Crack cocaine addiction: effects, risks and getting help in the UK

Cocaine is a stimulant. FRANK, the UK drug information service, describes three types: coke (a fine white powder), crack (small lumps or rocks) and freebase (a crystallised powder). Crack and freebase can be smoked, and powdered cocaine and crack can be prepared for injecting, which FRANK says is much more dangerous than snorting or smoking.

FRANK says crack cocaine can smell like burnt plastic or rubber. The effects of smoking crack are almost instant, but they are shorter lasting than those of snorting, around 10 minutes, and some people feel down, anxious and paranoid the next day or longer.

Because the high is brief, FRANK notes that frequent users begin to crave more of the drug, which is explained further below.

FRANK says cocaine can make people feel happy, excited, wide awake and confident, and can also make the heart beat faster, raise body temperature, stop feeling hungry, make you feel sick, make you anxious and panicky, make you paranoid and make you so confident that you do things you would not normally do, which might be risky.

Most users become chattier, more animated and more confident, but some become overconfident and arrogant, agitated, restless or edgy. FRANK also says cocaine can increase sexual desire, but taking lots of cocaine can actually reduce sex drive.

FRANK separates the risks. The list below follows its page on cocaine, which includes crack.

• Cocaine is risky for anyone with high blood pressure or a heart condition, but even healthy young people can have a fit, heart attack or stroke.

• The risk of overdose increases if you mix cocaine with other drugs or alcohol.

• Regularly smoking crack can cause breathing problems and pains in the chest.

• Injecting can damage veins and cause ulcers and gangrene, and sharing needles or other equipment can spread HIV and hepatitis infections; it is also easier to overdose from injecting.

• Regular use can make people feel depressed, run-down, anxious and paranoid, and can bring previous mental health problems to the surface.

• Taking cocaine when pregnant can damage the baby, cause miscarriage, premature labour and low birth weight.

FRANK says cocaine is very addictive because regular use changes the way the brain releases dopamine. Cocaine is mostly known for causing psychological dependence, but users can sometimes continue to use cocaine just to overcome the negative after-effects of using, which can lead to a binge pattern of use and increase the risk of dependence.

It also notes that frequent users find they begin to crave more of the drug, so it can become an expensive habit to keep up with.

Signs that use may have become a problem include using more than intended, being unable to cut down, spending a lot of time obtaining or recovering from the drug, using despite harm to health, relationships or work, and feeling low or anxious when not using. These are general descriptions rather than sourced diagnostic criteria, and a drug service can assess dependence properly.

FRANK says if you or someone else needs urgent help after taking drugs or drinking, call 999 for an ambulance and tell the crew everything you know, as it could save their life.

Chest pain, collapse, a seizure, severe breathing difficulty, extreme agitation or confusion after using crack or cocaine are medical emergencies. Do not wait for symptoms to settle, and tell the ambulance crew what was taken.

The NHS says if you need help for a drug problem you are entitled to treatment in the same way as anyone else who has a health problem. A GP may be a good place to start, and they can discuss your problems with you and help get you into treatment, usually referring you to your local drug service. If you are not comfortable talking to a GP, you can approach your local drug treatment service yourself, and FRANK can help find support near you.

The NHS says charities and the NHS provide most drug treatment, but there are also private drug and alcohol treatment organisations that can help you, for which you pay.

NICE's information for the public on drug misuse explains the support and treatment people can expect if they have a problem with or are dependent on opioids, stimulants or cannabis, and how families and carers may be able to support a person with a drug problem and get help for themselves.

The NHS says at your first appointment for drug treatment staff will ask about your drug use, work, family and housing situation, and you may be asked for a urine or saliva sample. They talk through your options and agree a treatment plan, and you are given a keyworker who supports you throughout treatment.

The NHS says staff at the drug service can tell you about local support groups for drug users and their families or carers, and points to the charity Adfam for a list of useful organisations. NICE's public information also covers how family members and carers can support a person with a drug problem and get help for themselves.

Living with someone who uses crack can be frightening and exhausting. Seeking support for yourself, as a family member, is a recognised part of the treatment landscape rather than something that has to wait until the person is ready.

In England most drug treatment is provided free by NHS and charity local drug services, accessed by self-referral or through a GP. The NHS says you will need to pay for private treatment.

If considering a private service, it is sensible to check what assessment, aftercare and links to NHS and community services are included, and to keep your GP informed so that physical health problems are looked after.