Crack cocaine

The origin of the name "crack" comes from the "crackling" sound (and hence the onomatopoeic moniker "crack") that is produced when the cocaine and its impurities (i.e. water, sodium bicarbonate) are heated past the point of vaporization.{{Cite book | vauthors = Nelson G |title=Hip Hop America |year=1998 |publisher=Viking Penguin |url={{Google books |8nw6VlsqOUsC|Hip Hop America |page=40 |plainurl=yes}} |page=40 }}

It is also commonly called "rock" on the street, a name that comes from its physical appearance after processing. When bulk quantities of powdered cocaine are mixed with baking soda or ammonia and water, then heated, it forms small, hard, solid crystals or pellets that resemble rocks.

Crack baby is a term for a child born to a mother who used crack cocaine during her pregnancy. The threat that cocaine use during pregnancy poses to the fetus is now considered exaggerated.{{Cite news | url=https://www.nytimes.com/2009/01/27/health/27coca.html | work=The New York Times | vauthors=Okie S | title=The Epidemic That Wasn't | date=27 January 2009 | access-date=23 July 2022 | archive-date=6 October 2017 | archive-url=https://web.archive.org/web/20171006035740/http://www.nytimes.com/2009/01/27/health/27coca.html | url-status=live }} Studies show that prenatal cocaine exposure (independent of other effects such as, for example, alcohol, tobacco, or physical environment) has no appreciable effect on childhood growth and development.{{Cite journal | vauthors = Frank DA, Augustyn M, Knight WG, Pell T, Zuckerman B | title = Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review | journal = JAMA | volume = 285 | issue = 12 | pages = 1613–1625 | date = March 2001 | pmid = 11268270 | pmc = 2504866 | doi = 10.1001/jama.285.12.1613 | publisher = Jama.ama-assn.org }}

In 2007, the National Institute on Drug Abuse of the United States warned about health risks while cautioning against stereotyping:

{{Blockquote|Many recall that "crack babies", or babies born to mothers who used crack cocaine while pregnant, were at one time written off by many as a lost generation. They were predicted to suffer from severe, irreversible damage, including reduced intelligence and social skills. It was later found that this was a gross exaggeration. However, the fact that most of these children appear normal should not be over-interpreted as indicating that there is no cause for concern. Using sophisticated technologies, scientists are now finding that exposure to cocaine during fetal development may lead to subtle, yet significant, later deficits in some children, including deficits in some aspects of cognitive performance, information-processing, and attention to tasks—abilities that are important for success in school.{{cite web | url = http://www.drugabuse.gov/ResearchReports/Cocaine/cocaine4.html#maternal | series = Research Report Series | work = U.S. National Institute on Drug Abuse (NIDA) | title = Cocaine Abuse and Addiction | archive-url = https://web.archive.org/web/20070926234838/http://www.drugabuse.gov/ResearchReports/Cocaine/cocaine4.html#maternal | archive-date=September 26, 2007 }}}}

{{Main|Freebase (chemistry)}}

As the name implies, "freebase" is the base form of cocaine, as opposed to the salt form. It is practically insoluble in water whereas hydrochloride salt is water-soluble.

Smoking freebase cocaine has the additional effect of releasing methylecgonidine into the user's system due to the pyrolysis of the substance (a side effect which insufflating or injecting powder cocaine does not create). Some research suggests that smoking freebase cocaine can be even more cardiotoxic than other routes of administration{{Cite journal | vauthors = Scheidweiler KB, Plessinger MA, Shojaie J, Wood RW, Kwong TC | title = Pharmacokinetics and pharmacodynamics of methylecgonidine, a crack cocaine pyrolyzate | journal = The Journal of Pharmacology and Experimental Therapeutics | volume = 307 | issue = 3 | pages = 1179–87 | date = December 2003 | pmid = 14561847 | doi = 10.1124/jpet.103.055434 | s2cid = 15619796 }} because of methylecgonidine's effects on lung tissue{{Cite journal | vauthors = Yang Y, Ke Q, Cai J, Xiao YF, Morgan JP | title = Evidence for cocaine and methylecgonidine stimulation of M(2) muscarinic receptors in cultured human embryonic lung cells | journal = British Journal of Pharmacology | volume = 132 | issue = 2 | pages = 451–60 | date = January 2001 | pmid = 11159694 | pmc = 1572570 | doi = 10.1038/sj.bjp.0703819 }} and liver tissue.{{Cite journal | vauthors = Fandiño AS, Toennes SW, Kauert GF | title = Studies on hydrolytic and oxidative metabolic pathways of anhydroecgonine methyl ester (methylecgonidine) using microsomal preparations from rat organs | journal = Chemical Research in Toxicology | volume = 15 | issue = 12 | pages = 1543–8 | date = December 2002 | pmid = 12482236 | doi = 10.1021/tx0255828 }}

Pure cocaine is prepared by neutralizing its compounding salt with an alkaline solution, which will precipitate non-polar basic cocaine. It is further refined through aqueous-solvent liquid–liquid extraction.

Purer forms of crack resemble off-white, jagged-edged "rocks" of a hard, brittle plastic, with a slightly higher density than candle wax. Like cocaine in other forms, crack rock acts as a local anesthetic, numbing the tongue or mouth only where directly placed. Purer forms of crack will sink in water and melt at the edges when near a flame (crack vaporizes at 90 °C, 194 °F).

