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What Does a Crack Cocaine Overdose Look Like?

Crack Cocaine Overdose Signs, Symptoms & Treatment

The symptoms of a crack cocaine overdose are distinct and typically easy to recognize—when you know what to look for.

Crack cocaine is a powerful, chemically modified version of cocaine, and one of the many oft-abused stimulant drugs—a broad class of substances that also includes methamphetamine and prescription medications such as Adderall. Crack cocaine is a particularly potent form of cocaine that is made by mixing cocaine with water and baking soda or ammonia. This process results in a form of cocaine that vaporizes at a relatively low temperature, is usually smoked, and is rapidly absorbed into the bloodstream. In this manner, crack cocaine is able to rapidly travel to your brain, where its effects are generally felt near-instantaneously.1

In addition, cocaine has a very short half-life, which means it does not remain in your system very long. As a result, people experience what is known as a “crash” when certain neurotransmitters (those brain chemicals responsible for your sense of wellbeing and emotional balance) quickly deplete following a crack cocaine binge. This crash produces apathy and severe depression in users, so they want to find more crack cocaine to satisfy the strong cravings for the drug and to avoid the crash. This results in a dangerous cycle of crack cocaine binges, crashes, and drug-seeking behaviors.1

Cocaine in all of its forms is classified as a Schedule II controlled substance by the United States Drug Enforcement Administration.2 This indicates that cocaine has some potential medicinal uses, but has a high potential for abuse, and a risk of leading to physical dependence in those who regularly use it.

Cocaine’s medicinal use historically has been as a topical anesthetic with vasoconstrictor properties, which means it causes veins and arteries to constrict when it is applied. Unlike pharmaceutical cocaine, crack cocaine has no medicinal purposes and is solely a drug of abuse. The extreme danger associated with abusing cocaine is illustrated by the Substance Abuse in Healthcare Administration’s observation that it was the number-one illicit drug associated with emergency department (ED) visits in the period between 2004 and 2011, accounting for approximately 162 out of every 100,000 ED visits.3

Signs of Crack Cocaine Overdose (Crack Abuse)

According to the American Society of Addiction Medicine,1 some of the common signs of crack cocaine abuse include:

  • Sudden, puzzling shifts in behavior (e.g. argumentative, irritable, easily agitated, anxious, hyperactive, hypervigilant, easily startled, paranoid, or suspicious).
  • Numerous absences from important activities such as work, school, and social commitments.
  • Lack of personal hygiene.
  • Flushed or pale skin.
  • Dry mouth.
  • Repeated licking of the lips.
  • Constant sore throat and hoarse voice.
  • Burns or blisters on the lips.
  • Burns or blisters on the fingers.
  • Coughing up dark phlegm.
  • Incoherent or disorganized speech.
  • Poor oral hygiene (sudden weakness in the teeth, broken teeth).
  • Extreme weight loss; loss of appetite.
  • Periods of very high energy.
  • Prolonged periods of sleeplessness followed by periods of depression and apathy.
  • Physical shaking.
  • Bloodshot eyes or dilated pupils.
  • Sweating.
  • Low-grade fever.
  • Being excessively talkative.
  • Being easily startled or nervous.

Because people tend to binge and crash on crack cocaine, physical dependence often develops quickly, resulting in markedly unpleasant psychological withdrawal symptoms when use eventually slows or stops.1,4 Taking increasing amounts of the drug to postpone or alleviate the withdrawal raises the risk of experiencing crack overdose symptoms.

Crack Cocaine Overdose Symptoms

General signs of a crack cocaine overdose include:5

  • Changes in vital signs:
    • Temperature changes (may increase initially but may decrease if serious complications occur)
    • Respiration rate (initially may increase but may decrease if serious complications occur)
    • Blood pressure (initially may increase but may decrease if serious complications occur)
    • Pulse (initially may increase, but may decrease if serious complications occur)
  • Clammy skin.
  • Chest pains.
  • Heaviness of the chest.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Hyperactivity.
  • Confusion.
  • Disorientation.
  • Hallucinations.
  • Paranoid delusions.

Additional symptoms associated with a crack cocaine overdose include:1,4

  • Shaking or trembling.
  • Irritability or agitation.
  • Extreme anxiousness.
  • Difficulty urinating.
  • Seizures or convulsions.
  • Unconsciousness.
  • Heart attack.
  • Stroke.

Can You Overdose From Smoking Crack?

