When cocaine is processed with ammonia, then heated, a smokable form of the drug known as freebase cocaine is formed. This inhaled form of the drug makes a crackling sound when burned, hence its street name, "crack."
The blood vessels in the lungs rapidly absorb this highly addictive drug. Crack provides an instant, euphoric effect by acting on the midbrain, where it blocks the removal of dopamine, a neurotransmitter associated with pleasure. The treatments for crack cocaine abuse can help break the addiction to this artificial euphoria.
Medication
The National Institute on Drug Abuse explains that, though the FDA has not yet approved any drugs for the express purpose of treating crack addiction, a number of pharmaceutical preparations currently used for treating other diseases have shown promise.
During a double-blind, placebo-controlled trial, the drug disulfiram was found to be effective in helping patients abstain from both cocaine and alcohol use, according to Helen M. Pettinati, Ph.D. of the Center for the Study of Addictions at the University of Pennsylvania School of Medicine. Pettinati's research was published in the March 2008 issue of the journal "Addictive Behaviors."
Contingency Management
Contingency management is a term for a motivational system that rewards patients for abstaining from crack or other drug use. These types of programs use vouchers or point systems that award abstinent patients with healthy living incentives such as acupuncture treatments, movie tickets or free meals. Participants submit urine samples to prove their continued abstinence.
This type of program has been shown to be effective in motivating initial abstinence and in encouraging individuals to stay in treatment. According to René Henskens, PhD, of the Municipal Health Service of Rotterdam in the Netherlands, an outreach program combining motivational incentives with other therapies has been effective in treating chronic high-risk crack addicts.
Cognitive Behavioral Therapies
Cognitive behavioral therapy, or CBT, is a collaboration between a patient seeking treatment and a therapist who works with him to create a workable set of goals for overcoming crack addiction. This form of therapy is based in the belief that substance abuse is a learned behavior and thus can be "unlearned."
CBT begins with an assessment of the initial motivators for crack use and a determination of the steps for coping with the triggers that prompt it. Skills training helps patients by teaching them to model more appropriate behavior and to practice strategies for altering patterns of abuse.
References
- National Institute on Drug Abuse: A Cognitive-Behavioral Approach---Treating Cocaine Addiction
- Psychiatric Services: Fidelity of an Outreach Treatment Program for Chronic Crack Abusers in the Netherlands to the ACT Model
- National Institute on Drug Abuse: Cocaine---Abuse and Addiction
- "Addictive Behaviors"; A Double Blind, Placebo-controlled Trial That Combines Disulfiram and Naltrexone for Treating Co-occurring Cocaine and Alcohol Dependence; Helen M. Pettinati. et al; May 2008
