Crack addiction occurs when repeated use of crack cocaine leads to physical and psychological dependence. Crack cocaine is a highly addictive stimulant made by processing powdered cocaine with baking soda or ammonia. Crack appears as small, off-white, or yellowish rocks, delivering a rapid and intense high. As of 2023, approximately 9.9 million people in the United States reported having used crack at some point in their lifetime, according to Statista’s report, “Number of People in the U.S. Who Used Crack in the Past Month from 2009 to 2023.”

The symptoms of crack addiction include intense cravings, inability to stop using, neglecting responsibilities, financial struggles, and physical health problems. These signs reflect the compulsive nature of the addiction. The United States Department of Justice reveals that approximately 6.2 million U.S. residents aged 12 and older have used crack at least once in their lifetime as conducted by the National Household Survey on Drug Abuse.

The causes of crack addiction are biological factors such as genetics, psychological factors like trauma, social and environmental influences such as peer pressure, and co-occurring mental health disorders that amplify vulnerability. Crack cocaine use is a major concern among high school students. Nearly 4% of high school seniors in the United States have used the drug at least once in their lifetime, with over 1% recounting use within the past month, as reported by the University of Michigan’s Monitoring the Future Survey.

The effects of crack addiction are cardiovascular issues, lung damage, neurological problems, and cognitive impairments. Long-term utilization of crack generates irreversible physical and mental health problems. Cocaine ranks as the second most common drug implicated in unintentional drug poisoning deaths and is the leading substance cited in drug-related emergency department (ED) visits. In 2011, nearly 80,000 drug-related ED visits occurred in New York City (960 per 100,000 residents), with cocaine accounting for over a third of these cases (27,752 visits or 336.6 per 100,000 residents), as referred to by the New York City Department of Health and Mental Hygiene (2015).

Withdrawal symptoms of crack addiction are depression, fatigue, insomnia, vivid dreams, restlessness, and increased appetite. These symptoms are physically and emotionally distressing, making recovery challenging. A study of 284 women in a 3-week detox program for Cocaine Use Disorder (CUD) used machine learning to classify severe withdrawal symptoms with 70% accuracy. Key predictors comprised psychiatric, family, and social problem severity, childhood maltreatment, drug-use behaviors (e.g., cravings and days using drugs in the prior month), addiction severity, and initial withdrawal severity. These factors aid clinicians in identifying high-risk patients, as analyzed by Heberle et al. 2024 in “Examining Predictors of Cocaine Withdrawal Syndrome at the End of Detoxification Treatment in Women with Cocaine Use Disorder.”

Treatment for crack addiction involves detoxification to remove the drug from the body, medication-assisted treatment to manage symptoms, behavioral therapies like CBT to address underlying issues, and support groups for ongoing recovery support. A five-year follow-up of 131 crack cocaine users treated in São Paulo found that 39.7% (n=52) achieved at least one year of abstinence, while 21.4% (n=28) continued drug use. Of those abstinent at 2 years, 62% (n=19) remained abstinent at 5 years. Mortality was high, with 17.6% (n=23) deceased, mostly from homicide (n=13). The annual adjusted mortality rate was 24.92 deaths/1,000 individuals, with an excess mortality rate of 21.64 and a standardized mortality ratio of 7.60. Risk factors for mortality included injecting drug use, unemployment, and administrative discharge, as observed by Ribeiro et al., 2007 in “Crack Cocaine: A Five-Year Follow-up Study of Treated Patients.”

What Is Crack Addiction?

Crack addiction is the compulsive use of crack cocaine, a highly addictive and potent form of cocaine that is smoked to produce an intense and immediate high. The addiction is driven by the drug’s ability to rapidly stimulate the brain’s reward system, causing a cycle of euphoria followed by intense cravings. 

With time, crack addiction presents physical and psychological dependence, characterized by tolerance, withdrawal symptoms, and a persistent inability to control use despite harmful consequences. Crack cocaine’s effects are short-lived, lasting only 5 to 10 minutes, which prompts repeated use and elevates the risk of addiction.

The North Carolina Department of Health and Human Services revealed that in 2020, an average of 9 residents in the state lost their lives to drug overdoses each day, marking a 40% rise from the previous year. The department goes on to say that over 60% of overdose deaths concerned multiple substances, with a notable uptick in the presence of stimulants such as cocaine and methamphetamine.