Crack is a type of cocaine that’s made into a rock crystal used for smoking. Its name comes from the sound that it produces when it’s heated.16 Crack is consumed by smoking either on its own or with tobacco or marijuana.17 Cocaine can cause an overdose both in its powder and crystal form.16 

The signs of a crack cocaine overdose include symptoms like:18

  • High body temperature
  • Rapid breathing
  • High blood pressure
  • Fast pulse
  • Increased sweating
  • Heaviness or tightness in the chest
  • Feeling sick
  • Vomiting
  • Diarrhea
  • Feeling confused or disoriented
  • Hallucinations and delusions
  • Shaking
  • Irritability
  • Anxiety
  • Trouble urinating
  • Seizures
  • Losing consciousness
  • Heart or brain infarction
  • Death

A crack overdose is a medical emergency. If you or someone close to you is exhibiting signs of this condition, call 911 immediately. The symptoms of a crack overdose exacerbate quickly and may result in death or leave lasting consequences.19

The risk of crack overdose is higher if the person is using it alongside alcohol or other drugs.16 Death most commonly occurs because the heart stops beating.18 Fatalities most frequently occur if a person uses both cocaine and an opioid, like heroin, fentanyl, or a prescription pill.16

How Long Does Crack Cocaine Stay in Your System?

Cocaine half-life is about an hour, which means that it takes an hour for half the drug to be removed from your system.12 It can get fully metabolized in about 4 hours, but exactly how long cocaine stays in your system varies based on multiple factors, like the quantity consumed and your metabolism.13 However, its presence can still be detected using specialized testing. For example, cocaine in urine can be identified for as long as 96 hours.14

Crack cocaine can be detected in a person’s saliva, blood, hair, and urine using laboratory testing. Cocaine blood testing produces accurate results for no longer than 2 days, similarly to cocaine saliva tests.13 Urine detection time is up to 3 days but it can be longer after heavy use.13 Hair tests can detect metabolites for up to 3 months.15 

Multiple factors can have an influence on the duration of the detection window, such as:16

  • How much of the drug is used: The more you consume, the longer it will be detectable.
  • How often the drug is used: More frequent use could enhance detection time
  • How the drug is used: Crack cocaine that’s smoked stays in your system for a shorter period of time than cocaine that’s snorted or gummed.
  • How pure the drug is: Contaminants can alter detection time.
  • The person’s body fat percentage: Higher body fat percentage means that the drug will be detectable for longer because it’s stored in fatty tissue.
  • Whether it’s mixed with alcohol: Mixing cocaine and alcohol makes the drug detectable for longer.



How Much Crack Cocaine Does It Take to Overdose?

Drug overdose happens when a person takes too much of a substance and suffers adverse health effects because of it. It can occur intentionally or accidentally. The quantity of the drug that will cause an overdose is unpredictable, which is what makes it particularly risky. Exactly how much crack cocaine is enough to cause an overdose depends on multiple factors, such as:10

  • Alterations in tolerance levels because of using more or less of the drug than usual.
  • Changes in the quality of the drug.
  • Using a combination of crack cocaine and alcohol or another drug, such as an opioid.
  • Suffering from chronic health conditions.
  • Having already overdosed in the past.

Someone with lower tolerance levels can typically overdose on a smaller amount, so it’s possible to overdose the first time you use the drug. Experienced users tend to binge on crack cocaine to magnify its effects, but this intensifies the likelihood of overdose.9

A crack cocaine overdose can cause serious complications and even result in death. Its adverse effects progress rapidly and they require urgent medical attention. In case you or a loved one may be overdosing on crack cocaine, call 911 immediately. Receiving necessary medical attention on time is crucial in these situations.9

How to Avoid a Crack Cocaine Overdose?

The number of cocaine overdose deaths tripled between 1999 and 2019 (from 3,822 to 15,883).6 Even when the person survives a cocaine overdose, they may still have to struggle with overarching health consequences.9 This calls for heightened awareness of the causes and effects of cocaine overdose, including crack cocaine, and an urgent need for its prevention. 

Overdose is possible the very first time someone tries crack cocaine, so the best method of prevention is to never start using it in the first place. Crack cocaine is highly addictive and its effects wear off fast, so people who use it have a tendency to binge on the drug. This puts them at a higher risk of overdose. As with other drugs, relapse poses increased chances of overdose because the person’s tolerance drops during the abstinence period.8

The greatest number of deaths associated with cocaine use happens when cocaine is mixed with alcohol or other drugs, primarily opioids.6 Depressants, such as alcohol, and opioids, like heroin, act in a way that minimizes the perceived effects of crack cocaine. This can make the person take more crack, directly causing an overdose.7

Generally, the only way to eliminate all risk of a crack cocaine overdose is to stop using it. If you or a loved one are struggling with crack cocaine addiction, you can seek evidence-based care at American Addiction Centers, one of the leaders in providing treatment for addiction to crack cocaine, as well as a range of other substances.

