Crack Users Risk Sudden Death, Doctor Warns

People who use crack, a smokable form of cocaine, risk dire results, including sudden death, and the potential perils increase with repeated use of the drug, which has rapid impact on both body and brain, warns an emergency-medicine specialist at New York University Medical Center.

“Crack is purer, cheaper and far more dangerous than the powdered form of cocaine,” said Dr. Neal A. Lewin, assistant professor of clinical medicine at the medical center. While both forms are taken to achieve a state of euphoria, cocaine sniffed in powder form takes effect gradually, over a 10- or 15-minute period; crack’s impact occurs within seconds.

“When the drug is smoked,” explained Lewin, who is also assistant director of emergency services at Bellevue and University hospitals, “it is rapidly absorbed through the lungs, and a high concentration in the bloodstream is quickly achieved. There is an instant, though short-lived, euphoria--a ‘two-minute high.’ But other effects may take place just as quickly.”

Among the latter, he lists life-threatening seizures, body temperature soaring as high as 115 degrees, hallucinations, psychosis, extreme blood-pressure elevation leading to brain hemorrhage and stroke and heart attack due to intense spasm of the coronary arteries.

New studies, the NYU physician adds, suggest that with either form of cocaine, a so-called kindling effect may occur--specifically with regard to the drugs’ impact on the brain. With repeated use, the brain becomes more sensitive to the drugs and even doses that previously seemed “safe” may trigger fatal seizures. This effect is more likely to occur with crack, since it is 90% pure cocaine (the powder form is generally heavily adulterated with other substances).

Is cocaine addictive?

“Classically, addiction is defined as including a physical withdrawal syndrome, as occurs with heroin. We do occasionally see some withdrawal symptoms with cocaine--and there is certainly a marked psychological dependence, with the high followed by a definite low. With crack, that depression, like the euphoria, occurs more quickly and is more intense,” Lewin said.

Even if the life-threatening physical effects do not occur, he points out, this emotional seesaw is a ruinous ride, especially for young people: “The teen-ager is normally in a period of turmoil, a person who is living through a volatile and tumultuous time and does not have the life experience to deal with major stress. Crack sets up a young person for disaster.”