Cocaine Addiction: Cocaine and Crack Cocaine, What’s the Difference?
Could cocaine and crack produce different patterns of dependence that require different types of support and treatment for each person?
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Cocaine addiction can vary widely between powder and crack, with distinct risks, withdrawal patterns and lasting harms that need tailored care for each person.
What is it?
Cocaine is an addictive stimulant drug derived from the leaves of the coca plant, native to South America. Cocaine reacts within the central nervous system and produces euphoria and rapid energy.
What does it look like?
Cocaine is distributed in two main forms. The first is cocaine hydrochloride, a fine white powder. The second is crack, which is cocaine hydrochloride processed with ammonia or sodium bicarbonate (baking soda) and water to create a ‘freebase’ form that appears as chips, chunks or rocks.
How is it used?
Cocaine can be snorted, rubbed into the gums or dissolved in water and injected. Crack is smoked. People who use cocaine usually take it in binge episodes, taking the drug repeatedly within a short frame of time, at increasingly higher doses in order to maintain their high.
What does it do?
Being a central nervous system stimulant, cocaine affects the brain by stimulating high levels of dopamine, a brain chemical associated with pleasure and reward. Using cocaine circumvents the normal process by blocking dopamine from being reabsorbed. This creates a flood of chemicals in the brain, and this causes the intense “high” experience. As the drug leaves the bloodstream, extreme lows may be felt as a “crash.”
Cocaine Addiction Patterns Differ For Powder And Crack
Powder and crack are the same drug in different forms, but they behave differently enough that the risks and the pull of each are not the same. The table below sets the two side by side.
| Feature | Powder Cocaine | Crack Cocaine |
|---|---|---|
| Form | Fine white powder (cocaine hydrochloride) | Hard chips, chunks or rocks, the freebase form |
| How it is used | Snorted, rubbed into the gums or injected | Smoked |
| Speed of effect | Comes on within a few minutes | Comes on within seconds |
| Length of the high | Around 20 to 30 minutes | Around 5 to 10 minutes |
| Craving pattern | Strong, but slower to repeat | More intense, with fast repeat use |
| Relative cost | More expensive | Cheaper |
Why Do People Get Addicted to Cocaine?
Cocaine is addictive because of what it does to the brain’s reward system. Each hit floods the brain with dopamine and produces a short, intense high, which the brain quickly learns to chase.
When the drug wears off, dopamine crashes and leaves the person flat, anxious and craving more, so they use again to escape the low. Repeated on this cycle, the brain adapts and starts to need cocaine just to feel normal, which is how casual use turns into addiction.
Side effects
The way cocaine is used may influence the side effects and risks of the drug. For example, people who usually smoke cocaine may be more prone to suffering from respiratory problems, whereas someone who snorts the drug may have nosebleeds and acquire damage to the nasal and sinus cavities. Intravenous drug users may share drug paraphernalia, resulting in compounding risks for infectious disease, wounds and collapsed veins with extended use.
Common side effects of cocaine use include:
- Constricted blood vessels
- Dilated pupils
- Nausea
- Raised body temperature and blood pressure
- Elevated or irregular heartbeat
- Tremors and muscle spasms
- Restlessness
Long-Term Effects include:
- Snorting: loss of smell, nosebleeds, frequent runny nose and issues with swallowing
- Smoking: cough, asthma, respiratory distress and higher risk of infections like pneumonia
- Consuming by mouth: severe bowel decay from reduced blood flow
- Injecting: compound risk of contracting infectious diseases
Overdose
When the brain and body become dangerously overstimulated with the use of too much cocaine, commonly experienced side effects, like increased heart rate, are raised to potentially lethal levels.
Signs of a potential overdose include:
- Irregular heartbeat
- Elevated heart rate
- Very high blood pressure
- Nausea
- Confusion
- Excessively high body temperature
- Sweating
- Severe anxiety or agitation
- Psychosis
- Tremors
- Seizures
- Stroke
A cocaine overdose is a medical emergency. Do not wait for it to pass. Call an ambulance immediately on 10177, or 112 from any mobile phone.
Withdrawal
The withdrawal symptoms experienced when a user attempts to stop using cocaine may include:
- Agitation or restlessness
- A general feeling of discomfort
- Strong cravings
- Irritability
- Lack of motivation
- Excessive sleepiness
- Decreased sexual desire
- Mental and physical exhaustion
- Depression
- Inability to feel pleasure
- Vivid and/or upsetting dreams
- Increased appetite
- Slowed activity
- Poor concentration
Only in severe cases will antagonistic and paranoid behaviours be present. Withdrawal usually peaks in the first one to two weeks, when symptoms are most intense, before easing off. Physical symptoms tend to settle within a couple of weeks. Low mood, poor concentration and cravings can linger for longer, and the exact pattern varies from person to person, depending on how much and how often they used cocaine.
Treatment
Because addiction is recognised as a chronic, primary illness, it is recommended that a reputable cocaine addiction treatment centre assist in the management, treatment and long-term recovery of the patient. Whilst the initial phase of addiction treatment is a short period of around 28 days, recovery is a lifelong process. Much like the management of other chronic illnesses such as high blood pressure and asthma, outcomes are much improved if treatment is extended for at least a year, allowing for constant monitoring and accountability. This is why cocaine addiction treatment programmes for pilots, doctors and nurses are so much more successful.
At Changes, cocaine treatment follows a clear path. It starts with a medically supervised detox to get you through the crash and early cravings safely, moves into primary care for intensive individual and group therapy, then into secondary care and structured aftercare that keep you supported once you go home. There is no medicine that cures cocaine addiction on its own, so the work is built around therapy, relapse prevention and treating any depression or anxiety underneath the use.
Some people try to stop on their own by avoiding dealers, cutting ties with using friends and riding out the cravings. The same moves help prevent cocaine problems in the first place, but once addiction has set in, cravings tend to win over willpower alone, which is why structured treatment gives you a far better chance of staying stopped. You can read more about our cocaine treatment programme and what it involves.
There is always hope and help available. Changes Rehab Johannesburg is here to guide and support you through each step. When you are ready to start, the fastest route in is to pre-authorise your admission or call our team on 081 444 7000.
Cocaine addiction varies widely between powder and crack, with distinct risks, withdrawal patterns and lasting harms that need tailored care for each person.. Changes team counsellors are here to help you.Cocaine Addiction Patterns Differ For Powder And Crack