How to Recover From a Crack Cocaine Overdose?

A crack cocaine overdose is a serious medical emergency because it can escalate quickly and lead to a fatal outcome. It’s crucial to call 911 without delay if you or a loved one are experiencing the symptoms of overdosing of crack cocaine. While there are no medications that could reverse this condition, medical professionals can still take different steps to minimize its detrimental effects and prevent death.20

The management of symptoms depends on their scope and nature. For example, a crack cocaine overdose sometimes causes a stroke, heart attack, and seizures. While they can’t stop crack cocaine’s harmful effects immediately, medical professionals focus on diagnosing and treating the conditions that it causes.20 

Typically, the main goal of treating a person who is overdosing on crack cocaine may be to:20

  • Restore blood flow to the heart in case of an ongoing heart attack.
  • Restore blood flow to the affected area of the brain if the person suffered a stroke.
  • Stop the seizure caused by consuming crack cocaine.

After the patient’s condition is stabilized, they could be referred to a drug rehab facility where they’ll get crack cocaine out of their system in a safe and medically supervised detox process.20

How to Get Crack Cocaine out of Your System?

Multiple factors influence how fast the cocaine metabolite will be excreted. For example, consuming alcohol alongside crack cocaine can enhance the concentration of the drug in your system by up to 30 per cent. It also leads to the production of the metabolite cocaethylene, which can have detrimental effects to the heart.17 

Crack cocaine is more slowly metabolized when it’s mixed with alcohol and cocaethylene gets out of your system even more slowly. These factors make crack cocaine detectable by drug tests for longer.18

Another factor that slows down the elimination of crack cocaine from the body is dehydration. This is due to the fact that water promotes the excretion of cocaine metabolites. is because water has the potential to speed up cocaine metabolite excretion.19 People who are more physically active and have a higher metabolic rate excrete crack cocaine more quickly.13 

The best way to get crack cocaine out of your system is to stop using the drug immediately and give your body time to metabolize it. You can also enter an evidence-based detox program at a drug addiction treatment facility to wean off crack cocaine safely, in a comfortable and controlled setting.6

How Does a Crack Cocaine Overdose Affect the Body?

While crack cocaine has multiple effects that are perceived as positive by the person who uses it, it also has an overwhelming negative impact on the body and mind, especially when taken in large quantities that can cause an overdose.20 

An overdose can compromise your health in multiple ways. Some of the most common signs of a crack cocaine overdose are:8,20

  • Elevated blood pressure.
  • Difficulty breathing.
  • Elevated body temperature.
  • Irregular and rapid heartbeat.
  • Hearing or seeing things that aren’t there (hallucinations).
  • Feeling intensely agitated and nervous.
  • Trembling.
  • Nausea, vomiting, and diarrhea.

While these signs aren’t life-threatening in and of themselves, they can rapidly progress to more extreme symptoms. The most worrying outcomes of a crack cocaine overdose include:20

  • Seizures, which involve jerking movements of the body.
  • Loss of consciousness, when the person becomes unresponsive.
  • Heart attack, which causes chest pain and tightness, shortness of breath, and discomfort in the shoulders, arms, back, jaw, or neck.
  • Stroke, which causes weakness in one side of the face and body, confusion, difficulty understanding speech or speaking, and loss of coordination and balance.

It’s vital for these symptoms to be addressed as soon as possible to prevent further exacerbation and death.20

Crack Cocaine Overdose Treatment

Ambulance moving fast with a person with crack cocaine overdose Because some of the more extreme symptoms such as heart attack, stroke, or seizures can be fatal, individuals with suspected crack cocaine overdose symptoms should be given medical attention as soon as possible by calling 911.

The immediate concerns associated with an individual who has overdosed on crack cocaine involve restoring the individual’s breathing to a functional level if respiration has been seriously affected and to treat any cardiovascular issues that may have occurred. This can involve a number of different interventions depending on the severity of the person’s issues. If seizures have occurred, these should be addressed medically.

Individuals who mix crack cocaine with other drugs of abuse or alcohol will require specific interventions targeted at those drugs of abuse as well, which can include having the individual’s stomach pumped and using specific medications (e.g. naloxone if opioids have been used).1,5

Once the person is medically stable, the next step is entering a program for crack cocaine addiction treatment and recovery that includes medical management, counseling, social support, and long-term aftercare planning.

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