Crack cocaine

A pile of crack cocaine ‘rocks’

Crack cocaine is the freebase form of cocaine that can be smoked. It may also be termed rock, hard, iron, cavvy, base, or just crack; it is the most addictive form of cocaine.^[1] Crack rocks offer a short but intense high to smokers.^[2][3] Crack appeared primarily in impoverished inner-city neighborhoods in New York, Los Angeles, and Miami in late 1984 and 1985.^[4] Its rise to popularity can be attributed to the discovery that baking soda (sodium bicarbonate, NaHCO₃) was a low cost and simple replacement for the ether used in preparation of free base cocaine. The name "crack" refers to the sound generated during its manufacture and when smoked.

Appearance and characteristics

In purer forms, crack rocks appear as off-white nuggets with jagged edges,^[2] with a slightly higher density than candle wax. Purer forms of crack resemble a hard brittle plastic, in crystalline form^[2] (snaps when broken). A crack rock acts as a local anesthetic (see: cocaine), numbing the tongue or mouth only where directly placed. When smoked, crack can leave the tongue numb where the smoke enters the mouth.^{[citation needed]} Purer forms of crack will sink in water or melt at the edges when near a flame (crack vaporizes at 90 °C, 194 °F).^[1]

Crack cocaine as sold on the streets may be adulterated or "buffed" to increase bulk. According to Cpl. Kent Dahl, with Red Deer RCMP Federal Drugs, Canada, white substances mimicking the appearance of cocaine are added to increase bulk. Use of toxic adulterants such as levamisole^[5] has been documented.^[3]

Chemistry

Possible reagents and equipment needed to convert cocaine into crack

Crack cocaine, often nicknamed "crack" after the sound made during its manufacture and when smoked, appeared primarily in impoverished inner-city neighborhoods in New York, Los Angeles, and Miami in late 1984 and 1985.^[6] Because of the dangers for manufacturers of using ether to produce pure freebase cocaine, producers began to omit the step of removing the freebase precipitate from the ammonia mixture. Typically, filtration processes are also omitted. The end result is that the cut, in addition to the ammonium salt (NH₄Cl), remains in the freebase cocaine after the mixture has evaporated. The "rock" that is thus formed also contains a small amount of water.^{[original research?]}

Crack being made in a spoon

Sodium bicarbonate (NaHCO₃, common baking soda) is a base used in preparation of crack, although other weak bases may substitute for it. The net reaction when using sodium bicarbonate is

Coc-H⁺Cl⁻ + NaHCO₃ → Coc + H₂O + CO₂ + NaCl

With Ammonium bicarbonate:

Coc-H⁺Cl⁻ + NH₄HCO₃ → Coc + NH₄Cl + CO₂ + H₂O

With Ammonium carbonate:

2(Coc-H⁺Cl⁻) + (NH₄)₂CO₃ → 2 Coc + 2 NH₄Cl + CO₂ + H₂O

Crack cocaine is usually purchased already in rock form,^[2] although it is not uncommon for some users to "wash up" or "cook" the cocaine into crack themselves. This process is done with baking soda (sodium bicarbonate), water, and a spoon. Once mixed and heated, the bicarbonate breaks down into carbon dioxide and sodium carbonate, which then reacts with the hydrochloride of the cocaine molecule, leaving cocaine as an oily free base. Once separated from the hydrochloride, the cocaine alkaloid floats to the top of the now leftover liquid. It is at this point that the oil is picked up rapidly, usually with a pin or long thin object. This pulls the oil up and spins it, allowing air to set and dry the oil, and allows the user and/or maker to roll the oil into the rock-like shape.

Crack vaporizes near temperature 90 °C (194 °F),^[1] much lower than the cocaine hydrochloride melting point of 190 °C (374 °F).^[1] Whereas cocaine hydrochloride cannot be smoked (burns with no effect),^[1] crack cocaine when smoked allows for quick absorption into the blood stream, and reaches the brain in 8 seconds.^[1] Users obtain an intense high much more quickly thusly than with the normal method of insufflating^{[citation needed]} ("sniffing" or "snorting") powder cocaine. Crack cocaine can also be injected intravenously with the same effect as powder cocaine. However, whereas powder cocaine dissolves in water, crack must be dissolved in an acidic solution such as lemon juice or white vinegar.