Cocaine, particularly crack cocaine, remains one of the most widely abused substances in North Carolina. The state’s cocaine abuse rate closely mirrored the national average. As per the 1999 National Household Survey on Drug Abuse (NHSDA), 1.9% of North Carolina residents recounted using cocaine within the past year, compared to the national rate of 1.7%, as detailed by the National Drug Intelligence Center in “North Carolina Drug Threat Assessment.”

Cocaine-related treatment admissions in North Carolina saw a 21% rise, rising from 14,848 in FY1996 to 17,935 in FY1999. During those years, these admissions outnumbered those for any other illicit drug, as made out by the North Carolina Department of Health and Human Services. Nearly all cocaine-related admissions were linked to crack cocaine. Treatment counselors emphasized that crack was not only vastly misused but also relatively affordable and exceptionally addictive, contributing to its persistent prevalence in the state.

What Is Crack?

Crack is a potent, smokable form of cocaine derived by processing powdered cocaine (cocaine hydrochloride) with water and baking soda (sodium bicarbonate) or ammonia. This process produces solid crystals or “rocks” that are off-white to light brown. Crack is most frequently smoked, allowing the drug to enter the bloodstream rapidly and create an intense but short-lived high. Crack appears as small, jagged chunks or pebble-like pieces, making it easily distinguishable from powdered cocaine.

The name “crack” originates from the crackling sound it produces when smoked. Crack cocaine differed from powder cocaine in being simpler to manufacture, more affordable to bring to form, and cheaper to purchase, making it accessible to a wider audience. Crack was sold for $5 to $20 per vial, a small capsule containing pebble-sized pieces of crack equivalent to about one-tenth of a gram of powdered cocaine. Known for its rapid and powerful high, crack cocaine triggered intense cravings, exacerbating a sharp rise in addictions. Between 1982 and 1985, the number of cocaine users surged by 1.6 million, as mentioned by the Encyclopaedia Britannica (2024).

Why Is Crack so Addictive?

Crack is highly addictive due to its rapid and intense effect on the brain’s reward system. When smoked, crack cocaine delivers a powerful dose of dopamine, a neurotransmitter associated with pleasure and reward. This surge creates an almost immediate euphoric high, leaving users craving more to sustain the feeling. The drug’s short-lived effects aggravate repeated use in a short period, accelerating the risk of acquiring an addiction.

Crack alters the brain’s chemistry by overstimulating dopamine receptors, causing long-term changes that make users dependent on the drug to experience pleasure or even feel normal.

Certain genes related to stress and brain health influence crack cocaine addiction and levels of brain-derived neurotrophic factor (BDNF), a protein essential for brain function. A study involving 280 individuals addicted to crack cocaine and 241 non-addicted individuals found that those with addiction had lower BDNF levels. Specific single nucleotide polymorphisms (SNPs) in the nuclear receptor subfamily 3 group C member 1 (NR3C1) and corticotropin-releasing hormone receptor 1 (CRHR1) genes affected BDNF levels only in non-addicted individuals, suggesting crack cocaine reduces this effect. These findings highlight the impact of addiction on brain health as mentioned by Rovaris et al. 2017 in “Effects of Crack Cocaine Addiction and Stress-related Genes on Peripheral BDNF Levels.”

What Are the Signs of Crack Cocaine Addiction?

The signs of crack addiction are intense cravings, compulsive use, neglect of responsibilities, and withdrawal symptoms. These behaviors disrupt daily life, relationships, and health, aligning with the criteria outlined in the DSM-5.

The signs of crack addiction are given below:

• Strong cravings for crack cocaine: Individuals experience an overwhelming desire to use crack attributable to its fast-acting effects, leading to compulsive drug-seeking behavior.
• Loss of control over use: Crack users find it nearly impossible to regulate their intake because the drug’s intense high reinforces repeated use.
• Neglect of responsibilities: Work, school, and family obligations are abandoned as crack use becomes the primary focus of the individual’s life.
• Increased tolerance: The body adapts to crack’s effects, requiring larger quantities to achieve the same euphoric feeling.
• Withdrawal symptoms: When crack use stops, users experience depression, anxiety, irritability, and fatigue, pushing them to seek the drug again.
• Risky behavior: Crack use lowers inhibitions, prompting actions like unprotected sex, driving under the influence, or illegal activities to obtain the drug.
• Continued use despite harm: Users persist with crack despite grave physical and mental health issues, financial troubles, or fractured relationships.
• Isolation: Crack addiction encourages withdrawing from loved ones and social circles to avoid judgment or focus solely on using.
• Spending excessive time using or recovering: Individuals devote hours to getting, using, or recovering from crack’s effects, leaving little time for other activities.
• Physical health decline: Crack’s impact on the body causes rapid weight loss, chronic respiratory issues, and signs of malnutrition.

