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Signs of Crack Cocaine Abuse

Signs of crack cocaine abuse include dilated pupils, increased energy, and weight loss. Long-term use leads to physical and mental dangers, including addiction, anxiety, depression, heart problems, and seizures. Overdose requires immediate medical help. Professional treatment is crucial for recovery.

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What Are the Most Common Signs & Symptoms of Crack Cocaine Abuse?

Look for these signs and symptoms if you think someone you know may be abusing crack: 

Signs & SymptomsDescription
Increased Energy & AlertnessOne of the primary effects of crack is an increase in energy and alertness. This can manifest as  incessant talking, restlessness, or an inability to sit still. While these behaviors might seem harmless at first, they may be indicative of a deeper issue if they persist or intensify over time.
EuphoriaOne of the primary effects of crack is an increase in energy and alertness. This can manifest as  incessant talking, restlessness, or an inability to sit still. While these behaviors might seem harmless at first, they may be indicative of a deeper issue if they persist or intensify over time.
Dilated PupilsUsing cocaine often leads to pupil dilation due to its stimulating effects on the nervous system. This can be easily observed by checking someone’s eyes in normal lighting conditions. If their pupils appear larger than usual, it might indicate recent cocaine use.
Weight Loss & Decreased AppetiteCocaine is known to suppress appetite and increase metabolism, often leading to weight loss in habitual users. Therefore, a sudden decrease in appetite or an unexplained drop in weight may be a sign of cocaine abuse.
Changes in Behaviors, Relationships & Social CirclesIndividuals who abuse crack frequently often distance themselves from friends and family, and choose to spend time with fellow crack users instead. They may exhibit erratic mood swings and unpredictable behaviors. This makes them more prone to taking risks.
Financial DifficultiesAny drug abuse is a costly habit that leads to financial strain. If you notice someone struggling with money all of a sudden, in conjunction with some of the other signs of crack abuse, it could be an indication that they are spending their money on crack.
Physical Signs of Prolonged AbuseLong-term crack use can lead to a variety of physical symptoms, such as sallow-looking skin and continual fatigue. 

Some physical signs and symptoms will depend on the method of use. For example, people who smoke crack cocaine may have a hoarse voice, persistent cough, asthma, or respiratory infections. Those who inject crack may have track marks on their arms, scarring, and soft-tissue infections. 

Short-Term & Long-Term Signs of Crack Abuse

The intoxication symptoms we’ve described are common in anyone who abuses crack. However, some signs of crack abuse only become clear when people have been using the drug for long periods.

Short-term users may experience issues such as increased energy, weight loss, and shifts in friendships and relationships. Outsiders (like employers or friends) may not realize that drugs are the problem.

Long-term users may develop profound problems that can only be explained by drug use.

In 2010, researchers in Brazil interviewed 28 people who had used crack for an average of 11.5 years. People in this study shared challenges, such as the following:[8]

  • Frequent paranoia
  • Increased risk of physical injury
  • Risky sexual habits
  • Aggression
  • Hallucinations
  • Overdose episodes
  • Using other substances (such as alcohol or marijuana) to ease crack symptoms
  • Unemployment

What Are the Dangers of Crack?

While there are no differences pharmacologically, crack cocaine is faster acting than powdered cocaine. The high lasts for a shorter time frame with crack, and it is often described as more intense. This is because crack is normally smoked, while powdered cocaine is frequently snorted. 

Smoking produces a quicker and more intense high. Some users inject crack cocaine by making it soluble, and this produces an even more pronounced effect.

While there are many dangers to cocaine, no matter the form used, some of the dangers of crack are associated with the methods of use (snorting and injecting the drug).

Mental Dangers of Using Crack

Crack can cause serious mental harm. These are some of the associated dangers:


Crack is highly addictive due to its potent and short-lived high. This prompts users to continuously chase the euphoric feeling the drug brings, and this can quickly lead to addiction. Soon, users can become reliant on crack to function and may prioritize their drug use over other aspects of their life.

Anxiety & Paranoia

Crack use can lead to extreme anxiety, paranoia, and even panic attacks. Users may become irrationally suspicious of others or develop unfounded fears while under the influence of crack. This can cause immense psychological distress.


Prolonged crack causes changes to the brain’s reward system, leading to depressive symptoms when  not under the influence of the drug. Users may experience feelings of hopelessness, anhedonia (loss of interest in pleasurable activities), and suicidal feelings and thoughts.


Crack may cause both auditory and visual hallucinations in users, altering their perception of reality. These experiences can be distressing and may exacerbate any underlying mental health issues the user may have.

Physical Dangers of Using Crack

These are some of the physical dangers of using crack:

Heart Problems

The stimulant effects of crack can place an immense strain on the cardiovascular system, contributing to increased heart rate, high blood pressure, and even heart attacks after prolonged use. These risks are even higher for individuals with pre-existing heart conditions.

Respiratory Issues

Smoking crack damages the lungs by causing inflammation and scarring of the airways of the respiratory tract. This can lead to chronic respiratory illnesses, such as bronchitis or life-threatening lung diseases like pneumonia.

Malnutrition & Weight Loss

Crack often suppresses appetite, causing users to consume less food, which ultimately leads to malnutrition and unhealthy weight loss. This lack of nutrition further weakens one’s physical condition, making them more susceptible to illness.


Crack use can constrict blood vessels, which increases the risk of stroke. A stroke occurs when blood flow to part of the brain is blocked, potentially resulting in life-altering or fatal results.


Crack’s stimulant effects may trigger seizures, posing a significant risk for individuals with epilepsy or other seizure disorders. Even those without a pre-existing health condition may experience seizures from regular crack use.

