What is crack?

History of Use

Crack first appeared in the US cities of Los Angeles, San Diego, and Houston in the early 1980s, reportedly as a means of moving a large amount of cocaine that was available in the United States in the 1970s. The major crack epidemic, as it came to be called, took place between 1984 and 1990, mostly in poor, urban areas in the United States. By 2002, the United Kingdom reported a crack epidemic, and today, crack is used worldwide.

Since about 2000, the use of crack has decreased substantially, though it has not disappeared. Young adults (at levels as high as 65 percent) report having tried crack at least once; however, repeat-usage percentages are significantly lower. Arrest rates for crack possession are also dramatically lower than those of the 1980s and 1990s, with some cities showing crack-arrest percentages in the single digits. In 2010 the National Institute on Drug Abuse reported that according to the National Survey on Drug Use and Health, there were an estimated 359,000 US crack cocaine users in 2008.

There are several explanations for these lowered rates, including higher prices for cocaine and also changes in how the law handles charges for crack possession. However, the most significant cause for the decrease in the use of crack is the dramatic rise in methamphetamine use. Methamphetamine’s low cost, easy availability, and extremely addictive nature make it popular among drug abusers.

Effects of Use

Crack is a stimulant that artificially increases the levels of dopamine
released from the brain. Also, crack prevents dopamine from being “recycled” by the body, leading to an excess of dopamine with repeated use. This excess causes an overamplification of the dopamine-receptor neurons and leads to a disruption of normal neural communications. For example, the brain loses the ability to properly respond to pleasurable stimuli, which causes the drug user to seek more drugs to feel any pleasure. While the initial response of the brain to this massive dopamine buildup is a drug-induced euphoria, an increase in self-confidence, and increased high energy, these effects become harder and harder to attain as the dopamine system becomes damaged, leading to addiction and tolerance.

Risks of Use

Crack affects not just the brain but also almost every system in the body. One of the most strongly affected is the pulmonary system. Because crack is inhaled using high temperatures (90 degrees Celsius, or 194 degrees Fahrenheit), users often suffer burned lips, tongue, and airways. Another common side effect of crack use is a cough with black sputum, which is caused by the butane torches used to heat the smoking pipes. Other crack-related respiratory illnesses include pulmonary edema (also known as crack lung), asthma, and adult respiratory distress syndrome.

Sudden death from cardiac arrest is another danger to crack users, especially those who drink alcoholic beverages while using crack. (Any polydrug use increases the risk of sudden cardiac arrest.) Psychiatric trauma also is common in crack users and may include severe paranoia, violent behavior, and hallucinations (including delusional parasitosis, or Ekbom’s syndrome, the belief that one is infested with parasites; this can cause a person to violently scratch themselves).

Crack users are especially at risk for infections with the human immunodeficiency virus and hepatitis virus. Shared needles are one source; the other source is the exchange of sex for drugs. This often places women at an especially high risk. Another danger is tuberculosis and other saliva-borne diseases, which are passed by sharing a common crack pipe.

The so-called crack-babies epidemic has been weighted by myth and misinformation, leading people to believe that a generation of children became an essentially lost generation. Studies show that the stereotype of the crack baby, born addicted to crack and facing insurmountable developmental issues and an inability to bond, is simply false. The reality is more complicated. Independent of other issues, such as alcohol and tobacco abuse and poor physical environment, many of these babies are living normal lives.

Further research shows that the area of the body most affected in these children is the dopamine system that develops early in the fetal cycle; the system may show long-term effects of crack and cocaine exposure. A child also may have a mild behavioral disorder or a subtler developmental phenotype that resembles attention deficit hyperactivity disorder. Cognitive and attention systems may be affected, and these children may require help from a special-needs program.

Bibliography

Laposata, Elizabeth A., and George L. Mayo. “A Review of Pulmonary Pathology and Mechanisms Associated with Inhalation of Freebase Cocaine (‘Crack’).” American Journal of Forensic Medicine and Pathology 14 (1993): 1–9. Print.

Lejuez, C. W., et al. “Risk Factors in the Relationship between Gender and Crack/Cocaine.” Experimental and Clinical Psychopharmacology 15 (2007): 165–75. Print.

Palamar, Joseph J., et al. “Powder Cocaine and Crack Use in the United States: An Examination of Risk for Arrest and Socioeconomic Disparities in Use.” Drug and Alcohol Dependence 149.(2015): 108–116. PsycINFO. Web. 29 Oct. 2015.

Natl. Inst. on Drug Abuse. “Cocaine: What Is the Scope of Cocaine Use in the United States?” National Institute on Drug Abuse. NIH, Sept. 2010. Web. 29 Oct. 2015.

United Nations. Office on Drugs and Crime. World Drug Report 2014. Vienna: UNODC, 2014. Digital file.

Thompson, Barbara L., Pat Levitt, and Gregg D. Stanwood. “Prenatal Exposure to Drugs: Effects on Brain Development and Implications for Policy and Education.” Nature 10 (2009): 303–12. Print.