Crack Overdose: Signs, Symptoms, and Treatment

Reading Time: 5 minutes

Crack cocaine is a very dangerous and addictive stimulant drug, and using it can lead to a crack overdose, which may involve life-threatening consequences. Knowing the crack overdose symptoms can help you identify when you may need to seek emergency treatment for yourself or someone else.

What Are the Effects of Crack?

Crack cocaine causes a rush of the neurotransmitter, dopamine, by preventing it from being recycled back into the brain cell it was released from.¹ This causes a buildup of dopamine in your brain that results in feelings of euphoria, often referred to as a “high.”

Most people who use crack cocaine smoke it, which results in a rapid onset of effects, both desired and undesired. The positive effects of happiness and mental alertness may only last five to 10 minutes, which could lead you to continue using crack at a high volume and frequency to achieve the high more frequently—a practice known as binging.¹

Can You Overdose on Crack?: Overdose Symptoms

It is possible to overdose on crack cocaine. In fact, a recent study shows that crack overdose deaths have been steadily increasing over the past 10 years, with close to 20,000 reported in 2020.²

A crack overdose is different from overdoses on drugs that are central nervous system (CNS) depressants. CNS depressant drugs, like opioids, alcohol, or barbiturates, can result in slowed breathing and lack of oxygen to the brain, or hypoxia, which can ultimately lead to a coma and death. In contrast, crack cocaine is a stimulant drug, and overdoses can occur at any dose or time while taking the drug. A crack overdose is characterized by cardiovascular and neurological events and other life-threatening effects, as opposed to oversedation from CNS depressants.

Further, crack cocaine is a street drug, meaning you can never know for certain the potency or exact contents of the drug you take. As such, you could take a small amount and experience overdose symptoms—especially if it’s cut with fentanyl, a deadly synthetic opioid—or take large amounts and not feel much effect. The unpredictability of the drug contributes to the crack overdose risk.

The most severe results of an overdose from crack include heart attacks, seizures, and strokes.¹ Some of the other signs of a crack cocaine overdose include:³

• High blood pressure
• Weak pulse
• Altered mental status
• Chest pain or irregular heart rhythms
• Nose bleeds
• Headaches
• Paranoia, agitation, anxiety
• Confusion
• High body temperature
• Extreme sweating
• Itching
• Blurring or loss of vision
• Coming in and out of consciousness
• Diarrhea, vomiting, abdominal pain
• Excited delirium, a condition involving intense paranoia, hallucinations, and violence toward objects and people

How to Treat a Crack Overdose

If you notice signs of a crack overdose in yourself or another, you should call 911 and provide emergency personnel with as much information as possible. Stay with the affected person and provide any care as instructed by the 911 operator until first responders arrive. Such care may include keeping a seizing person safe from injury or using cold compresses to help reduce an elevated temperature.

Some of the interventions medical professionals may use to treat an overdose on crack cocaine include:⁴

• Providing oxygen through a breathing tube or ventilator
• Blood and urine tests to better understand the toxicity levels
• Chest x-ray or CT scans
• EKG to measure and monitor heart functioning
• Intravenous fluids or medicines to treat symptoms

Transitioning to Crack Addiction Treatment After an Overdose

Someone who has experienced a crack overdose will likely be referred to an addiction treatment program by the medical team treating them, as an overdose is often indicative of a crack cocaine addiction. Treating the overdose only addresses the immediate medical needs of a person and doesn’t promote lasting change, whereas long-term recovery can yield lasting improvement.

Long-term recovery should include these elements:⁵

• Detoxification to remove the substance from your body safely
• Medication, when appropriate, to treat symptoms of withdrawal and any co-occurring mental health conditions, such as depression or anxiety
• Behavioral therapy to improve thoughts, patterns of behavior, and relational issues
• Evaluation and treatment to address co-occurring mental health conditions
• Ongoing care and follow-up to prevent relapse

Types of Treatment

Different types of treatment are available for crack cocaine addiction and may include any of the following:

• Inpatient rehab—This level of care provides 24-hour treatment in a hospital or residential setting and may involve therapy, medication, and group work.
• Partial hospitalization—This treatment route will provide recovery services in a hospital setting during part of your week, with the rest of your time spent recovering at home.
• Intensive outpatient—This type of program may require you to attend multiple therapies, medical, or group appointments a week, but you will be able to return home between treatments.
• Standard outpatient—This level of care is like intensive outpatient but with less frequent appointments, sometimes reduced to just one counseling session per week.

Types of Therapy

Each level of treatment for a crack cocaine use disorder will likely involve various forms of therapy. Some types you can expect to see in treatment are:

• Individual therapy sessions utilizing cognitive behavioral therapy (CBT) to help you become aware of how your emotions and thoughts are tied to addictive behavior
• Group therapy sessions to learn and practice coping skills, sober social skills, relapse prevention strategies, drug refusal skills, and more
• Family therapy, which includes at least one other cohabitant or significant other, to help address behaviors and co-occurring issues, such as conflict

How Long Will Treatment Last?

The length of time someone is in treatment depends on many different variables. Research shows that longer stays in treatment programs usually produce the most positive and longest-lasting results.⁶ If you attend a program, whether inpatient or outpatient, for fewer than 90 days, the effectiveness of your treatment may be limited.⁶

If you or someone you know is misusing crack cocaine or other substances, please call 800-681-1058 (Who Answers?) to speak to a specialist about treatment options. Our helpline is confidential and available 24/7, and we can verify insurance coverage for available treatments.

Resources

1. National Institute on Drug Abuse. (2021). Cocaine DrugFacts. United States Department of Health and Human Services National Institutes of Health.
2. National Institute on Drug Abuse. (2022). Overdose Death Rates. United States Department of Health and Human Services National Institutes of Health.
3. Richards JR, Le JK. (2021, July). Cocaine Toxicity. StatPearls Publishing.
4. National Library of Medicine. (2022), Overdose. United States Department of Health and Human Services National Institutes of Health.
5. National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction. United States Department of Health and Human Services National Institutes of Health.
6. National Institute on Drug Abuse. How long does drug addiction treatment usually last?. United States Department of Health and Human Services National Institutes of Health.