Psychological effects

Crack cocaine is a substance that affects the brain chemistry of the user: causing euphoria,^[7] supreme confidence,^[8] loss of appetite,^[7] insomnia,^[7] alertness,^[7] increased energy,^[7] a craving for more cocaine,^[8] and potential paranoia (ending after use).^[7][9] Its initial effect is to release a large amount of dopamine,^[2] a brain chemical inducing feelings of euphoria. The high usually lasts from 5–10 minutes,^[2][7] after which time dopamine levels in the brain plummet, leaving the user feeling depressed and low.^[2] When cocaine is dissolved and injected, the absorption into the bloodstream is at least as rapid as the absorption of the drug which occurs when crack cocaine is smoked,^[7] and similar euphoria may be experienced.

A typical response among users is to have another hit of the drug; however, the levels of dopamine in the brain take a long time to replenish themselves, and each hit taken in rapid succession leads to progressively less intense highs.^[2] However, a person might binge for 3 or more days without sleep, while partying with hits from the pipe.^[9]

Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high doses, leads to a state of increasing irritability, restlessness, and paranoia.^[7] This may result in a full-blown paranoid psychosis, in which the individual loses touch with reality and experiences auditory hallucinations.^[7]

Stimulant drug abuse (particularly amphetamine and cocaine) can lead to delusional parasitosis (aka Ekbom's Syndrome: a mistaken belief they are infested with parasites).^[10] For example, excessive cocaine use can lead to formication, nicknamed "cocaine bugs" or "coke bugs," where the affected people believe they have, or feel, parasites crawling under their skin.^[10] (Similar delusions may also be associated with high fever or in connection with alcohol withdrawal, sometimes accompanied by visual hallucinations of insects.)^[10]

People experiencing these hallucinations might scratch themselves to the extent of serious skin damage and bleeding, especially when they are delirious.^[9][10]

Physiological effects

Main physiological effects of Crack cocaine.

The short-term physiological effects of cocaine include^[7] constricted blood vessels, dilated pupils, and increased temperature, heart rate, and blood pressure. Large amounts (several hundred milligrams or more) intensify the user's high, but may also lead to bizarre, erratic, and violent behavior.^[7] Large amounts can induce tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction closely resembling amphetamine poisoning.^[7] Some users of cocaine report feelings of restlessness, irritability, and anxiety. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter.^[7] Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.

An appreciable tolerance to cocaine’s high may develop, with many addicts reporting that they seek but fail to achieve as much pleasure as they did from their first experience.^[7] Some users will frequently increase their doses to intensify and prolong the euphoric effects. While tolerance to the high can occur, users might also become more sensitive (sensitization) to cocaine's anesthetic and convulsant effects, without increasing the dose taken: this increased sensitivity may explain some deaths occurring after apparently low doses of cocaine.^[7]

Addiction

Main article: Substance dependence

Crack cocaine is popularly thought to be the most addictive form of cocaine,^[1] and one of the most addictive forms of any drug.^[1] However, this claim has been contested: Morgan and Zimmer wrote that available data indicated that "...smoking cocaine by itself does not increase markedly the likelihood of dependence.... The claim that cocaine is much more addictive when smoked must be reexamined."^[11] They argued that cocaine users who are already prone to abuse are most likely to "move toward a more efficient mode of ingestion" (that is, smoking).

The intense desire to recapture the initial high is what is so addictive for many users.^[2] On the other hand, Reinarman et al. wrote that the nature of crack addiction depends on the social context in which it is used and the psychological characteristics of users, pointing out that many heavy crack users go for days or weeks without using the drugs.^[12]

Health issues

Smoking crack cocaine

Because crack also refers to non-pure (or fake) versions of rock cocaine,^[3] the health issues also include risks beyond smoking cocaine. However, crack usage is less dangerous than speedballing or "snowballing" (mixing cocaine with heroin), which can lead to more fatalities than either drug used on its own.