Crack cocaine sold on the streets may be adulterated (or "cut") with other substances mimicking the appearance of crack to increase bulk. Use of toxic adulterants such as levamisole,{{cite journal |url=http://www.mdconsult.com/das/article/body/154945316-2/jorg=journal&source=&sp=21877276&sid=0/N/691072/1.html?issn=01960644 |title=Levamisole Found in Patients Using Cocaine |journal=Annals of Emergency Medicine |volume=53 |issue=4 |date=April 2009 |first=Erik |last=Kinzie |pages=546–7 |doi=10.1016/j.annemergmed.2008.10.017 |pmid=19303517 |access-date=August 18, 2009|doi-access=free }} a drug used to treat parasitic worm infections, has been documented.{{cite news|last=Moisse|first=Katie|date=June 22, 2011|title=Cocaine Laced With Veterinary Drug Levamisole Eats Away at Flesh|website=ABC News|url=https://abcnews.go.com/Health/Wellness/flesh-eating-cocaine-laced-veterinary-drug-levamisole/story?id=13902353|access-date=10 July 2020}}

File:Crack Ingredients.JPG, a commonly used base in making crack, metal spoon, tealight, and cigarette lighter. The spoon is held over the heat source to "cook" the cocaine into crack.]]

Sodium bicarbonate (NaHCO₃, common baking soda) is a base used in the preparation of crack, although other weak bases may substitute for it.{{cite journal |last1=Treadwell |first1=SD |last2=Robinson |first2=TG |title=Cocaine use and stroke |journal=Postgraduate Medical Journal |date=June 2007 |volume=83 |issue=980 |pages=389–94 |pmid=17551070|pmc=2600058|type=Review |doi=10.1136/pgmj.2006.055970}}{{cite web |title=Cocaine Abuse & Addiction |url=https://www1.nyc.gov/site/doh/health/health-topics/cocaine-abuse-and-addiction.page |publisher=City of New York}}

The net reaction when using sodium bicarbonate is

:Coc-H⁺Cl⁻ + NaHCO₃ → Coc + H₂O + CO₂ + NaCl

With ammonium bicarbonate:

:Coc-H⁺Cl⁻ + NH₄HCO₃ → Coc + NH₄Cl + CO₂ + H₂O

With ammonium carbonate:

:2(Coc-H⁺Cl⁻) + (NH₄)₂CO₃ → 2 Coc + 2 NH₄Cl + CO₂ + H₂O

Crack cocaine is frequently purchased already in rock form, although it is not uncommon for some users to "wash up" or "cook" powder cocaine into crack themselves. This process is frequently done with baking soda (sodium bicarbonate), water, and a spoon. Once mixed and heated, the bicarbonate reacts with the hydrochloride of the powder cocaine, forming free base cocaine and carbonic acid (H₂CO₃) in a reversible acid-base reaction. The heating accelerates the degradation of carbonic acid into carbon dioxide (CO₂) and water. Loss of CO₂ prevents the reaction from reversing back to cocaine hydrochloride. Free base cocaine separates as an oily layer, floating on the top of the now leftover aqueous phase. It is at this point that the oil is picked up rapidly, usually with a pin or long thin object. This pulls the oil up and spins it, allowing air to set and dry the oil, and allows the maker to roll the oil into the rock-like shape.

File:Cooking Crack.JPG

Crack vaporizes near temperature 90 °C (194 °F), much lower than the cocaine hydrochloride melting point of 190 °C (374 °F). Whereas cocaine hydrochloride cannot be smoked (burns with no effect),

Crack cocaine can also be injected intravenously with the same effect as powder cocaine. However, whereas powder cocaine dissolves in water, crack must be dissolved in an acidic solution such as lemon juice (containing citric acid) or white vinegar (containing acetic acid), a process that effectively reverses the original conversion of powder cocaine to crack.{{cite journal |last1=Ponton |first1=Rhys |last2=Scott |first2=Jenny |title=Injection preparation processes used by heroin and crack cocaine injectors |journal=Journal of Substance Use |date=12 July 2009 |volume=9 |issue=1 |pages=7–19 |doi=10.1080/14659890410001665041|s2cid=56725689 }} Harm reduction and public health agencies may distribute packets of citric acid or ascorbic acid (vitamin C) for this purpose.{{cite journal |last1=Harris |first1=Magdalena |last2=Scott |first2=Jenny |last3=Wright |first3=Talen |last4=Brathwaite |first4=Rachel |last5=Ciccarone |first5=Daniel |last6=Hope |first6=Vivian |title=Injecting-related health harms and overuse of acidifiers among people who inject heroin and crack cocaine in London: a mixed-methods study |journal=Harm Reduction Journal |date=13 November 2019 |volume=16 |issue=1 |pages=60 |doi=10.1186/s12954-019-0330-6|pmid=31722732 |pmc=6854679 |doi-access=free }}

Effects of crack cocaine include euphoria, supreme confidence, loss of appetite, insomnia, alertness, increased energy, a craving for more cocaine,{{cite book|first=Tim|last=Madge|title=White Mischief: A Cultural History of Cocaine|publisher=Mainstream Publishing|location=Edinburgh, Scotland|date=2001|isbn=1-56025-370-3|page=18}}

and paranoia (ending after use)."DEA, Drug Information, Cocaine",

United States DOJ Drug Enforcement Administration, 2008, webpage:

[http://www.usdoj.gov/dea/concern/cocaine.html DEA-cocaine] {{Webarchive|url=https://web.archive.org/web/20080622214514/http://www.usdoj.gov/dea/concern/cocaine.html |date=2008-06-22 }}. {{PD-inline}}

"Life or Meth – CRACK OF THE 90'S",

Salt Lake City Police Department, Utah, 2008, PDF file:

[http://www.ci.slc.ut.us/police/pdf/methlife.pdf Methlife-PDF] {{webarchive|url=https://web.archive.org/web/20071031024458/http://www.ci.slc.ut.us/police/pdf/methlife.pdf |date=October 31, 2007 }}.