What Are the Effects of Crack Addiction?

The effects of crack cocaine addiction are increased body temperature, high blood pressure, racing heart,  headaches, nausea, asthma exacerbation, lung damage, worsened asthma, lung damage, respiratory infections, cardiovascular issues, such as heart disease and arrhythmias, neurological problems, such as seizures, as well as cognitive impairments, affecting memory and decision-making.

The short-term and long-term effects are given below:

Short-term Effects of Crack Addiction

The short-term effects of crack addiction are listed below:

• Constricted blood vessels: Crack tightens the blood vessels, minimizing blood flow and provoking cardiovascular issues.
• Dilated pupils: Crack stimulates the nervous system, making pupils enlarge as part of the body’s response to the drug.
• Increased body temperature, heart rate, and blood pressure: Crack triggers the release of adrenaline with a rise in heart rate, blood pressure, and body temperature, which stresses the cardiovascular system.
• Bizarre, erratic, and violent behavior: The stimulant effects of crack alter mood and behavior, resulting in unpredictable and aggressive actions.
• Tremors: Crack use overstimulates the nervous system inducing muscle tremors or uncontrollable shaking.
• Vertigo: Crack interferes with the body’s balance system, contributing to dizziness or the spinning sensation.
• Muscle twitches: The drug’s impact on the nervous system educes involuntary muscle movements.
• Paranoia: Crack use elicits extreme fear and suspicion, as it sparks chemical misproportion in the brain.
• Headache: The stimulant effects of crack generate a headache owing to the strain on the body’s systems.
• Abdominal pain: Crack irritates the stomach and digestive system, breeding discomfort or pain in the abdomen.
• Nausea: The body’s reaction to crack upsets the digestive system, precipitating nausea and vomiting.
• Restlessness: Crack’s stimulating effects prevent users from feeling calm, hence physical and mental agitation.
• Panic attacks: Crack induces a heightened state of anxiety, leading to panic attacks characterized by overwhelming fear.
• Psychosis: Crack impairs brain function, spawning hallucinations, delusions, and a break from reality.
• Seizures: The overstimulation of the brain and nervous system from crack use evokes convulsions.
• Heart rhythm problems: Crack affects the electrical signals in the heart, bringing about irregular heartbeats.
• Heart attack: Crac strains the cardiovascular system, escalating the risk of a heart attack attributable to heightened blood pressure and constricted arteries.
• Stroke: Crack elevates blood pressure and constricts blood vessels, growing the peril of a stroke.
• Coma: In extreme cases, crack overdose or prolonged use causes brain damage, leading to a coma.

Long-term Effects of Crack Addiction

The long-term effects of crack addiction are listed below:

• Lung damage: Crack smoke abrades the lungs, hence long-standing damage with respiratory failure over time.
• Worsened asthma: The harsh chemicals in crack exacerbate asthma symptoms, making it more difficult to breathe and multiplying the frequency of attacks.
• Cough: Chronic crack intake breeds a persistent cough ascribed to fretting in the lungs and airways.
• Blackened sputum (mucus): The accumulation of tar and other harmful substances in the lungs brings on a dark, thick mucus when coughing, a sign of severe lung damage.
• Chest pain: Crack use substantially strains the heart and lungs, leading to chest pain, especially during exertion or respiratory distress.
• Reduced lung function: The long-term effects of crack destroy lung tissues, diminishing the ability to effectively breathe and process oxygen.
• Impaired ability to force air out: Crack harms the muscles and tissues in the lungs, impeding the body’s ability to expel air, occasioning labored breathing.
• Abnormal collection of gas between the lungs and chest wall: Crack use builds up air between the lungs and chest wall, a dangerous condition called pneumothorax.
• Air present between the two lungs in the chest: This condition, known as a bilateral pneumothorax, comes from crack-induced damage to the lungs and has life-threatening complications.
• Muscle necrosis (severe tissue infection): Prolonged crack usage restricts blood flow with the onset of serious infections and muscle tissue death (necrosis).
• Neurological problems such as seizures and brain hemorrhages: The drug’s stimulant effects impose long-term brain damage,  seizures, strokes, and brain hemorrhages due to the strain on the nervous system.