When large amounts of dopamine are released by crack consumption, it becomes easier for the brain to generate motivation for other activities. The activity also releases a large amount of adrenaline into the body, which tends to increase heart rate^[13] and blood pressure, leading to long-term cardiovascular problems. It is suggested by research that smoking crack or freebase cocaine has additional health issues beyond other methods of taking cocaine. Many of these issues relate specifically to the release of methylecgonidine, and the specific effect of methylecgonidine on the heart,^[13] lungs,^[14] and liver.^[15]

• Toxic adulterants: As noted previously, virtually any substance may have been added in order to expand the volume of a batch, or appear to be pure crack. Occasionally, highly toxic substances are used, with an indefinite range of corresponding short and long-term health risks. For example, if candle wax or macadamia are procured (as a form of fake crack) they will burn in a crack pipe producing a noxious smoke.

• Smoking problems: The task of introducing the drug into the body further presents a series of health risks. Crack cannot be snorted like regular cocaine, so smoking is the most common consumption method. Crack has a melting point of around 90 °C (194 °F),^[1] and the smoke does not remain potent for long. Therefore, crack pipes are generally very short, to minimise the time between evaporating and losing strength. This often causes cracked and blistered lips, colloquially "crack lip", from having a very hot pipe pressed against the lips. The use of "convenience store crack pipes"^[16] - glass tubes which originally contained small artificial roses - may also create this condition. These 4-inch (10-cm) pipes^[16] are not durable and will quickly develop breaks; users will typically continue to use the pipe even though it has been broken to a shorter length. The hot pipe might burn the lips, tongue, or fingers, especially when shared with other people quickly taking another hit from the already hot short pipe.

• Pure or large doses: Because the quality of crack can vary greatly, some people might smoke larger amounts of diluted crack, unaware that a similar hit of a new batch of purer crack could cause an overdose: triggering heart problems or rendering the user unconscious.

• Pathogens on pipes: When pipes are shared, unless users rotate and push the pipe to the burnt, sterilized end, any bacteria or viruses from the previous user's mouth can be transferred: tuberculosis can be spread by saliva. In terms of harm reduction, mouth pieces (lengths of tubing added to the end of the glass pipe) should be used and not shared.

• Pathogens in needles/spoons: When crack is cooked down, as in a spoon with vinegar or lemon juice, for injecting with a syringe, diseases can be spread. Blood-borne disease such as HIV can be passed through a shared needle (or shared spoon if the needle is emptied into the spoon). From a harm reduction perspective, clean injection equipment should always be used and never shared. Ascorbic acid is safer for use than vinegar.

As a comparison, studies have shown that long-term insufflation (snorting) of cocaine in powder form can, after extensive use, destroy tissues in the nasal cavity,^[17] and has been known to create deviated septa, potentially collapsing the nose.^[17]

• Addiction is widely considered a health issue. Many governments have made access to clean equipment and education regarding safer practices difficult, as the use of cocaine is illegal.

Effects in pregnancy and nursing

Main article: Prenatal cocaine exposure

"Crack baby" is a term for a child born to a mother who used crack cocaine during her pregnancy. The notion that cocaine use during pregnancy poses a threat to the fetus is now widely discredited.^[18] Studies show that prenatal cocaine exposure (independent of other effects such as, for example, alcohol, tobacco, or physical environment) has no appreciable effect on childhood growth and development.^[19] However, the official opinion of the National Institute on Drug Abuse of the United States warns about health risks while cautioning against stereotyping:

Many recall that "crack babies," or babies born to mothers who used crack cocaine while pregnant, were at one time written off by many as a lost generation. They were predicted to suffer from severe, irreversible damage, including reduced intelligence and social skills. It was later found that this was a gross exaggeration. However, the fact that most of these children appear normal should not be overinterpreted as indicating that there is no cause for concern. Using sophisticated technologies, scientists are now finding that exposure to cocaine during fetal development may lead to subtle, yet significant, later deficits in some children, including deficits in some aspects of cognitive performance, information-processing, and attention to tasks—abilities that are important for success in school.^[20]