Its initial effect is to release a large amount of dopamine,{{cite web|first=Jeremy|last=Arias|website=A.M. Costa Rica|date=July 2008|url=http://www.amcostarica.com/071808.htm|title=Crack rocks offer a short but intense high to smokers}} a brain chemical inducing feelings of euphoria. The high usually lasts from five to ten minutes, after which time dopamine levels in the brain plummet, leaving the user feeling depressed and low. When (powder) cocaine is dissolved and injected, the absorption into the bloodstream is at least as rapid as the absorption of the drug which occurs when crack cocaine is smoked, and similar euphoria may be experienced.

In a 2000 Brookhaven National Laboratory medical department study, based on self-reports of 32 people who used cocaine who participated in the study, "peak high" was found at a mean of 1.4 ± 0.5 minutes.{{Cite journal | vauthors = Volkow ND, Wang GJ, Fischman MW, Foltin R, Fowler JS, Franceschi D, Franceschi M, Logan J, Gatley SJ, Wong C, Ding YS, Hitzemann R, Pappas N | title = Effects of route of administration on cocaine-induced dopamine transporter blockade in the human brain | journal = Life Sciences | volume = 67 | issue = 12 | pages = 1507–1515 | date = August 2000 | pmid = 10983846 | doi = 10.1016/S0024-3205(00)00731-1 }}

The onset of cocaine's euphoric effects is fastest with inhalation, beginning after 3–5 seconds.{{Cite journal | vauthors = Zimmerman JL | title = Cocaine intoxication | journal = Critical Care Clinics | volume = 28 | issue = 4 | pages = 517–26 | date = October 2012 | pmid = 22998988 | doi = 10.1016/j.ccc.2012.07.003 }} The drug is then quickly transported to the brain, where it acts on the central nervous system, producing an almost immediate "high" that can be very powerful – this initial crescendo of stimulation known as a rush. This is followed by an equally intense low, leaving the user craving more of the drug. Addiction to crack usually occurs within four to six weeks - much more rapidly than regular cocaine.{{Cite news |vauthors=Lamar JV |title=Crack – A Cheap and Deadly Cocaine Is a Spreading Menace. |url=https://www.ojp.gov/ncjrs/virtual-library/abstracts/crack-cheap-and-deadly-cocaine-spreading-menace |access-date=17 June 2022 |publisher=Time |date=2 June 1986 |pages=16–18 |archive-date=8 July 2024 |archive-url=https://web.archive.org/web/20240708191833/https://www.ojp.gov/ncjrs/virtual-library/abstracts/crack-cheap-and-deadly-cocaine-spreading-menace |url-status=live }}

File:Smoking Crack.jpg" in San Francisco, California, in December 2005]]

Crack cocaine is usually heated in a drug pipe until sublimation occurs at a relatively low temperature (about 90°C) and the vapor is inhaled.{{Cite journal | vauthors = Zimmerman JL | title = Cocaine intoxication | journal = Critical Care Clinics | volume = 28 | issue = 4 | pages = 517–26 | date = October 2012 | pmid = 22998988 | doi = 10.1016/j.ccc.2012.07.003 }}{{cite web |url=https://www.tni.org/files/publication-downloads/tni-smokablecocaine_eng_web-def.pdf}}{{Cite web |url=https://www.justice.gov/oig/special/9712/appb.htm |title=Appendix B: Production of Cocaine Hydrochloride and Cocaine Base |publisher=US Justice Dep |url-status=live |archive-url=https://web.archive.org/web/20091130195140/https://www.justice.gov/oig/special/9712/appb.htm |archive-date=30 November 2009 }} This process is commonly referred to as "freebasing." Although commonly called "smoking," this method actually involves vaporizing the drug rather than burning it. If crack cocaine is burned directly, such as in a regular tobacco pipe or roll-your-own cigarette, higher temperatures may lead to decomposition of the active compound, reducing its effectiveness. This is why vaporization at lower temperatures, rather than combustion, is the preferred method for administration. While no formal studies have specifically quantified the extent of drug loss during combustion, users commonly choose to vaporize crack cocaine in order to maximize its effects and potentially avoid wasting money. Additionally, vaporizing is generally considered less harsh on the throat and lungs compared to smoking crack through a tobacco pipe, as combustion can produce more irritating and toxic by-products.

Pyrolysis products of cocaine that occur only when heated/smoked have been shown to change the effect profile, i.e. anhydroecgonine methyl ester, when co-administered with cocaine, increases the dopamine in CPu and NAc brain regions, and has M₁ — and M₃ — receptor affinity.{{Cite journal | vauthors = Garcia RC, Torres LH, Balestrin NT, Andrioli TC, Flório JC, de Oliveira CD, da Costa JL, Yonamine M, Sandoval MR, Camarini R, Marcourakis T | title = Anhydroecgonine methyl ester, a cocaine pyrolysis product, may contribute to cocaine behavioral sensitization | journal = Toxicology | volume = 376 | pages = 44–50 | date = February 2017 | pmid = 27129946 | doi = 10.1016/j.tox.2016.04.009 | bibcode = 2017Toxgy.376...44G }}

The effects felt almost immediately after inhaled, are very intense and do not last long — usually 2 to 10 minutes.{{Cite web|url=https://www.talktofrank.com/drug/cocaine|title=Cocaine|website=www.talktofrank.com|access-date=23 January 2017|url-status=live|archive-url=https://web.archive.org/web/20170202020535/https://www.talktofrank.com/drug/cocaine|archive-date=2 February 2017}} When smoked, cocaine is sometimes combined with other drugs, such as cannabis, often rolled into a joint or blunt.

