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Effects of Crack Cocaine

The term “crack” refers to cocaine that has been processed with baking soda or ammonia, water, and heat to produce a “rock” form that can be smoked.1 Cocaine produces fast-acting effects; however, they are short-lived and typically last for just a few minutes.1, 2 Smoking crack cocaine results in a faster onset of effects, is associated with a more pleasurable response, and has a greater addiction liability than inhaling powder cocaine.

The quick, but short-acting “high” that people feel may lead to people using it in binge cycles, where cocaine is used repeatedly and at increasingly higher doses. This pattern of repeated use increases the risk of adverse health effects and overdose.3

What Happens When You Smoke Crack?

Cocaine is a powerful and addictive stimulant drug. The effects of smoking crack can be felt almost immediately (within 8 to 12 seconds) and last between 2 and 20 minutes.2, 4 Many people experience cravings for crack cocaine when the effects wear off, which can result in a dangerous cycle of using over and over again.4 Cravings can also occur after someone has been abstinent for a period of time.4

The effects that a person may experience will vary based on several factors including:4

  • How long they’ve been using crack.
  • How much crack do they use?
  • Physical condition and other medical complications.
  • Use of other substances (polysubstance use).
  • Co-occurring mental health conditions.
  • An individual’s genetics and metabolism.
  • Purity of crack cocaine.

How Does Crack Cocaine Work in the Brain?

Crack exerts its effects the same way as powder cocaine, but smoking crack delivers the drug more quickly to the brain than inhaling powder cocaine. Cocaine’s pleasurable and addictive effects are due in part, to blocking the reabsorption of dopamine, a brain chemical related to pleasure, movement, and reward.3 The resulting buildup of dopamine and increased dopamine signaling contributes to the pleasurable effects of the drug.3, 5

Due to the faster, almost immediate onset of crack cocaine’s effects versus powder cocaine, which takes about 3 minutes, smoking crack cocaine is considered to have a higher potential for addiction.4

Short-Term Effects of Crack

The short-term effects of crack cocaine typically occur almost immediately after smoking.2 Even small amounts of cocaine can produce short-term effects like euphoria, pleasure, and alertness; however, not all people experience the same effects.2

People who use larger doses of crack cocaine may experience more bizarre or erratic changes in behavior in the short term.2

The increased activity of several neurotransmitters, including dopamine, contributes to crack’s short-term effects, which can include:2, 7

  • Euphoria or extreme happiness and pleasure.
  • Mental alertness.
  • Paranoia.
  • Extra sensitive to sights, sounds, and touch.
  • Irritability.
  • Dilated pupils.
  • Constricted blood vessels.
  • Rapid heartbeat.
  • High blood pressure.

Long-Term Effects of Crack

A person who uses crack cocaine regularly may develop tolerance. This can lead them to use crack more frequently and in larger doses, which may result in adverse physiological or psychological effects.3 A person who has developed a tolerance and is using crack in binge cycles is also at an increased risk of overdose.3

The long-term effects of crack cocaine vary depending on the person and their substance use. However, risk of neurological problems, damage to bodily organs, and decreased cognitive functioning are all potential effects associated with long-term crack cocaine use.3

Other specific long-term effects of crack can include:3, 7

  • Worsening of asthma.
  • Damage to the body’s respiratory system and lungs.
  • Heart and cardiovascular damage.
  • Movement disorders.
  • Decreased appetite and malnourishment.
  • Psychosis.

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What are the Effects of Crack Cocaine on the Lungs?

Smoking crack cocaine can be especially damaging to a person’s lungs and respiratory system. In addition to difficulty breathing and chest pain, crack cocaine is associated with an increased risk of potentially severe pulmonary issues like:2, 3, 9

  • Worsening of asthma.
  • Pulmonary edema (accumulation of fluid in the lungs).
  • Pneumonia.
  • Pneumothorax (collapsed lung).
  • Pulmonary hemorrhage (bleeding in the lungs) and coughing up blood.
  • Thermal airway injury (from inhalation).
  • Barotrauma, which is caused by spasmodic or violent coughing after smoke inhalation.

Alveolitis, or “crack lung” is also associated with chronic cocaine use. This condition is characterized by severe chest pain, difficulty breathing, and high fever despite X-rays of the lungs appearing normal.9

What are the Effects of Using Crack Cocaine on the Heart?

Cocaine can result in several physiological changes that ultimately strain the cardiovascular system. It can constrict blood vessels, increase blood pressure, and lead to rapid heart rate.3, 8

Constricted coronary arteries in the face of simultaneous increases in cardiac muscle oxygen demand can result in a catastrophic mismatch between the amount of oxygen supplied to the heart versus the amount of oxygen the heart needs to function.12

With regular use or at high enough doses, cocaine and crack cocaine can contribute to several heart and cardiovascular problems including:3, 8, 10, 12

  • Intense chest pain.
  • Hypertension.
  • Inflammation of the heart muscle.
  • Aortic ruptures or dissection.
  • The inability of the heart to contract over time (cardiomyopathy).
  • Arrhythmias (irregular heart rhythms).
  • Congestive heart failure.
  • Myocardial infarction (heart attack).
  • Endocarditis (infection of the heart).
  • Stroke.
  • Sudden death.

Get Help for Crack Addiction

If you are struggling with drug misuse and have experienced adverse effects related to smoking crack, getting treatment can be an important step toward a healthier lifestyle.

There are several types of treatment available for crack addiction like detox, inpatient or outpatient facilities, mutual support groups, and therapy. Finding a treatment that is designed to meet your individual needs (physical and mental health, medical, social, vocational, and legal) is more likely to help you to return to normal, productive functioning.11

If you are struggling with crack addiction and are noticing that the effects of crack use are impacting your life or those around you, it may be time to seek help. American Addiction Centers provides evidence-based treatment for drug and alcohol addiction at our facilities across the U.S. Contact our team of caring admissions navigators at to learn more about treatment options, check your insurance coverage, and connect you with resources to start the road to recovery.

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