Some people previously believed that crack cocaine caused infant death as SIDS, but when investigators began looking at the incidence of SIDS in the children of women who used crack cocaine, they found it to be no higher than in children of women who smoked cigarettes.^[21]

There are also warnings about the threat of breastfeeding: "It is likely that cocaine will reach the baby through breast milk." The March of Dimes advises the following regarding cocaine use during pregnancy:

Cocaine use during pregnancy can affect a pregnant woman and her unborn baby in many ways. During the early months of pregnancy, it may increase the risk of miscarriage. Later in pregnancy, it can trigger preterm labor (labor that occurs before 37 weeks of pregnancy) or cause the baby to grow poorly. As a result, cocaine-exposed babies are more likely than unexposed babies to be born with low birthweight (less than 5.5 lb/2.5 kg). Low-birthweight babies are 20 times more likely to die in their first month of life than normal-weight babies, and face an increased risk of lifelong disabilities such as mental retardation and cerebral palsy. Cocaine-exposed babies also tend to have smaller heads, which generally reflect smaller brains. Some studies suggest that cocaine-exposed babies are at increased risk of birth defects, including urinary-tract defects and, possibly, heart defects. Cocaine also may cause an unborn baby to have a stroke, irreversible brain damage, or a heart attack.^[22]

Legal status

Canada

As a Schedule I substance, crack is not differentiated from cocaine and other coca products in the Criminal Code of Canada. However, the court may weigh the socio-economic factors of crack usage in sentencing. As a guideline, Schedule I drugs carry a maximum 7 year prison sentence for possession for an indictable offense, up to life imprisonment for trafficking and production. A summary conviction on possession carries a $1000–$2000 fine and/or 6 months to a year imprisonment.

United States

Cocaine is listed as a Schedule I drug in the United Nations 1961 Single Convention on Narcotic Drugs, making it illegal for non-state-sanctioned production, manufacture, export, import, distribution, trade, use and possession.^[23][24]

In the United States cocaine is a Schedule II drug under the Controlled Substances Act since it has high abuse potential but also carries a medicinal purpose.^[25][26] Under the DEA listing of schedule I substances, crack is not considered separate from cocaine since they are essentially the same drug compound in different forms.

There has been some controversy over the disproportionate sentences mandated by the Federal Sentencing Guidelines for crack cocaine (versus powder cocaine) since 1986. Whereas there was a 5-year minimum sentence for trafficking 500g of powdered cocaine, the same sentence could be imposed for mere possession of 5 grams of crack cocaine, a 100:1 ratio. There is no mandatory minimum sentence for mere possession of powder cocaine.^{[27][Need quotation to verify]} The United States Sentencing Commission long recommended that this disparity be rectified and existing sentences reduced.^[28] Some claim that this disparity amounts to institutional racism, as crack cocaine is more common in inner-city black communities, and powder cocaine in white suburban communities.^[29][30] The Supreme Court ruled in Kimbrough v. United States (2007) that the Guidelines for cocaine are advisory only, and that a judge may consider the disparity between the Guidelines' treatment of crack and powder cocaine offenses when sentencing a defendant. The Fair Sentencing Act reduced the disparity between United States federal criminal penalties for crack cocaine and powder cocaine offenses from a 100:1 ratio to an 18:1 ratio (based on the number of grams of cocaine in possession) and eliminated the five-year mandatory minimum sentence for simple possession of crack cocaine, among other provisions.^[31]

Europe

In the United Kingdom crack is a Class A drug. In the Netherlands it is a List 1 drug of the Opium Law.