What Are the Causes of Crack Addiction?

The causes of crack cocaine addiction are biological, psychological, social and environmental factors, and co-occurring mental health disorders.

The common causes of crack cocaine addiction include:

• Biological Factors: Individuals have a genetic predisposition that makes them more likely to become addicted to substances like crack cocaine. The brain’s reward system becomes overstimulated by crack use, setting off cravings, and compulsive behavior. Research from the University of Utah’s Genetic Science Learning Center, as outlined in “Genes Affect Your Risk for Addiction,” estimates that genetic factors contribute to 40-60% of an individual’s susceptibility to addiction, spotlighting the familial transmission of risk factors.
• Psychological Factors: Many people use crack cocaine as a form of self-medication to cope with stress, trauma, or unresolved emotional issues. Psychological factors such as depression, anxiety, or a history of abuse make individuals more vulnerable to addiction. 

Family conflict, maltreatment, deviant behaviors, and easy access to drugs are major predictors of early crack-cocaine use. A study of 577 patients in Southern Brazil found that parental monitoring delayed initiation, while exposure to violence and drug accessibility accelerated it. These findings emphasize the need for targeted prevention and intervention strategies, as observed in “Factors Associated with Crack-cocaine Early Initiation: A Brazilian Multicenter Study” by Perrenoud et al. 2021.

• Social and Environmental Factors: Growing up in an environment where drug use is prevalent or experiencing peer pressure contributes to the development of addiction. Lack of social support, poverty, or exposure to drug use during childhood increases the likelihood of addiction.
• Co-occurring Mental Health Disorders: People with mental health disorders such as anxiety, depression, or PTSD are more prone to developing a substance use disorder, as they turn to crack cocaine to alleviate symptoms of these conditions. These co-occurring disorders make it more difficult to treat addiction effectively.

Crack-cocaine dependence strongly correlates with mental disorders, especially when combined with polysubstance abuse. Among 885 patients, most were male (80.3%), unemployed (52%), and daily drug users (56.4%), highlighting the need for integrated public health policies, as shown in the study “Main Mental Disorders in Crack-Cocaine Users Treated at Psychosocial Care Centers for Alcohol and Drugs in the City of Recife, Brazil” by Neto et al. 2016.

What Are the Withdrawal Symptoms of Crack Addiction?

The withdrawal symptoms are depression, fatigue, increased appetite, insomnia, vivid unpleasant dreams, slowed thinking and movement, and restlessness. These symptoms occur as the body and brain adjust to the absence of crack cocaine, which had previously altered various neurological functions. These symptoms are a result of the brain and body adjusting to the absence of the drug after prolonged use. These symptoms peak within the first 24-72 hours and last for weeks, making detoxification and recovery particularly challenging.

Common withdrawal symptoms of crack addiction are given below:

• Depression: Crack increases dopamine levels, which spark feelings of pleasure and reward. When the drug is no longer present, the sudden drop in dopamine spawns sadness and hopelessness.
• Fatigue: Crack acts as a stimulant, keeping the body in an alert state. Without it, users experience extreme tiredness and exhaustion as their bodies attempt to return to normal functioning.
• Increased appetite: Crack suppresses appetite by affecting hunger-related brain chemicals. When withdrawing, the body overcompensates, resulting in cravings and heightened hunger.
• Insomnia: Crack promotes wakefulness and energy by exciting the central nervous system. Once the drug is gone, the body struggles to regulate sleep patterns, leading to difficulty falling or staying asleep.
• Vivid unpleasant dreams: Crack affects the brain’s ability to regulate sleep cycles. Without it, users experience disrupted sleep patterns with intense or disturbing dreams.
• Slowed thinking and movement: Crack accelerates brain activity and physical movement by rocketing dopamine and norepinephrine. During withdrawal, users are assailed by cognitive slowness and physical sluggishness as their brain reframes.
• Restlessness: Crack quickens the release of dopamine generating emotions of excitement and energy. In its deficiency, individuals feel agitated, uncomfortable, or unable to sit still as their body reworks to the lack of stimulation.

How Long Does Crack Stay in Your System?