{{also|Drug pipe}}

File:Smoking Crack crop.jpg

People often freebase crack with a pipe made from a small glass tube, often taken from "love roses", small glass tubes with a paper rose that are promoted as romantic gifts.{{Cite news|url=https://www.journalstar.com/news/local/article_28e66c86-1ef8-52dc-ac0a-f3933ed6ec5a.html|title=A rose by another name: crack pipe|newspaper=Lincoln Journal Star | vauthors = Reist M | date=16 January 2005|access-date=21 August 2009|url-status=live|archive-url=https://web.archive.org/web/20100726074900/https://journalstar.com/news/local/article_28e66c86-1ef8-52dc-ac0a-f3933ed6ec5a.html|archive-date=26 July 2010}} These are sometimes called "stems", "horns", "blasters" and "straight shooters". A small piece of clean heavy copper or occasionally stainless steel scouring pad{{spaced ndash}}often called a "brillo" (actual Brillo Pads contain soap, and are not used) or "chore" (named for Chore Boy brand copper scouring pads){{spaced ndash}}serves as a reduction base and flow modulator in which the "rock" can be melted and boiled to vapor. Crack is smoked by placing it at the end of the pipe; a flame held close to it produces vapor, which is then inhaled by the smoker.

{{Also|Chasing the dragon}}

File:Physiological effects of Crack cocaine.png

Incidental exposure of the eye to sublimated cocaine while smoking crack cocaine can cause serious injury to the cornea and long-term loss of visual acuity.{{Cite journal | vauthors = Gohil H, Miskovic M, Buxton JA, Holland SP, Strike C | title = Smoke Gets in the Eye: A systematic review of case reports of ocular complications of crack cocaine use | journal = Drug and Alcohol Review | pages = 347–355 | date = August 2021 | volume = 41 | issue = 2 | pmid = 34337815 | doi = 10.1111/dar.13366 | s2cid = 236775586 }}

The short-term physiological effects of cocaine include constricted blood vessels, dilated pupils, and increased temperature, heart rate, and blood pressure. Some users of cocaine report feelings of restlessness, irritability, and anxiety. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.{{cite web |title=Cocaine Research Report: What are the short-term effects of cocaine use? |url=https://nida.nih.gov/publications/research-reports/cocaine/what-are-short-term-effects-cocaine-use |website=National Institute on Drug Abuse |publisher=National Institutes of Health |access-date=12 March 2023 |date=May 2016}}{{PD-inline}}

Like other forms of cocaine, smoking crack can increase heart rate and blood pressure, leading to long-term cardiovascular problems. Some research suggests that smoking crack or free base cocaine has additional health risks compared to other methods of taking cocaine. Many of these issues relate specifically to the release of methylecgonidine and its effect on the heart,{{cite journal |first1=Karl|last1=Scheidweiler|first2=Mark A.|last2=Plessinger|first3=Jalil|last3=Shojaie|first4=Ronald W.|last4=Wood|first5=Tai C.|last5=Kwong|title=Pharmacokinetics and pharmacodynamics of methylecgonidine, a crack cocaine pyrolyzate |journal=Journal of Pharmacology and Experimental Therapeutics |publisher=American Society for Pharmacology and Experimental Therapeutics|location=Rockville, Maryland|volume=307 |issue=3 |pages=1179–1187 |year=2003 |pmid=14561847 |doi=10.1124/jpet.103.055434 |s2cid=15619796|url=http://pdfs.semanticscholar.org/b70c/b72a01c30205621d07ca2c667b8b19894ce1.pdf|archive-url=https://web.archive.org/web/20190303143332/http://pdfs.semanticscholar.org/b70c/b72a01c30205621d07ca2c667b8b19894ce1.pdf|url-status=dead|archive-date=2019-03-03}} lungs,{{cite journal |vauthors=Yang Y, Ke Q, Cai J, Xiao YF, Morgan JP |title=Evidence for cocaine and methylecgonidine stimulation of M(2) muscarinic receptors in cultured human embryonic lung cells |journal=British Journal of Pharmacology |volume=132 |issue=2 |pages=451–460 |year=2001 |pmid=11159694 |doi=10.1038/sj.bjp.0703819 |pmc=1572570}} and liver.{{cite journal |vauthors=Fandiño AS, Toennes SW, Kauert GF |year=2002 |title=Studies on hydrolytic and oxidative metabolic pathways of anhydroecgonine methyl ester (methylecgonidine) using microsomal preparations from rat organs |journal=Chemical Research in Toxicology |volume=15 |issue=12 |pages=1543–1548 |doi=10.1021/tx0255828 |pmid=12482236}}