See also

• CIA and Contras cocaine trafficking in the US
• Cocaine paste ("paco")
• Crack epidemic
• Oxi, a similar drug made from cocaine paste
• Related numbing (analgesic) medicines: proparacaine, tetracaine, lidocaine, procaine, hexylcaine, bupivacaine, benoxinate, mepivacaine, prilocaine, etidocaine, benzocaine, chloroprocaine, propoxycaine, dyclonine, dibucaine, and pramoxine.
• Substance abuse
• War on Drugs

References

1. ^ ^{a b c d e f g h i} Manual of Adolescent Substance Abuse Treatment, Todd Wilk Estroff, M.D., 2001 (306 pages), pp. 44-45, (describes cocaine/crack processing & melting points): p.44 has "cannot be smoked because...melting point of 190°C"; p.45 has "It is the most addictive form of cocaine", webpage: Google Books.
2. ^ ^{a b c d e f g h i} A.M. Costa Rica, July 2008, Crack rocks offer a short but intense high to smokers.
3. ^ ^{a b c} Stacy O'Brien, Red Deer Advocate, December 2008, Officials warn of life-threatening cocaine in area.
4. ^ Reinarman, Craig; Levine, Harry G. (1997). "Crack in Context: America's Latest Demon Drug". In Reinarman, Craig; Levine, Harry G.. Crack in America: Demon Drugs and Social Justice. Berkeley, CA.: University of California Press. 
5. ^ Kinzie, Erik (April 2009). "Levamisole Found in Patients Using Cocaine". Annals of Emergency Medicine 53 (4). http://www.mdconsult.com/das/article/body/154945316-2/jorg=journal&source=&sp=21877276&sid=0/N/691072/1.html?issn=01960644. Retrieved 2009-08-18. 
6. ^ Reinarman, Craig; Levine, Harry G. (1997). "Crack in Context: America's Latest Demon Drug". In Reinarman, Craig; Levine, Harry G.. Crack in America: Demon Drugs and Social Justice. Berkeley, Ca.: University of California Press. 
7. ^ ^{a b c d e f g h i j k l m n o p} "DEA, Drug Information, Cocaine", United States DOJ Drug Enforcement Agency, 2008, webpage: DEA-cocaine.
8. ^ ^{a b} White Mischief: A Cultural History of Cocaine, Tim Madge, 2004, ISBN 1560253703, Google Books link: books-google-PT18.
9. ^ ^{a b c} "Life or Meth - CRACK OF THE 90'S", Salt Lake City Police Department, Utah, 2008, PDF file: Methlife-PDF.
10. ^ ^{a b c d} "Delusional Parasitosis", The Bohart Museum of Entomology, 2005, webpage: UCDavis-delusional.
11. ^ Morgan, John P.; Zimmer, Lynn (1997). "Social Pharmacology of Smokeable Cocaine". In Reinarman, Craig; Levine, Harry G.. Crack in America: Demon Drugs and Social Justice. Berkeley, Ca.: University of California Press. 
12. ^ Reinarman, Craig; Waldorf, Dan; Murphy, Sheigla B.; Levine, Harry G. (1997). "The Contingent Call of the Pipe: Bingeing and Addiction Among Heavy Cocaine Smokers". In Reinarman, Craig; Levine, Harry G.. Crack in America: Demon Drugs and Social Justice. Berkeley, Ca.: University of California Press. 
13. ^ ^{a b} Scheidweiler KB, Plessinger MA, Shojaie J, Wood RW, Kwong TC (2003). "Pharmacokinetics and pharmacodynamics of methylecgonidine, a crack cocaine pyrolyzate". J. Pharmacol. Exp. Ther. 307 (3): 1179–87. doi:10.1124/jpet.103.055434. PMID 14561847. http://jpet.aspetjournals.org/cgi/pmidlookup?view=long&pmid=14561847. Retrieved 2008-02-24. 
14. ^ Yang Y, Ke Q, Cai J, Xiao YF, Morgan JP (2001). "Evidence for cocaine and methylecgonidine stimulation of M(2) muscarinic receptors in cultured human embryonic lung cells". Br. J. Pharmacol. 132 (2): 451–60. doi:10.1038/sj.bjp.0703819. PMC 1572570. PMID 11159694. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1572570. Retrieved 2008-02-24. 
