primarily a brain-based condition, and addicts can have very distorted patterns of thinking. It’s important to get an addict off a drug to address the underlying psychological issues which compel use, but the addict needs to be willing to change.

    Look into Al-anon and Narc-Anon for yourself. Family counseling or individual counseling can help you identify what you need to do to set up and keep boundaries with your daughter. You can look into planning an intervention or contact your state attorney general’s office to learn if there are any laws in place which can REQUIRE drug addiction treatment for someone who may hurt themselves or others. But the first thing you can do is seek support for yourself.

  14. My daughter was on herion, shooting it up to 5 times a day. For some reason she started to smoke crack, I still do not believe ut, and now she credits crack for getting her off heroin, I just don’t know what to say to this belief. My mind draws a blank, I realize how sick she is. In her mind herion is worse Helpy

I am ready to call
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