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

While nearly always smoked, there are reports of users injecting crack in a few Pulse Check cities (Baltimore, Boston, Sioux Falls, and Washington, D.C.). In some cases, when users can not find powder cocaine to inject, they inject crack instead.⁴

According to the 2001 National Household Survey on Drug Abuse, approximately 6.2 million (2.8 percent) Americans age 12 or older had tried crack at least once in their lifetime, 1.0 million (0.5 percent) used crack in the past year, and 406,000 (0.2 percent) reported past month crack use.⁵

Among high school students surveyed in the 2002 Monitoring the Future Study, 2.5% of 8th graders, 3.6% of 10th graders, and 3.8% of 12th graders reported using crack at least once during their lifetime. In 2001, these percentages were 3.0%, 3.1%, and 3.7%, respectively.⁶

Percent of Students Reporting Crack Use, 2002

Student Crack Use	Eighth Grade	Tenth Grade	Twelfth Grade
Past month use	0.8%	1.0%	1.2%
Past year use	1.6	2.3	2.3
Lifetime use	2.5	3.6	3.8

Regarding the ease by which one can obtain crack cocaine, 23.7% of eighth graders, 31.3% of tenth graders, and 40.2% of twelfth graders surveyed in 2002 reported that crack was "fairly easy" or "very easy" to obtain.⁷

More than 47% of eighth graders, 57% of tenth graders, and 50% of twelfth graders surveyed in 2002 reported that using crack cocaine once or twice was a "great risk."⁸

Percent of Students Reporting Risk of Using Crack, 2002

Percent Saying "Great Risk"	Eighth Grade	Tenth Grade	Twelfth Grade
Try crack once or twice	47.4	57.4	50.8
Use crack occasionally	69.7	75.7	65.6

In 2001, 2% of college students and 4.7% of young adults (ages 19–28) reported using crack cocaine at least once during their lifetimes. 0.9% of college students and 1.3% of young adults reported past year crack use, while 0.1% of college students and 0.4% of young adults reported using crack in the past month.⁹

According to data from the Arrestee Drug Abuse Monitoring (ADAM) Program, a median of 29.1% of adult male arrestees and 30.7% of adult female arrestees tested positive for cocaine (all varieties) at arrest in 2001. The adult male samples were compiled from 33 U.S. sites and the adult female samples were compiled from 22 sites. A median of 18.9% of adult male arrestees and 28.5% of adult female arrestees reported using crack at least once in the year before being arrested.¹⁰

Past Drug Use by Arrestees, 2001

Past Crack Cocaine Use by Arrestees	Male	Female
Used in past 7 days	13.3%	18.8%
Used in past 30 days	15.6%	22.1%
Used in past year	18.9%	28.5%
Average number of days used in past 30 days	7.6 days	9.7 days

Consequences of Use

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 sever 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

Almost a quarter (24%) of the cocaine emergency department (ED) mentions in 2001 were attributed to crack. The number of cocaine ED mentions increased 35% since 1994 and 20% since 2000. During 2001, there were 46,964 crack ED mentions. Preliminary data show that there were 20,694 ED crack mentions from January to June 2002, representing 23% of the total cocaine ED mentions during that time period.¹⁹

From 1992–2000, the number of admissions to treatment in which crack cocaine was the primary drug of abuse decreased from 183,282 in 1992 to 158,524 in 2000. The crack admissions represented 12% of the total drug/alcohol treatment admissions during 1992 and 9.9% of the admissions during 2000. The average age of those admitted to treatment for crack cocaine during 2000 was 35.7 years. ²⁰

The Drug Enforcement Administration (DEA) made 13,588 cocaine-related arrests (includes crack) during FY 2001, representing 38.8% of the total arrests made by the DEA during the year.²¹

During FY 2000, the DEA made 6,734 arrests involving crack cocaine. More than 3,000 of those arrested by the DEA for crack-related offenses were between the ages of 21 and 30.²²

In FY 2001, 41.2% of the Federal defendants nationwide were charged with committing drug offenses. Cocaine was involved in 5,358 (22.1%) of the cases and crack cocaine was involved in 4,941 (20.4%) of the Federal drug cases.²³

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

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

Street Terminology²⁹

Common Terms Associated with Crack
Term		Definition			Term	Definition
Bingers		Crack addicts			Oolies	Marijuana laced with crack
Geeker		Crack user			Rooster	Crack
Jelly beans		Crack			Tornado	Crack
Moonrock		Crack mixed with heroin			Wicky stick	PCP, marijuana, and crack

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.

Sources of Information