It takes approximately 1 to 4 days for crack cocaine to leave your system, but the exact time varies depending on several factors such as an individual’s metabolism, frequency of use, body mass, age, gender, and dosage. For occasional users, crack is detectable in urine for up to 3 days, while for chronic users, it lingers for a longer period.

Chronic cocaine use prolongs drug elimination, with metabolites persisting longer than after acute use. Among six participants receiving up to 2 g/day of oral cocaine, initial half-lives were 1.5 hours (plasma), 1.2 hours (saliva), and 4.1 hours (urine), with terminal urinary half-lives reaching up to 19 hours for cocaine and 14.6–52.4 hours for metabolites according to the study “Elimination of Cocaine and Metabolites in Plasma, Saliva, and Urine Following Repeated Oral Administration to Human Volunteers” by Jufer et al. 2000.

What Are the Treatments for Crack Addiction?

The main treatments for crack addiction are detox, medication-assisted treatment (MAT), inpatient and outpatient treatment, and behavioral therapies. These methods aid individuals to stop using crack cocaine and manage the psychological and physical dependence associated with addiction.

Common treatments for crack addiction are given below:

Detox

Detox is the first step in treating crack addiction, focusing on safely removing the drug from the body while managing withdrawal symptoms. Medications such as benzodiazepines (e.g., diazepam or lorazepam) are used to tackle anxiety and agitation during the detox process, while antidepressants or antipsychotic medications are utilized to handle mood swings, depression, or other psychiatric symptoms. 

Detox allows the body to rid itself of the drug, cutting physical dependence before moving on to other forms of treatment. 68% of individuals who complete drug and alcohol detox programs report positive treatment outcomes, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) fuses medication with counseling to treat crack addiction. While there is no FDA-approved medication specifically for crack addiction, drugs like bupropion (a norepinephrine-dopamine reuptake inhibitor), disulfiram (used to create an adverse reaction when alcohol is consumed), and topiramate (an anticonvulsant) have been studied for their effectiveness in bringing down cravings and maintaining abstinence. MAT is beneficial in treating crack addiction by easing withdrawal symptoms and cravings, boosting the chances of long-term recovery.

Inpatient and Outpatient Treatment

Inpatient treatment provides intensive, 24-hour care in a rehab facility, where patients receive round-the-clock supervision and therapy. Inpatient treatment lasts 30 to 90 days but extends depending on the individual’s needs and progress. Outpatient treatment offers more flexibility, with patients attending treatment sessions during the day while living at home. Outpatient treatment differs in length, lasting between 6 to 12 weeks, but goes for longer periods if necessary. Both inpatient and outpatient options are tailored to an individual’s needs and assist people with crack addiction to redress the psychological and emotional aspects of their dependency.

Behavioral Therapies

Behavioral therapies, such as cognitive-behavioral therapy (CBT), support individuals to explore the root causes of their addiction and develop healthy coping strategies. These therapies are deployed in inpatient and outpatient settings.

Cognitive Behavioral Therapy (CBT) has an effectiveness rate of 50-75%, majorly minimizing substance use and pivoting long-term recovery, making it a key component in addiction treatment programs, as explored by Pybis, Jo, et al. 2017 in “The Comparative Effectiveness and Efficiency of Cognitive Behaviour Therapy and Generic Counselling in the Treatment of Depression: Evidence from the 2nd UK National Audit of Psychological Therapies.”

Support Groups

Support groups like Narcotics Anonymous (NA) provide a community of individuals who are also recovering from addiction. These groups offer a sense of belonging and support during the recovery process. 56% of individuals who stay in AA for over 90 days continue attending meetings throughout the year, as emphasized in the 2008 study “Alcoholics Anonymous Recovery Outcome Rates: Contemporary Myth and Misinterpretation,” as referenced by 12steps.com.

Can You Overdose on Crack Cocaine?

Yes, you can overdose on crack cocaine, and the consequences are fatal. Crack cocaine overdose has severe health complications such as cardiac arrest, stroke, and respiratory failure. From 2022 to 2023, cocaine deaths increased by 4.9%, rising from 8.2 to 8.6 per 100,000 people, as reported by Garnett M. and Miniño A. 2024 in the CDC’s publication, “Drug Overdose Deaths in the United States, 2003–2023.”

What Are the Symptoms of Crack Overdose?

