Pure cocaine was first used in the 1880s as a local anesthetic in eye, nose, and throat surgeries because of its ability to provide anesthesia as well as to constrict blood vessels and limit bleeding. Many of its therapeutic applications are now obsolete due to the development of safer drugs.1
Approximately 100 years after cocaine entered into use, a new variation of the substance emerged. This substance, crack, became enormously popular in the mid-1980s due in part to its almost immediate high and the fact that it is inexpensive to produce and buy.2
Crack is a highly addictive form of cocaine that is typically smoked. The term "crack" refers to the crackling sound heard when the substance is heated, presumably from the sodium bicarbonate that is used in the production of crack.3
According to the 2003 National Survey on Drug Use and Health, approximately 7.9 million Americans ages 12 and older reported trying crack at least once during their lifetimes, representing 3.3% of the population ages 12 and older. Approximately 1.4 million (0.6%) reported past year crack cocaine use and 604,000 (0.3%) reported past month crack use.5
Among high school students surveyed as part of the 2003 Monitoring the Future Study, 2.5% of eighth graders, 2.7% of tenth graders, and 3.6% of twelfth graders reported using crack cocaine at least once during their lifetimes. In 2002, these percentages were 2.5%, 3.6%, and 3.8%, respectively.6
Percent of Students Reporting Crack Cocaine Use, 2003
Regarding the ease by which one can obtain crack cocaine, 22.5% of eighth graders, 29.6% of tenth graders, and 35.3% of twelfth graders surveyed in 2003 reported that crack cocaine was "fairly easy" or "very easy" to obtain.7
Nearly 49% of eighth graders, 58% of tenth graders, and 47% of twelfth graders reported that using crack cocaine once or twice was a "great risk."8
Percent of Students Reporting Risk of Using Crack Cocaine, 2003
During 2003, 3.1% of college students and 4.7% of young adults (ages 19–28) reported using crack cocaine at least once during their lifetimes. Approximately 1.3% of college students and 1.0% of young adults reported past year use of crack cocaine, and 0.4% of college students and 0.3% of young adults reported past month use of crack cocaine.9
According to data from the Arrestee Drug Abuse Monitoring (ADAM) Program, a median of 30.1% of adult male arrestees and 35.3% of adult female arrestees tested positive for cocaine (all varieties) at arrest in 2003. The adult male samples were compiled from 39 U.S. sites and the adult female samples were compiled from 25 sites. A median of 17.2% of adult male arrestees and 24.5% of adult female arrestees reported using crack cocaine at least once in the year before being arrested.10
Past Crack Cocaine Use by Arrestees, 2003
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Health Effects
Cocaine is a strong central nervous system stimulant. Physical effects of cocaine use, including crack, include constricted blood vessels and increased temperature, heart rate, and blood pressure. Users may also experience feelings of restlessness, irritability, and anxiety.11
Smoking crack delivers large quantities of the drug to the lungs, producing effects comparable to intravenous injection. These effects are felt almost immediately after smoking, are very intense, but do not last long.12 For example, the high from smoking cocaine may last from 5 to 10 minutes, while the high from snorting the drug can last for 15 to 20 minutes.13
Evidence suggests that users who smoke or inject cocaine may be at even greater risk of causing harm to themselves than those who snort the substance. Cocaine smokers may suffer from acute respiratory problems including coughing, shortness of breath, and severe chest pains with lung trauma and bleeding.14 Smoking crack cocaine can also cause particularly aggressive paranoid behavior in users.15
An added danger of cocaine use is when cocaine and alcohol are consumed at the same time. When these substances are mixed, the human liver combines cocaine and alcohol and manufactures a third substance, cocaethylene. This intensifies cocaine's euphoric effects, while also possibly increasing the risk of sudden death.16 Most cocaine-related deaths are a result of cardiac arrest or seizures followed by respiratory arrest.17
Cocaine is a powerfully addictive drug. Compulsive cocaine use seems to develop more rapidly when the substance is smoked rather than snorted. A tolerance to the cocaine high may be developed and many addicts report that they fail to achieve as much pleasure as they did from their first cocaine exposure.18
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Drug Episode: A drug-related
ED episode is an ED visit that
was induced by or related to the
use of drug(s).
Drug Mention: A drug mention
refers to a substance that was
recorded during an ED episode. Because up to 4 drugs can be reported for each drug abuse episode, there are more mentions than episodes.
