Treatment For "Crack" Addicts

"Crack is a highly addictive drug, but there are treatments for people who use it regularly. There are two main types of treatments: medication and cognitive or behavioral therapy. As of November 2004, no medication exists to treat crack addicts, but the National Institute on Drug Abuse (NIDA) is researching several promising options. The drug Selegiline, used to treat Parkinson's disease, is under investigation for its ability to reduce dopamine metabolism. Disulfiram, which has been used to treat alcoholism, is another candidate. The drug creates a negative physical reaction (nausea, vomiting, etc.) whenever the addicted person ingests alcohol. Researchers are hoping that it might help people who are addicted to both cocaine and alcohol. Antidepressants are sometimes prescribed to treat the mood swings associated with the withdrawal process.

Behavioral therapies are currently the most common way to treat crack addiction. Patients may be treated at either inpatient or outpatient centers. In 2002, 176,000 people were admitted to treatment centers for addiction to smoked cocaine, according to the Treatment Episode Data Set produced by the Substance Abuse and Mental Health Services Administration (SAMHSA). Crack admissions represented just under 10 percent of all admissions into drug- and alcohol-related treatment centers in 2002.

One of the most popular behavioral therapies is contingency management, which rewards addicts for staying drug-free by giving them vouchers for everything from movies to gym memberships. Another approach is cognitive-behavioral therapy, which teaches people how to avoid and/or deal with situations in which they might be tempted to use crack. People with severe addictions, mental illness or a criminal record may need to stay at a therapeutic community for a six- to 12-month period while they undergo rehabilitation and learn how to reenter society drug-free."

"Crack" Addict Culture

"In the mid-1980s, crack use exploded in the United States, primarily because of its quick high and relatively low cost: Crack cocaine costs significantly less than its powdered counterpart.


The low cost of crack helps explain its rampant spread through poor, urban areas. The highest numbers of crack users are African-American men between the ages of 18 and 30 who come from low socioeconomic backgrounds.

Street Terms for Crack
Basa, french fries, real tops, base, glo, rock(s), black rock, hard rock, roxanne, CDs, hotcakes, twinkie, candy sugar, jelly beans, yam, electric kool-aid, nuggets
Crack has touched almost 4 percent of the American population. Nearly 8 million Americans ages 12 and older say they have taken crack at some point in their lives, according to the 2003 National Survey on Drug Use and Health (NSDUH). According to the same survey, the number of users currently taking crack in 2002 was about 567,000.

Crack is not just a problem among adults. A 2003 Monitoring the Future Study by the University of Michigan found that nearly 4 percent of high school seniors and 2.5 percent of junior high school students said they had tried crack at least once.


Crack addiction is taking a toll on America's health. In 2002, emergency rooms reported more than 42,000 crack-related cases to the Drug Abuse Warning Network. That number was down from nearly 49,000 in 2001, but up from the approximately 34,000 cases reported in 1995."

Crack is associated with more prostitution, violent crimes and gang-related crimes than any other drug.

Crack Outside the United States

America is not the only country dealing with crack addiction. Cocaine use has been on the rise in Europe over the last several years, although the biggest problem in most countries (with the exception of the United Kingdom and the Netherlands) is the powder form of the drug. The United Kingdom reports the highest crack use in Europe.

How People Become "Crack" Addicts

"Cocaine is a highly addictive substance. People who take it can become physically and psychologically dependant upon it to the point where they can't control their cravings. Researchers have found that cocaine-addicted monkeys will press a bar more than 12,000 times to get a single dose of it. As soon as they get it, they will start pressing the bar for more.

Crack and other addictive drugs chemically alter a part of the brain called the reward system. As mentioned previously, when people smoke crack, the drug traps the chemical dopamine in the spaces between nerve cells. Dopamine creates the feelings of pleasure we get from enjoyable activities such as eating and having sex. But in crack users, dopamine keeps stimulating those cells, creating a "high" -- a euphoric feeling that lasts anywhere from five to 15 minutes. But then the drug begins to wear off, leaving the person feeling let-down and depressed, resulting in a desire to smoke more crack in order to feel good again.

The brain responds to the dopamine overload of the crack high by either destroying some of it, making less of it or shutting down its receptors. The result is that, after taking the drug for a while, crack users become less sensitive to it and find that they must take more and more of it to achieve the desired effect. Eventually, they cannot stop taking the drug because their brains have been "rewired" -- they actually need it in order to function. How long does it take to become addicted? That varies from person to person, and an exact number is difficult to pin down, especially when physical addiction is paired with psychological addition.

