There is nothing more devastating for a substance abuser and his family than going to treatment and then relapsing. One of the main reasons that someone relapses is that he did not go to a long term drug rehab center. What is long term drug treatment? If you search for long term drug treatment centers in the Facility Locator of the Substance Abuse and Mental Health Services Administration, treatment program more than 30 days is considered a long term drug treatment center. Yet, research done by the National Insitute on Drug Abuse shows that less than 90 days treatment for someone severely afflicted with substance abuse is not successful. On this web-site, we consider long term drug and alcohol treatment to be 90 days or more.
Crack and Cocaine - Cocaine is a powerfully
addictive drug of abuse. Once having tried cocaine, an individual cannot
predict or control the extent to which he or she will continue to use the drug.
Crack is the free-base form of cocaine, which is a chemical description of the drug that allows it to be smoked and, therefore, it enters the blood stream faster and gives the user a faster and more dramatic high. It also wears off somewhat quickly, causing the user to want more and more to keep the high going. In the middle 1980's, the major inner cities in the US were show the devastating effects of what was called the crack epidemic.
The major routes of administration of cocaine are
sniffing or snorting, injecting, and smoking (including free-base as described ablove for crack
cocaine). Snorting is the process of inhaling cocaine powder through the nose
where it is absorbed into the bloodstream through the nasal tissues. Injecting
is the act of using a needle to release the drug directly into the bloodstream.
Smoking involves inhaling cocaine vapor or smoke into the lungs where
absorption into the bloodstream is as rapid as by injection.
"Crack" is the street name given to cocaine
that has been processed from cocaine hydrochloride to a free base for smoking.
Rather than requiring the more volatile method of processing cocaine using
ether, crack cocaine is processed with ammonia or sodium bicarbonate (baking
soda) and water and heated to remove the hydrochloride, thus producing a form
of cocaine that can be smoked. The term "crack" refers to the
crackling sound heard when the mixture is smoked (heated), presumably from the
There is great risk whether cocaine is
ingested by inhalation (snorting), injection, or smoking. It appears that
compulsive cocaine use may develop even more rapidly if the substance is smoked
rather than snorted. Smoking allows extremely high doses of cocaine to reach
the brain very quickly and brings an intense and immediate high. The injecting
drug user is at risk for transmitting or acquiring HIV infection/AIDS if
needles or other injection equipment are shared.
Cocaine is a strong central nervous system
stimulant that interferes with the reabsorption process of dopamine, a chemical
messenger associated with pleasure and movement. Dopamine is released as part
of the brain's reward system and is involved in the high that characterizes
Physical effects of cocaine use include constricted peripheral
blood vessels, dilated pupils, and increased temperature, heart rate, and blood
pressure. The duration of cocaine's immediate euphoric effects, which include
hyper-stimulation, reduced fatigue, and mental clarity, depends on the route of
administration. The faster the absorption, the more intense the high. On the
other hand, the faster the absorption, the shorter the duration of action. The
high from snorting may last 15 to 30 minutes, while that from smoking may last
5 to 10 minutes. Increased use can reduce the period of stimulation.
Users of cocaine report feelings of
restlessness, irritability, and anxiety. An appreciable tolerance to the high
may be developed, and many addicts report that they seek but fail to achieve as
much pleasure as they did from their first exposure. Scientific evidence
suggests that the powerful neuropsychologic reinforcing property of cocaine is
responsible for an individual's continued use, despite harmful physical and
social consequences. In rare instances, sudden death can occur on the first use
of cocaine or unexpectedly thereafter. However, there is no way to determine
who is prone to sudden death.
High doses of cocaine and/or prolonged use
can trigger paranoia. Smoking crack cocaine can produce a particularly
aggressive paranoid behavior in users. When addicted individuals stop using
cocaine, they often become depressed. This also may lead to further
cocaine use to alleviate depression. Prolonged
cocaine snorting can result in ulceration of the mucous
membrane of the nose and can damage the nasal septum enough to cause it to
collapse. Cocaine-related deaths are often a result of cardiac
arrest or seizures followed by respiratory arrest. Crack Lung is a condition that is caused by the hot toxic fumes of crack scaring the lung tissue. The vapors from burning crack are unstable and the smokers know that they get higher with a short pipe, causing the heat from th burning crack to damage their lips and their lungs.
Added Danger: Cocaethylene
When people mix cocaine and alcohol
consumption, they are compounding the danger each drug poses and unknowingly
forming a complex chemical experiment within their bodies. NIDA-funded
researchers have found that the human liver combines cocaine and alcohol and
manufactures a third substance, cocaethylene, that intensifies cocaine's
euphoric effects, while possibly increasing the risk of sudden death.
Extent of Use
Monitoring the Future Study (MTF)
The MTF assesses the extent of drug use among adolescents and
young adults across the country.
The proportion of high school seniors who have used cocaine at
least once in their lifetimes has increased from a low of 5.9 percent in 1994
to 9.8 percent in 1999. However, this is lower than its peak of 17.3 percent in
1985. Current (past month) use of cocaine by seniors decreased from a high of
6.7 percent in 1985 to 2.6 percent in 1999. Also in 1999, 7.7 percent of
10th-graders had tried cocaine at least once, up from a low of 3.3 percent in
1992. The percentage of 8th-graders who had ever tried cocaine has increased
from a low of 2.3 percent in 1991 to 4.7 percent in 1999.
Of college students 1 to 4 years beyond high school, in 1995,
3.6 percent had used cocaine within the past year, and 0.7
percent had used cocaine in the past month.