The symptoms of crack overdose are severe agitation or paranoia, rapid heart rate (tachycardia), high blood pressure, hyperthermia, seizures, respiratory distress, loss of consciousness, and chest pain. Common symptoms of crack overdose are given below:

• Severe agitation or paranoia: Crack cocaine’s stimulant properties generate intense agitation and irrational fear, pushing the user to become violent or uncontrollable, as their nervous system is overwhelmed.
• Rapid heart rate (tachycardia): Crack raises the heart rate by exciting the central nervous system, causing the heart to beat faster than normal. This prompts arrhythmias or even cardiac arrest, especially in those with underlying heart conditions.
• High blood pressure: The intense vivification from the crack causes blood vessels to constrict, eliciting a dangerous nascence in blood pressure. Long high blood pressure damages vital organs and expands the hazard of stroke or heart attack.
• Hyperthermia: Crack cocaine rushes the body’s metabolic processes, leading to dangerously high body temperatures. If not treated fast, hyperthermia sets in with organ failure, brain damage, or heatstroke.
• Seizures: Crack overwrought the brain, which triggers seizures. These electrical disturbances induce loss of consciousness, convulsions, and, in some cases, brain destruction if not properly dealt with.
• Respiratory distress: Crack affects the respiratory system, making it difficult for the body to breathe properly. Respiratory failure ensues, especially if the crack is smoked, injuring the lungs and provoking severe breathing difficulties.
• Loss of consciousness: Crack’s intense psychotropic impositions on the brain bewilder the body’s ability to function, evoking a loss of consciousness. If untreated, this progresses to a coma, putting the user at extreme risk of death.
• Chest pain: The constriction of blood vessels and rapid heart rate from crack use breeds harmful chest pain, which is a warning sign of a heart attack. If left untreated, it cultivates permanent heart complications or fatal cardiac events.

What Is the Difference Between Crack and Cocaine?

The difference between crack and cocaine lies primarily in their form, method of use, and potency. Cocaine is sold as a fine white powder and is snorted or injected, whereas crack is a solid, crystalline form that is smoked. Crack is derived by processing cocaine powder with baking soda or ammonia, making it more potent and quicker when smoked, which elicits an intense, short-lived high. This difference in potency and method of consumption precipitates crack being associated with a higher potential for addiction in comparison to regular cocaine.

Is Crack More Addictive Than Cocaine?

Yes, crack is considered more addictive than cocaine. This is principally due to its method of use and the intensity of the high it produces. When smoked, crack cocaine reaches the brain more quickly than snorted cocaine, hence a more immediate and intense euphoria. This rapid onset of effects greatly elevates the risk of addiction, as individuals repeatedly use the drug to maintain that high. 

Snorting cocaine delivers a bioavailability of 57%, while smoking it increases this to 70%, indicating that the drug becomes more active in the bloodstream more rapidly and intensely when smoked, leading to a stronger high. This rapid onset contributes to its addictive potential. A crack high occurs almost instantly but lasts for only 10–15 minutes, whereas a cocaine high persists for up to 45 minutes. Consequently, crack users tend to seek highs with greater frequency and intensity. This is highlighted by DrugAbuse.com in “Can You Get Addicted to Crack After the First Use?” and further analyzed by Palamar et al. 2016 in “Powder Cocaine and Crack Use in the United States: An Examination of Risk for Arrest and Socioeconomic Disparities in Use.”

What Is the Legal Status of Crack?

The legal status of crack cocaine in the United States is strictly prohibited, and classified as a Schedule II controlled substance under the Controlled Substances Act, meaning it has a high potential for abuse despite limited medical use in certain situations. 

Possession, distribution, or manufacturing of crack cocaine is illegal and carries severe penalties, including imprisonment and hefty fines. The Anti-Drug Abuse Act of 1986 established mandatory minimum sentences for crack-related offenses, which were initially much harsher than those for powdered cocaine, reflecting the drug’s societal impact and widespread abuse. While reforms like the Fair Sentencing Act of 2010 have cut sentencing disparities, crack remains one of the most heavily penalized substances in the U.S. legal system.

Smoking crack or injecting cocaine has greater abuse liability, dependence, and grave consequences relative to intranasal cocaine use. Given that crack cocaine is linked with more crime, the federal sentencing guidelines—allowing 100 times more cocaine hydrochloride than crack cocaine to trigger mandatory minimum penalties, according to a meta-analysis by Hatsukami D. & Fischman M. 1996 in “Crack Cocaine and Cocaine Hydrochloride. Are the Differences Myth or Reality?”