Of course, not everyone reacts the same way to extended use. Some users actually become more sensitive to crack as they take it. Some people die after taking a very small amount because of this increased sensitization."

In Dollars


Americans spent a total of $35.3 billion on cocaine in the year 2000.
When an addicted person stops taking crack, there is a "crash." He or she experiences the symptoms of withdrawal, including:

* Depression
* Anxiety
* Intense cravings for the drug
* Irritability
* Agitation
* Exhaustion
* Anger

Rehab Treatment Methods

"To understand rehab-treatment methods, we must first understand how addiction works. Our understanding of addiction has evolved over the past two centuries, and we've arrived at the conclusion that addiction is a "brain disease." Under this model, addiction is a chemical transition that takes place within the brain's processes. This transition takes the decision of whether to abuse a substance or engage in a compulsive behavior out of the hands of the addict.


To this end, addiction researchers have concluded that treatment is a long, multifaceted process that takes time. How much time is debatable; some say a month, some say a lifetime. But most modern researchers have concluded that treatment should consist of a combination of methods in order to achieve the highest potential for lifetime abstinence.

When an addict enters rehab for a substance-abuse problem, the first order of treatment is to help him through the withdrawal process. Some rehabs end there, while others include them as part of a larger treatment program including other aspects detailed below.

Twelve-step programs are considered by many addiction researchers to be the most effective form of treatment. The 12 steps to recovery, originally created by AA cofounders Bill W. and Dr. Bob, have been shown to increase sobriety rates over two years by 30 percent compared with Cognitive Behavioral Counseling (more on that later). Though it's repeatedly been shown to be effective, it's often criticized as being too indulgent to the addict's ego and too reliant on a belief in God. As a response to this, Narcotics Anonymous, one of the many 12-step programs that has roots in AA, has molded its program to support both believers as well as atheists.

Cognitive Behavioral Counseling (CBC) is a type of psychotherapy that's used for a variety of mental disorders, like depression and post-traumatic stress disorder. CBC practitioners believe that concentrating on the reasons for the addict's behavior can help eradicate addiction from his life. Most rehabs include CBC as part of an overall treatment program, and counseling is usually offered in group, individual and family settings.

Medication is another aspect of modern dependency treatment. Medications may be used to help alleviate the physical and psychological symptoms of withdrawal. Heroin withdrawal is considered particularly excruciating, so methadone is often administered during the weeklong withdrawal period, but it's also used as a long-term treatment.

Antidepressants are also commonly used in the rehab setting. Depression may exist in conjunction with an addiction -- either a substance dependency or a compulsive disorder -- and may be used as part of treatment in both cases.

There's also a wide variety of nontraditional methods of treating addictive behavior. Some are ancient-- acupuncture is one good example of this kind of treatment. Others are relatively new, like the detox treatment created by Scientologist founder L. Ron Hubbard. This treatment is purported to rid the body of toxins and addictive substances through a regimen of vitamins, exercise and exposure to saunas.

Some conventional rehab facilities incorporate nontraditional methods of treatment into their wider program. High-end facilities sometimes include as treatment wilderness survival programs to build self-confidence and activities like helicopter rides to inspire awe and humility.

Other nontraditional programs stand alone. The Jude Thaddeus Program uses no medications and operates on the notion that addiction is a learned behavior that can simply be unlearned. Rather than viewing the battle against addiction as a lifelong process, this program aims to completely free its patients after a six-week stay.

But do these programs -- in conjunction or alone -- have any affect on addiction?"

The History of "Rehab"

"The idea of rehabilitating addictive behavior has existed since the beginning of the early temperance movement in19th-century America. This movement, which began in the 1800s, gave rise to our modern notions of addiction and the need for our society to help alleviate the suffering of its addicts.

The goal of the temperance movement was abstinence, or the complete disuse of a substance -- in this case alcohol. Eventually, alcohol became identified as an agent of social decay, and the movement increasingly believed that it was up to society to care for its alcoholics by doing away with any spirituous beverage.

The organization gave birth to the first rehab centers in the United States, called "sober houses," where men lived collectively, sequestered away from the temptations of the world. Sober houses were set up as early as 1840 in cities like Boston and New York by the Washingtonian society, a branch of the temperance movement.

The temperance movement began to focus on the general public. If society could be free of alcohol, they reasoned, then it could then be free of alcoholics.

After a century of gaining momentum in their beliefs and membership, the temperance movement helped to get the Prohibition Act -- the law that outlawed the sale, possession or consumption of alcohol in the United States -- passed in 1920. But American society as a whole wasn't prepared to give up its booze, and the law was repealed 13 years later. The experiment had a lasting effect: If America couldn't provide its alcoholics with a country free of temptation, alcoholics needed a refuge within the larger society where they could be free from the temptation of alcohol: rehab.