• Toxic adulterants: Many substances may have been added to expand the weight and volume of a batch, while still appearing to be pure crack. Occasionally, highly toxic substances are used, with a range of corresponding short and long-term health risks. Adulterants used with crack and cocaine include milk powder, sugars such as glucose, starch, caffeine, lidocaine, benzocaine, paracetamol, amphetamine, scopolamine and strychnine.{{cite book |last1=Cole |first1=Claire |last2=Jones |first2=Lisa |last3=McVeigh |first3=Jim |last4=Kicman |first4=Andrew |last5=Syed |first5=Qutub |last6=Belis |first6=Mark A. |date=2010 |title=Cut: A Guide to Adulterants, Bulking Agents and other Contaminants found in Illicit Drugs |publisher=Centre for Public Health, Liverpool John Moores University |pages=6–25 | url= https://www.drugsandalcohol.ie/13119/ }}
• Smoking problems: Any route of administration poses its own set of health risks; in the case of crack cocaine, smoking tends to be more harmful than other routes. Crack users tend to smoke the drug because that has a higher bioavailability than other routes typically used for drugs of abuse, such as insufflation. Crack has a melting point of around {{nowrap|90 °C}} {{nowrap|(194 °F)}}, and the smoke does not remain potent for long. Therefore, crack pipes are generally very short, to minimize the time between evaporating and ingestion (thereby minimizing loss of potency).{{cite book |last1=Mieczkowski |first1=Tom |title=Drug Testing Technology: Assessment of Field Applications |date=25 November 2020 |publisher=CRC Press |page=124|isbn=978-1-000-14222-8 |url=https://books.google.com/books?id=-N8GEAAAQBAJ&pg=PA124-IA9 |language=en}}{{cite book |last1=Cutler |first1=Janis |last2=Marcus |first2=Eric |title=Psychiatry |date=28 April 2010 |publisher=Oxford University Press |isbn=978-0-19-970682-2 |page=228 |url=https://books.google.com/books?id=nMvqeG7lGwwC&pg=PA228 |language=en}} Having a very hot pipe pressed against the lips often causes cracked and blistered lips, colloquially known as "crack lip". The use of "convenience store crack pipes"—glass tubes which originally contained small artificial roses—may contribute to this condition. These 4-inch (10-cm) pipes{{cite news |url=https://www.washingtonpost.com/archive/local/2006/04/05/a-rose-with-another-name-crack-pipe/430fc938-18e4-4457-bcd1-72601deb118d/ |title=A Rose With Another Name: Crack Pipe |first=Allan |last=Lengel |newspaper=The Washington Post |date=April 5, 2006 |access-date=May 28, 2017}} are not durable and will quickly develop breaks; users may continue to use the pipe even though it has been broken to a shorter length. The hot pipe might burn the lips, tongue, or fingers, especially when passed between people who take hits in rapid succession, causing the short pipe to reach higher temperatures than if used by one person alone.
• Pure or large doses: Because the quality of crack can vary greatly, some people might smoke larger amounts of diluted crack, unaware that a similar amount of a new batch of purer crack could cause an overdose. This can trigger heart problems or cause unconsciousness.
• Pathogens on pipes: When pipes are shared, bacteria or viruses can be transferred from person to person.

Crack cocaine causes DNA damage in multiple organs of rats{{Cite journal |last1=Moretti |first1=Eduardo Gregolin |last2=Yujra |first2=Veronica Quispe |last3=Claudio |first3=Samuel Rangel |last4=Silva |first4=Marcelo Jose Dias |last5=Vilegas |first5=Wagner |last6=Pereira |first6=Camilo Dias Seabra |last7=de Oliveira |first7=Flavia |last8=Ribeiro |first8=Daniel Araki |date=April 2016 |title=Acute crack cocaine exposure induces genetic damage in multiple organs of rats |journal=Environmental Science and Pollution Research International |volume=23 |issue=8 |pages=8104–8112 |doi=10.1007/s11356-016-6141-3 |pmid=26825523|bibcode=2016ESPR...23.8104M |hdl=11449/172464 |s2cid=34132872 |url=http://americanae.aecid.es/americanae/es/registros/registro.do?tipoRegistro=MTD&idBib=1757384 |hdl-access=free }} and mice.{{Cite journal |last1=Yujra |first1=Veronica Quispe |last2=Moretti |first2=Eduardo Gregolin |last3=Claudio |first3=Samuel Rangel |last4=Silva |first4=Marcelo Jose Dias |last5=Oliveira |first5=Flavia de |last6=Oshima |first6=Celina Tizuko Fujiyama |last7=Ribeiro |first7=Daniel Araki |date=October 2016 |title=Genotoxicity and mutagenicity induced by acute crack cocaine exposure in mice |journal=Drug and Chemical Toxicology |volume=39 |issue=4 |pages=388–391 |doi=10.3109/01480545.2015.1126843 |pmid=26712310|hdl=11449/172358 |s2cid=207437479 |url=http://americanae.aecid.es/americanae/es/registros/registro.do?tipoRegistro=MTD&idBib=1756268 |hdl-access=free }}

In crack users, acute respiratory symptoms have been reported, sometimes termed "crack lung". Symptoms include fever, coughing up blood and difficulty breathing.{{cite journal |title=The large spectrum of pulmonary complications following illicit drug use: features and mechanisms |pmid=24144776 |last1=Mégarbane |first1=B |last2=Chevillard |first2=L |journal=Chemico-Biological Interactions |date=5 December 2013 |volume=206 |issue=3 |pages=444–51 |doi=10.1016/j.cbi.2013.10.011|bibcode=2013CBI...206..444M }} In the 48-hour period after use, people with these symptoms have also had associated radiographic findings on chest X-ray of fluid in the lungs (pulmonary edema), interstitial pneumonia, diffuse alveolar hemorrhage, and eosinophil infiltration.

Physical side effects from chronic smoking of cocaine include coughing up blood, bronchospasm, itching, fever, diffuse alveolar infiltrates without effusions, pulmonary and systemic eosinophilia, chest pain, lung trauma, sore throat, asthma, hoarse voice, dyspnea (shortness of breath), and an aching, flu-like syndrome.