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During 2002, emergency departments (ED) nationwide reported 42,146 crack mentions to the Drug Abuse Warning Network. Crack accounted for 21% of the total cocaine mentions during the year. The number of crack ED mentions has increased from 33,789 in 1995, but has decreased from 46,964 in 2001.19
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Treatment
From 1992 to 2002, the number of admissions to treatment in which crack cocaine was the primary drug of abuse decreased from 183,282 in 1992 to 176,014 in 2002. The crack admissions represented 12% of the total drug/alcohol admissions to treatment during 1992 and 9.3% of the treatment admissions in 2002. The average age of those admitted to treatment for crack cocaine during 2002 was 37 years.20
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Arrests & Sentencing
The Drug Enforcement Administration (DEA) made 10,518 cocaine-related arrests (includes crack) during FY 2003, representing 38.7% of the total arrests made by the DEA during the year.21
During FY 2002, the DEA made 4,400 arrests involving crack cocaine, representing 15% of all DEA arrests made in FY 2002. More than half (2,296) of those arrested by the DEA for crack-related offenses in FY 2002 were between the ages of 21 and 30.22
Of the 25,609 Federal drug offense cases during FY 2002, powder cocaine was involved in 5,867 (22.9%) and crack cocaine was involved in 5,166 (20.17%).23
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Production & Trafficking
Crack is cocaine that has been processed from cocaine hydrochloride to a free base for smoking. Crack cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water. It is then heated to remove the hydrochloride producing a form of cocaine that can be smoked.24
The majority of law enforcement and epidemiologic/ethnographic Pulse Check sources consider crack to be widely available in their communities. Most of the crack available in Pulse Check cities is processed locally, either by users or by local distributors. Crack rocks tend to be sold in sizes of approximately 0.1 to 0.2 grams, which sell for approximately $10 and $20, respectively.25
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Legislation
Cocaine (all forms) was first Federally-regulated in December 1914 with the passage of the Harrison Act. This Act banned the non-medical use of cocaine; prohibited its importation; imposed the same criminal penalties for cocaine users as for opium, morphine, and heroin users; and required a strict accounting of medical prescriptions for cocaine. As a result of the Harrison Act and the emergence of cheaper, legal substances such as amphetamines, cocaine became scarce in the U.S. However, use began to rise again in the 1960s, prompting Congress to classify it as a Schedule II substance in 1970.26
Schedule II substances have a high potential for abuse, a currently accepted medical use in treatment in the United States with severe restrictions, and may lead to severe psychological or physical dependence.27 While cocaine can currently be administered by a doctor for legitimate medical uses, such as a local anesthetic for some eye, ear, and throat surgeries, there are currently no medical uses for crack cocaine.28
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Street Terms29
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Other Links
Cocaine Abuse and Addiction
This report provides information on powder and crack cocaine abuse, effects, and describes effective treatment.
Cocaine Publications
A listing of powder and crack cocaine-related publications from various sources.
Common Drugs of Abuse: Cocaine
This site provides links to NIDA resources related to crack and cocaine.
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Sources
1 Drug Enforcement Administration, Drugs of Abuse, February 2003
2 National Institute on Drug Abuse, Cocaine Abuse and Addiction, May 1999
3 National Institute on Drug Abuse, Infofax: Crack and Cocaine, October 2001
4 Office of National Drug Control Policy, Pulse Check: Trends in Drug Abuse, July-December 2001 Reporting Period, April 2002
5 Substance Abuse and Mental Health Services Administration, Results from the 2003 National Survey on Drug Use and Health: National Findings, September 2004
6 National Institute on Drug Abuse and University of Michigan, Monitoring the Future 2003 Data from In-School Surveys of 8th-, 10th-, and 12th- Grade Students, December 2003.
7 Ibid.
8 Ibid.
9 National Institute on Drug Abuse and University of Michigan, Monitoring the Future National Survey Results on Drug Use, 1975–2003, Volume II: College Students & Adults Ages 19–45 (PDF), 2004
10 National Institute of Justice, Drug and Alcohol Use and Related Matters Among Arrestees, 2003 (PDF), 2004
11 National Institute on Drug Abuse, Infofax: Crack and Cocaine, October 2001
12 Drug Enforcement Administration Web site, Drug Descriptions: Cocaine
13 National Institute on Drug Abuse, Infofax: Crack and Cocaine, October 2001
14 Drug Enforcement Administration Web site, Drug Descriptions: Cocaine
15 National Institute on Drug Abuse, Infofax: Crack and Cocaine, October 2001
16 National Institute on Drug Abuse, Infofax: Crack and Cocaine, October 2001
17 National Institute on Drug Abuse, Infofax: Crack and Cocaine, October 2001
18 National Institute on Drug Abuse, Infofax: Crack and Cocaine, October 2001
19 Substance Abuse and Mental Health Services Administration, Emergency Department Trends from the Drug Abuse Warning Network, Final Estimates 1995–2002, July 2003
20 Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) Highlights—2002 (PDF), May 2004
21 Drug Enforcement Administration, Defendant Statistical System, as reported in Sourcebook of Criminal Justice Statistics
22 Bureau of Justice Statistics, Compendium of Federal Justice Statistics, 2002, September 2004
23 U.S. Sentencing Commission, 2002 Sourcebook of Federal Sentencing Statistics, 2004
24 National Institute on Drug Abuse, Infofax: Crack and Cocaine, October 2001
25 Office of National Drug Control Policy, Pulse Check: Trends in Drug Abuse, July-December 2001 Reporting Period, April 2002
26 U.S. Department of Justice, CIA-Contra-Crack Cocaine Controversy, Appendix C
27 Drug Enforcement Administration, Drugs of Abuse, February 2003
28 National Institute on Drug Abuse, Cocaine: Abuse and Addiction (PDF), May 1999
29 Office of National Drug Control Policy, Drug Policy Information Clearinghouse, Street Terms: Drugs and the Drug Trade
Crack cocaine section
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