Crack is back in the news with Lamar Odom. Smoking cocaine (“freebase” or “crack”) is now the most common method of cocaine abuse. Those of us in medicine are never surprised to hear continued struggles with crack as we are all too familiar with that devil. Here are things that will shock you about crack.
1. It is the illegal drug most often associated with emergency department visits in the US.
2. One in six persons who use cocaine will develop dependence or a moderate to severe cocaine use disorder.
3. Cocaine use is most prevalent in urban men aged 15 to 35 years.
4. Abuse is greater with smoked cocaine (crack) compared to intranasal cocaine.
5. Cocaine base has a low melting point, which is why it is easily smoked.
6. Use of alcohol with cocaine may cause more severe and longer lasting toxic effects.
7. Toxicity can occur without heavy use. There is poor correlation between cocaine plasma concentrations and toxicity. Use it even once, in moderation, and you can get into trouble. I’ve seen this.
8. Drug testing detects cocaine two to four days after the last cocaine use, although this can be up to 14 days after heavy, prolonged use.
9. Seizures, heart failure, stroke, dead (ischemic) bowel leading to resection of your colon, psychosis that doesn’t resolve, fibrotic lungs with emphysema are among the few things I’ve seen more than once in our patients smoking crack.
10. There is no “treatment” for withdrawal from crack cocaine. Depression, anxiety, cocaine craving, and increased sleep are the most common symptoms which usually resolve within one to two weeks.
Crack. Just say no.
- Dr. O
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