Crack cocaine users sometimes smoke "fry," which refers to cigarettes or marijuana sticks that have been dipped in embalming fluid and laced with PCP. Formaldehyde and methyl alcohol are the main ingredients found in fry, and their use has been linked to a range of physical health problems, including bronchitis, destruction of body tissues, brain and lung damage, impaired coordination, and inflammation or sores in the throat, nose, and esophagus.{{cite journal | vauthors = Peters RJ, Williams M, Ross MW, Atkinson J, McCurdy SA | title = The Use of Fry (Embalming Fluid and PCP-Laced Cigarettes or Marijuana Sticks) among Crack Cocaine Smokers | journal = Journal of Drug Education | volume = 38 | issue = 3 | pages = 285–295 | year = 2008 | pmid = 19157045 | pmc = 2873769 | doi = 10.2190/DE.38.3.f }}

Intranasal cocaine and crack use are both associated with pharmacological violence. Crack-related violence is also systemic, relating to disputes between crack dealers and users.{{Cite journal | vauthors = Boles SM, Miotto K |title=Substance abuse and violence: A review of the literature |journal=Aggression and Violent Behavior |date=March–April 2003 |volume=8 |issue=2 |pages=155–174 |doi=10.1016/S1359-1789(01)00057-X }}

Stimulant drug abuse (particularly amphetamine and cocaine) can lead to delusional parasitosis (aka Ekbom's Syndrome: a mistaken belief they are infested with parasites). For example, excessive cocaine use can lead to formication, nicknamed "cocaine bugs" or "coke bugs", where the affected people believe they have, or feel, parasites crawling under their skin (similar delusions may also be associated with high fever or in connection with alcohol withdrawal, sometimes accompanied by visual hallucinations of insects—see delirium tremens).

"Delusional Parasitosis", The Bohart Museum of Entomology,

2005, webpage:

[http://delusion.ucdavis.edu/delusional UCDavis-delusional]{{dead link|date=August 2017 |bot=InternetArchiveBot |fix-attempted=yes }}.

People experiencing these hallucinations might scratch themselves to the extent of serious skin damage and bleeding, especially when they are delirious.

Paranoia and anxiety are among the most common psychological symptoms of crack cocaine use. Psychosis is more closely associated with smoking crack cocaine than intranasal and intravenous use.{{cite journal |last1= Morton |first1= W. Alexander |date= August 1999 |title= Cocaine and Psychiatric Symptoms |pmc= 181074 |journal= Primary Care Companion to the Journal of Clinical Psychiatry |volume=1 |issue=4 |pages= 109–113 |doi=10.4088/pcc.v01n0403 |pmid=15014683}}

{{main|Prenatal cocaine exposure}}

Crack baby is a term for a child born to a mother who used crack cocaine during her pregnancy. The threat that cocaine use during pregnancy poses to the fetus is now considered exaggerated.{{cite news| url=https://www.nytimes.com/2009/01/27/health/27coca.html | work=The New York Times | first=Susan | last=Okie | title=The Epidemic That Wasn't | date=2009-01-27}} Studies show that prenatal cocaine exposure (independent of other effects such as, for example, alcohol, tobacco, or physical environment) has no appreciable effect on childhood growth and development.{{cite journal|title=Growth, Development, and Behavior in Early Childhood Following Prenatal Cocaine Exposure, Frank et al. 285 (12): 1613 – JAMA |journal=JAMA |publisher=Jama.ama-assn.org |date=2001-03-28 |volume=285 |issue=12 |pages=1613–1625 |doi=10.1001/jama.285.12.1613 |last1=Zuckerman |first1=Barry |last2=Pell |first2=Tripler |last3=Knight |first3=Wanda Grant |last4=Augustyn |first4=Marilyn |last5=Frank |first5=Deborah A. |pmid=11268270 |pmc=2504866 }} However, the official opinion of the National Institute on Drug Abuse of the United States warns about health risks while cautioning against stereotyping:

{{blockquote|Many recall that "crack babies", or babies born to mothers who used crack cocaine while pregnant, were at one time written off by many as a lost generation. They were predicted to suffer from severe, irreversible damage, including reduced intelligence and social skills. It was later found that this was a gross exaggeration. However, the fact that most of these children appear normal should not be over-interpreted as indicating that there is no cause for concern. Using sophisticated technologies, scientists are now finding that exposure to cocaine during fetal development may lead to subtle, yet significant, later deficits in some children, including deficits in some aspects of cognitive performance, information-processing, and attention to tasks—abilities that are important for success in school.[http://www.drugabuse.gov/ResearchReports/Cocaine/cocaine4.html#maternal NIDA – Research Report Series – Cocaine Abuse and Addiction] {{webarchive |url=https://web.archive.org/web/20070926234838/http://www.drugabuse.gov/ResearchReports/Cocaine/cocaine4.html#maternal |date=September 26, 2007 }}}}

There are also warnings about the threat of breastfeeding: The March of Dimes said "it is likely that cocaine will reach the baby through breast milk," and advises the following regarding cocaine use during pregnancy:

{{blockquote|Cocaine use during pregnancy can affect a pregnant woman and her unborn baby in many ways. During the early months of pregnancy, it may increase the risk of miscarriage. Later in pregnancy, it can trigger preterm labor (labor that occurs before 37 weeks of pregnancy) or cause the baby to grow poorly. As a result, cocaine-exposed babies are more likely than unexposed babies to be born with low birth weight (less than {{convert|5.5|lb|kg|disp=or|abbr=on}}). Low-birthweight babies are 20 times more likely to die in their first month of life than normal-weight babies, and face an increased risk of lifelong disabilities such as mental retardation and cerebral palsy. Cocaine-exposed babies also tend to have smaller heads, which generally reflect smaller brains. Some studies suggest that cocaine-exposed babies are at increased risk of birth defects, including urinary tract defects and, possibly, heart defects. Cocaine also may cause an unborn baby to have a stroke, irreversible brain damage, or a heart attack.{{cite web |url=http://www.marchofdimes.org/pregnancy/illicit-drug-use-during-pregnancy.apx |title=Street Drugs and pregnancy |work=March of Dimes |access-date=2009-05-26 }}{{Dead link|date=December 2023 |bot=InternetArchiveBot |fix-attempted=yes }}}}

An appreciable tolerance to cocaine's high may develop, with many addicts reporting that they seek but fail to achieve as much pleasure as they did from their first experience. Some users will frequently increase their doses to intensify and prolong the euphoric effects. While tolerance to the high can occur, users might also become more sensitive (drug sensitization) to cocaine's local anesthetic (painkilling) and convulsant (seizure-inducing) effects, without increasing the dose taken; this increased sensitivity may explain some deaths occurring after apparent low doses of cocaine.