Eventually providing treatment for addicts was taken from the hands of goodwill societies and placed in the trust of the medical field. As medical science came to play a larger role in caring for the world's addicts, treatment came to be moved into more of a clinical setting. Rehabilitation now took place in hospitals, psychiatric wards and sanitariums.

This isn't the only contribution that temperance made to our modern rehabs. It also gave rise to fraternal organizations, like the International Order of the Good Templars, which served in part as support groups. These groups set the stage for America's first organized support-group treatment program, Alcoholics Anonymous (AA). Cofounded by Robert Smith and Bill Wilson (Dr. Bob and Bill W.) in 1935, AA created the 12-step program.

Throughout the 20th century, thanks to the success and popularity of programs like AA, it became clear that treatment programs were a viable solution to the nation's substance-abuse problems. As a result, President Richard Nixon was the first commander in chief to create federal funding for treatment programs. The budget for his antidrug policy, which would serve as the origins of the War on Drugs, was divvied up, with one-third toward eradicating the supply (police enforcement), and two-thirds toward getting rid of the demand (treatment). When his successor, President Gerald Ford, came to office he cut the budget for federal funding of treatment programs, making the division fifty-fifty.


This is ironic, because it was President Ford's wife who founded one of the United States' iconic rehab facilities, the Betty Ford Clinic. Mrs. Ford developed an addiction to alcohol and prescription medication in the 1970s, and as a result, she opened the Clinic in 1982 as a way to help others who shared her problem.

In the 1980s, the proliferation of private residential treatment facilities mushroomed. The peak of the War on Drugs fueled fears of addiction, and fueled the demand for rehab treatment. Interestingly, as the War on Drugs was showing a major effect on reducing drug usage in the United States, the use of rehab facilities in the country continued to increase.

So what kind of treatment is offered at these facilities, and how do they help addicts recover from their dependency?"

The Meaning of "Rehab"

"The word "rehab" has become a part of the international lexicon. While it can mean several things, it most frequently refers to a center or program where a person can find treatment for addiction. Although it's become so firmly embedded in our consciousness as a natural byproduct of the addictive nature of Western society, rehab is a relatively new concept.

Prior to the 1980s, anyone seeking help for a drug or alcohol addiction was sent to a sanitarium -- a psychiatric hospital -- or a traditional hospital. Think Patty Duke's character in "Valley of the Dolls" or Winona Ryder's character in "Girl, Interrupted."

In the '80s, rehab centers branched off from their psychiatric foundations to encompass several forms of treatment. This was partly due to a change in the perception of addiction. Rather than pinpointing a substance (with its addictive properties) as the cause of addiction, or believing addiction to be a weakness of will, addiction itself became viewed as a disease. However, what hasn't changed is the purpose of rehab centers: to provide a place of solace and respite where an addict can "kick the habit."

For many years, going to rehab was viewed as somewhat taboo. It wasn't an experience that was openly discussed and is still sometimes looked upon as somewhat shameful, as if the patient had failed somehow. But as more and more people go to rehab to find help for their addictions, it has come to play an accepted -- and necessary -- role in society.

Recently, the acceptance of a stay (or several stays) at a rehab -- as a consequence of fast living -- has became so widespread that some celebrities are reputed to have used rehab excursions as a publicity stunt to boost their fame.

Actress Lindsey Lohan made several highly publicized trips to rehab in 2007. Even Amy Winehouse, the British singer notable for her first American single "Rehab" (including the lyrics "They tryin' to make me go to rehab / I said no, no, no") eventually said "yes" to several short rehab stays after a brush with death from an overdose consisting of heroin, cocaine, ketamine (a horse tranquilizer) and ecstasy [source: Daily Mail].

Celebrities have even managed to boost some rehab facilities to fame. Centers like Promises in Malibu, Calif., and Crossroads in Antigua, West Indies, now enjoy elevated status thanks to some of their high-profile patients.

Although celebrities get the lion's share of the publicity for their visits, they aren't the only ones who utilize rehab services. The 2005 National Survey on Drug Use and Health found that 3.9 million Americans age 12 and older received some kind of treatment for drug and/or alcohol dependency in 2005. Treatment was received in a variety of locales, including inpatient rehab centers, self-help groups (the largest portion) and prison [source: Department of Health and Human Services].

The wide array of treatments for people suffering from addiction reveals that a large portion of Western society has succumbed to dependency on everything from liquor to pills to sex, and even food. So what are these places where people can go to get help?"