Economic Dangers of Using Crack

These are some of the economic effects of using crack regularly:

Money Problems

Crack addiction can quickly spiral out of control. As a result, users may find themselves spending money on crack instead of paying bills, buying groceries, or taking care of other essential expenses.

Legal Troubles

In addition to the direct cost of the drug, crack use can also lead to legal troubles and financial concerns. Users may find themselves facing fines, court costs, and legal fees, all of which can quickly add up.

Job Loss & Problems Finding Work

Crack use frequently leads to job loss or difficulties in finding employment. As dependence on the drug takes hold, users may miss work, come to work under the influence, or end up getting fired. 

Long-Term Financial Difficulties

Even after quitting crack, users may face long-term financial repercussions, such as problems with getting approved for loans or renting or buying housing because of a damaged credit score due to issues related to their addiction.

Crack Cocaine Withdrawal Symptoms 

Regular crack cocaine use can result in dependence, and withdrawal symptoms may appear when use is stopped. Withdrawal symptoms may be physical or psychological.

Physical Symptoms

Physical symptoms are some of the most apparent signs that someone is experiencing withdrawal from crack cocaine. These may include the following:

  • Fatigue: As the body tries to recover from the effects of crack cocaine, individuals may experience extreme tiredness and lethargy.
  • Intense cravings: A strong desire to continue using crack cocaine is a common symptom of withdrawal.
  • Increased appetite. The user may gain weight. This compensatory response is believed to be metabolic or behavioral.
  • Muscle pain: Tense or achy muscles can be a sign that an individual is experiencing withdrawal.
  • Tremors or shakiness: This symptom often accompanies feelings of anxiety and agitation during withdrawal.

Psychological Symptoms

Withdrawal from crack cocaine can also lead to various psychological symptoms, including these:

  • Anxiety: Individuals withdrawing from crack cocaine may experience heightened stress or feelings of worry.
  • Depression: A sense of sadness or hopelessness may settle in as individuals struggle with their drug cravings and physical symptoms.
  • Irritability: Withdrawal can cause heightened emotional sensitivity, leading to irritability or emotional outbursts.
  • Insomnia or disturbed sleep patterns: Difficulty falling asleep or staying asleep can contribute to ongoing fatigue and mood disturbances.

Crack Cocaine Withdrawal Timeline

We’ve outlined the signs of crack abuse. However, you may wonder when they start, how long they last, and how they’re treated. This table may help:[10]

Time FrameSymptomsSeverityTypical Treatment
Within 24 hours of quittingDysphoria, anxiety, agitation, cravingsSevereBenzodiazepines, channel blockers
2 weeks after last useFatigue, depression, increased appetite, cravingsSevereSleep medications, benzodiazepines
Weeks 2-4 after last useFatigue, depression, limited interest in lifeModerateCounseling and antidepressants

How to Respond to a Crack Overdose

If you see someone who you think may have overdosed on crack, follow these steps. 

  • Immediately call 911. When it comes to overdose, time is of the essence, so don’t delay in making the call.
  • Don’t leave the person alone. If they are conscious, keep them talking in a calm, comfortable manner. If they are unconscious, monitor their breathing until medical professionals arrive.
  • Start CPR. If you’re trained in first aid and the person is not breathing, you may administer CPR. Ask the 911 operator how to proceed.
  • Clear the area. If the person is having seizures, try to protect their head and clear the area around them.

Crack overdose can be fatal, so it’s important to act quickly. Professional medical help is always needed.  

How to Support Someone Showing Signs of Crack Abuse

If you suspect that a friend or family member is abusing crack cocaine, you can help. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends the following steps:[9]

·   Learn. Read articles like this about how crack cocaine works and why it’s so dangerous. The more you know, the more helpful you can be.

·   Talk. Tell the person about your concerns, and remind them that you’re here to help. Discuss your own struggles with mental health if you think it might be helpful.

·   Love. Be compassionate with the person. Provide a judgment-free zone and a gentle ear.

·   Connect. Call 1-800-662-HELP for free treatment information from SAMHSA. You can get a referral to treatment from this line too.

The Importance of Treatment

If you or someone you love has been abusing crack, professional addiction treatment is needed. With comprehensive and tailored addiction care, you can stop abusing crack and all other substances. In treatment, you’ll gain skills you need to build a new life in recovery, and you’ll build a support system that can help you avoid relapse for the long term.

Profile image for Dr. Alison Tarlow
Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated May 10, 2024
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  2. Cocaine's Appetite for Fat and the Consequences on Body Weight. (March 2015). American Journal of Drug and Alcohol Abuse.
  3. Illicit Drugs: Effects on the Eye. (September 2019). Indian Journal of Medical Research.
  4. First Comes Cocaine, Then Comes Crack: Origin Stories. (October 2019). Crack.
  5. Crack-Cocaine Dependence and Aging: Effects on Working Memory. (March 2016). Revista Brasileira de Psiquiatria.
  6. Effects of Long-Term Cocaine Self-Administration on Brain Resting-State Functional Connectivity in Nonhuman Primates. (December 2020). Translational Psychiatry.
  7. Depression, Anxiety, Hopelessness and Quality of Life in Users of Cocaine/Crack in Outpatient Treatment. (January–March 2016). Trends in Psychiatry and Psychotherapy.
  8. Surviving Crack: A Qualitative Study of the Strategies and Tactics Developed by Brazilian Users to Deal with the Risks Associated with the Drug. (November 2010). BMC Public Health.
  9. Helping a Loved One Dealing with Mental and/or Substance Use Disorder. Substance Abuse and Mental Health Services Administration.
  10. Chapter 3: Medical Aspects of Stimulant Use Disorders. (2021). Treatment for Stimulant Use Disorders.
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