{{Main|Substance dependence}}

File:Roxanne,_Dave,_and_Michelle_Smoking_Crack_in_Alley.jpg of Vancouver BC Canada.]]

Crack cocaine is popularly thought to be the most addictive form of cocaine. However, this claim has been contested: Morgan and Zimmer wrote that available data indicated that "smoking cocaine by itself does not increase markedly the likelihood of dependence ... The claim that cocaine is much more addictive when smoked must be reexamined."{{Cite book

| first1 = John P.

| last1 = Morgan

| first2 = Lynn

| last2 = Zimmer

| editor-last = Reinarman

| editor-first = Craig

| editor2-last = Levine

| editor2-first = Harry G.

| contribution = Social Pharmacology of Smokeable Cocaine

| title = Crack in America: Demon Drugs and Social Justice

| year = 1997

| place = Berkeley, Ca.

| publisher = University of California Press

}}

They argued that cocaine users who are already prone to abuse are most likely to "move toward a more efficient mode of ingestion" (that is, smoking).

The intense desire to recapture the initial high is what is so addictive for many users. On the other hand, Reinarman et al. wrote that the nature of crack addiction depends on the social context in which it is used and the psychological characteristics of users, pointing out that many heavy crack users can go for days or weeks without using the drug.{{Cite book

| first1 = Craig

| last1 = Reinarman

| first2 = Dan

| last2 = Waldorf

| first3 = Sheigla B.

| last3 = Murphy

| first4 = Harry G.

| last4 = Levine

| editor-last = Reinarman

| editor-first = Craig

| editor2-last = Levine

| editor2-first = Harry G.

| contribution = The Contingent Call of the Pipe: Bingeing and Addiction Among Heavy Cocaine Smokers

| title = Crack in America: Demon Drugs and Social Justice

| year = 1997

| place = Berkeley, Ca.

| publisher = University of California Press

}}

A typical response among users is to have another hit of the drug; however, the levels of dopamine in the brain take a long time to replenish themselves, and each hit taken in rapid succession leads to progressively less intense highs. Nonetheless, a person might binge for 3 or more days without sleep, while inhaling hits from a pipe.

Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high doses, leads to a state of increasing irritability, restlessness, and paranoia. This may result in total paranoid psychosis, in which the individual loses touch with reality and experiences auditory hallucinations.

Large amounts of crack cocaine (several hundred milligrams or more) intensify the user's high, but may also lead to bizarre, erratic, and violent behavior. Large amounts can induce tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction closely resembling amphetamine poisoning.

Synonyms used to refer to crack cocaine include atari; base; bazooka; beamers; beemers; bebe; bee-bee; berry; bing; bolo; bomb; boulder; boulders; butter; caine; cane; Casper; Casper the ghost; cavvy; chemical; chewies; cloud; cloud nine; crills; crunch and munch; dip; famous dimes; fan; fish scale; fries; fry; glo; golfball; gravel; grit; hail; hamburger helper; hard; hubba; ice cube; kangaroo; kibbles and bits; kibbles; krills; lightem; paste; patico; pebbles; pee wee; pony; raw; ready; ready rocks; redi rocks; roca; rock; rooster; rox; Roxanne; scud; Scotty; scramble; scruples; seven-up; sleet; snowballs; stones; teeth; tension; top gun; tweak; ultimate; wash; white cloud; work; yahoo; yale; yay; yayoo; yeah-O; yeyo; yeo; and yuck.{{citation | author=Tom Dalzell | title=The Routledge Dictionary of Modern American Slang and Unconventional English | publisher=Routledge | year=2009 | isbn=978-0-415-37182-7}}

Crack cocaine may be combined with amphetamine ("croak"); tobacco ("coolie"); marijuana ("buddha"; "caviar"; "chronic"; "cocoa puffs"; "fry daddy"; "gimmie"; "gremmie"; "juice"; "primo"; "torpedo"; "turbo"; "woolie"; "woola"); heroin ("moon rock"); and phencyclidine ("clicker"; "p-funk"; "spacebase").

{{further|Drug pipe#Love rose{{!}}Crack pipe (smoking utensil)}}

Crack smoking ("hitting the pipe"; "puffing"; "beaming up (to Scotty)") is commonly performed with utensils such as pipes ("bowl"; "devil's dick"; "glass dick"; "horn"; "Uzi"); improvised pipes made from a plastic bottle ("Masarati"); water pipes ("bong"; "hubbly-bubbly"); and laboratory pipettes ("demo").

File:Publicizing Dangers of Crack Cocaine (078) (7395870920).jpg anti-crack poster distributed in the 1980s{{cite book|url=https://themetropole.blog/2020/10/05/entrepreneurial-greed-a-review-of-crack-rock-cocaine-street-capitalism-and-the-decade-of-greed/|title="Entrepreneurial Greed" — A Review of Crack: Rock Cocaine, Street Capitalism, and the Decade of Greed|publisher=Cambridge University Press/The Metropole/Pennsylvania State University|last=Farber|first=David|date=2019|access-date=December 30, 2024}}]]

Cocaine is listed as a Schedule I drug in the United Nations 1961 Single Convention on Narcotic Drugs, making it illegal for non-state-sanctioned production, manufacture, export, import, distribution, trade, use and possession.{{cite web

|title=Single Convention on Narcotic Drugs, 1961

|publisher=International Narcotics Control Board

|url=http://www.incb.org/pdf/e/conv/convention_1961_en.pdf

|access-date=2008-05-01

|url-status=dead

|archive-url=https://web.archive.org/web/20080509063404/http://www.incb.org/pdf/e/conv/convention_1961_en.pdf

|archive-date=2008-05-09

}} In most states (except in the United States) crack falls under the same category as cocaine.