15. ^ Fandiño AS, Toennes SW, Kauert GF (2002). "Studies on hydrolytic and oxidative metabolic pathways of anhydroecgonine methyl ester (methylecgonidine) using microsomal preparations from rat organs". Chem. Res. Toxicol. 15 (12): 1543–8. doi:10.1021/tx0255828. PMID 12482236. 
16. ^ ^{a b} "A Rose With Another Name: Crack Pipe", Allan Lengel, The Washington Post, April 5, 2006, webpage: highbeam-576: states "four-inch-long tube that holds the flower" and "Convenience stores, liquor stores and gas stations...sell what the street calls 'rosebuds' or 'stems' for $1 to $2".
17. ^ ^{a b} Kaplan & Sadock's Synopsis of Psychiatry: Behavioral, Benjamin J. Sadock, Harold I. Kaplan, 2007, page 426, Google-Books webpage: books-google-KS426.
18. ^ Okie, Susan (2009-01-27). "The Epidemic That Wasn't". The New York Times. http://www.nytimes.com/2009/01/27/health/27coca.html. 
19. ^ "Growth, Development, and Behavior in Early Childhood Following Prenatal Cocaine Exposure, Frank et al. 285 (12): 1613 — JAMA". Jama.ama-assn.org. 2001-03-28. http://jama.ama-assn.org/cgi/content/abstract/285/12/1613. Retrieved 2010-12-22. 
20. ^ NIDA - Research Report Series - Cocaine Abuse and Addiction^{[dead link]}
21. ^ "Preventing Poisoned Minds", Dennis Meredith, Duke Magazine, July/August 2007, webpage: DM-17.
22. ^ "Illicit Drug Use During Pregnancy". March of Dimes. http://www.marchofdimes.com/professionals/14332_1169.asp. Retrieved 2009-05-26. 
23. ^ "Cocaine and Crack". European Monitoring Centre for Drugs and Drug Addiction. http://www.emcdda.europa.eu/?nnodeid=25482#control. Retrieved 2008-05-01. 
24. ^ "Single Convention on Narcotic Drugs, 1961". International Narcotics Control Board. http://www.incb.org/pdf/e/conv/convention_1961_en.pdf. Retrieved 2008-05-01. 
25. ^ "DEA, Title 21, Section 812". Usdoj.gov. Archived from the original on 2008-08-22. http://web.archive.org/web/20080822024838/http://www.usdoj.gov/dea/pubs/csa/812.htm#a. Retrieved 2008-09-05. 
26. ^ 21 U.S.C. § 812(b)(2) Retrieved on 2008-05-01.
27. ^ Sabet, Kevin A. Making it Happen: The Case for Compromise in the Federal Cocaine Law Debate
28. ^ U.S. Sentencing Commission, U.S. Sentencing Commission Votes To Amend Guidelines For Terrorism, Firearms, And Steroids, news release, April 27, 2007.
29. ^ Lynn Eberhardt, Jennifer; Fiske, Susan T. (1998). Confronting racism: the problem and the response. Thousand Oaks, Calif.: Sage Publications. ISBN 0-7619-0368-2. 
30. ^ Angeli, David H. (1997). "A "Second Look" at Crack Cocaine Sentencing Policies: One More Try for Federal Equal Protection". American Criminal Law Review 34. http://www.questia.com/googleScholar.qst;jsessionid=LQBFZ08JvHdpqlv2dbzdB9z5knzfJlp1drLDyXLWnGSs2sTPKLdt!-368423529?docId=5000470681. Retrieved 2008-04-12. 
31. ^ "Fair Sentencing Act of 2010", Families Against Mandatory Minimums, famm.org. Retrieved September 30, 2010.

Further reading

• Cooper, Edith Fairman, The emergence of crack cocaine abuse, Nova Publishers, 2002

External links

• Frank Parlato's interview with two 19-year old crack dealers
• (US) Why is crack cocaine so hard to stop using?
• Crackpot Ideas - July/August 1995 issue of Mother Jones.
• US: The Myth of the 'Crack Baby'
• The rising peril of crack cocaine (UK)
• Top Medical Doctors and Scientists Urge Major Media Outlets to Stop Perpetuating "Crack Baby" Myth - a petition.