In Australia, crack falls under the same category as cocaine, which is listed as a Schedule 8 controlled drug, indicating that any substances and preparations for therapeutic use under this category have a high potential for abuse and addiction. It is permitted for some medical use but is otherwise outlawed.

As a Schedule I substance under the Controlled Drugs and Substances Act, crack is not differentiated from cocaine and other coca products. However, the court may weigh the socio-economic factors of crack usage in sentencing. As a guideline, Schedule I drugs carry a maximum seven-year prison sentence for possession for an indictable offense and up to life imprisonment for trafficking and production. A summary conviction on possession carries a $1000–2000 fine and/or six months to a year imprisonment.

In the United States, cocaine is a Schedule II drug under the Controlled Substances Act, indicating that it has a high abuse potential but also carries a medicinal purpose.{{cite web|url=http://www.usdoj.gov/dea/pubs/csa/812.htm#a |title=DEA, Title 21, Section 812 |publisher=Usdoj.gov |access-date=2008-09-05 |archive-url = https://web.archive.org/web/20080822024838/http://www.usdoj.gov/dea/pubs/csa/812.htm#a |archive-date = 2008-08-22}}{{uscsub|21|812|b|2}} {{retrieved | accessdate=2008-05-01}} Under the Controlled Substances Act, crack and cocaine are considered the same drug.

The Anti-Drug Abuse Act of 1986 increased penalties for crack cocaine possession and usage. It mandated a mandatory minimum sentence of five years without parole for possession of five grams of crack; to receive the same sentence with powder cocaine one had to have 500 grams.{{cite web|last=Sterling|first=Eric|title=Drug Laws and Snitching: A Primer|url=https://www.pbs.org/wgbh/pages/frontline/shows/snitch/primer/|publisher=PBS|access-date=20 May 2013}} This sentencing disparity was reduced from {{nowrap|100-to-1}} to {{nowrap|18-to-1}} by the Fair Sentencing Act of 2010.

File:Marion Barry smoking crack.gif captured on a surveillance camera smoking crack cocaine during a sting operation]]

In the United Kingdom, crack is a Class A drug under the Misuse of Drugs Act 1971. In the Netherlands it is a List 1 drug of the Opium Law.

Marion Barry, Mayor of Washington D.C., was filmed smoking crack in 1990 in a sting operation.{{cite news |title= Barry Arrested on Cocaine Charges in Undercover FBI, Police Operation |newspaper= The Washington Post |date= January 19, 1990 |page= A1 |first= Sharon |last= LaFraniere |url=https://www.washingtonpost.com/wp-srv/local/longterm/tours/scandal/barry.htm}} Rob Ford, Mayor of Toronto, Ontario was filmed smoking crack in 2013 by gang members while holding office.

File:TiresYesCatSellingNo.JPG

Many major American urban areas contain crack houses.{{cite web|url=https://www.latimes.com/archives/la-xpm-1997-01-25-mn-21974-story.html|title=10 Children Found Left in Crack House|agency=Associated Press|date=25 January 1997|via=LA Times}}{{cite web|url=https://www.chicagotribune.com/2006/09/15/23-gang-members-charged-in-huge-englewood-drug-bust/|title=23 gang members charged in huge Englewood drug bust|website=Chicago Tribune |date=15 September 2006 }}{{cite web|url=http://www.highbeam.com/doc/1G1-67782578.html|archive-url=https://web.archive.org/web/20121105104043/http://www.highbeam.com/doc/1G1-67782578.html|url-status=dead|archive-date=5 November 2012|title=MAN CLEARED OF ARSON CHARGES IN FIRE AT ALLEGED CRACK HOUSE.(News/National/International)|date=27 July 1996}} In some cases, enraged citizens have burned crack houses to the ground, in hopes that by destroying the sites for drug operations they would also drive the illegal industries from their neighborhoods.{{cite web|url=https://www.nytimes.com/1988/10/22/us/crack-house-fire-justice-or-vigilantism.html|title='Crack House' Fire: Justice or Vigilantism?|date=22 October 1988|work=The New York Times}}

• Calixcoca, an experimental vaccine against the effect of crack cocaine being developed by UFMG
• CIA involvement in Contra cocaine trafficking
• Cocaine paste ("paco")

{{-}}

{{Reflist}}

• {{Cite book |last=Cooper |first=Edith Fairman |year=2002 |title=The Emergence of Crack Cocaine Abuse |url=https://books.google.com/books?id=kzbPwayMLsEC |location=New York |publisher=Novinka Books |isbn=9781590335123 |oclc=50684137}}
• {{Cite book |last=Ramsey |first=Donovan X. |year=2023 |title=When Crack Was King: A People's History of a Misunderstood Era |title-link=When Crack Was King |location=New York |publisher=One World |isbn=9780525511809 |oclc=1385420783}}

• {{Wiktionary inline}}
• {{Commons category inline}}

{{Stimulants}}

{{Authority control}}

{{DEFAULTSORT:Crack Cocaine}}

Category:American inventions

Category:Cocaine

Category:Drug culture