Crack cocaine

Crack cocaine, crack or rock is a solid, smokable form of cocaine. It is a freebase form of cocaine that can be made using baking soda (sodium bicarbonate) or sodium hydroxide, in a process to convert cocaine hydrochloride (powder cocaine) into methylbenzoylecgonine (freebase cocaine).

Health issues
Because crack also refers to non-pure (or fake) versions of rock cocaine, the health issues also include risks beyond smoking cocaine. However, crack usage is less dangerous than speedballing or "snowballing" (mixing cocaine with heroin), which leads to more fatalities than either drug used on its own.

When large amounts of dopamine are released by crack consumption, it becomes easier for the brain to generate motivation for other activities. The activity also releases a large amount of adrenaline into the body, which tends to increase heart rate and blood pressure, leading to long-term cardiovascular problems. It is suggested by research that smoking crack or freebase cocaine has additional health issues beyond other methods of taking cocaine. Many of these issues relate specifically to the release of methylecgonidine, and the specific effect of methylecgonidine on the heart, lungs, and liver.

Toxic impurities - Other substances are often added to a batch to increase its volume. Occasionally, highly toxic substances are used, with an indefinite range of corresponding short- and long-term health risks. If candle wax is included), it will burn in the pipe as a noxious smoke.

Smoking problems - The task of introducing the drug into the body further presents a series of health risks. Crack cannot be snorted like regular cocaine, so smoking is the most common consumption method. Crack has a melting point of around 90 °C (194 °F), and the smoke does not remain potent for long. Therefore, crack pipes are generally very short, to minimise the time between evaporating and losing strength. This often causes cracked and blistered lips, colloquially "crack lip", from having a very hot pipe pressed against the lips. The use of "convenience store crack pipes" - glass tubes which originally contained small artificial roses - may also create this condition. The hot pipe might burn the lips, tongue, or fingers, especially when shared with other people quickly taking another hit from the already hot short pipe.

Pure or large doses - Because the quality of crack can vary greatly, some people might smoke larger amounts of diluted crack, unaware that a similar hit of a new batch of purer crack could cause an overdose: triggering heart problems or rendering the user unconscious.

Germs on pipes - When pipes are shared, unless users rotate and push the pipe to the burnt, sterilized end, any germs from the previous user's mouth can be transferred: tuberculosis can be spread by saliva. Mouth pieces (lengths of tubing added to the end of the glass pipe) are used.

Effects in pregnancy and nursing
"Crack baby" is a term for a child born to a mother who used crack cocaine during her pregnancy. There remains some dispute as to whether cocaine use during pregnancy poses a unique threat to the fetus. A major potential confounder is that nearly all crack cocaine users also use cigarettes; thus it may be difficult to appropriately attribute perceived deficiencies of children born to mothers who used crack cocaine.

A report in 2001 concluded that there was insufficient evidence to determine whether prenatal exposure to crack cocaine was an independent risk factor for physical growth, cognition, language skills, motor skills, and behavior, attention, affect, and neurophysiology. The opinion of the National Institute on Drug Abuse of the United States warns about health risks while cautioning against stereotyping:

"Many recall that "crack babies," or babies born to mothers who used crack cocaine while pregnant, were at one time written off by many as a lost generation. They were predicted to suffer from severe, irreversible damage, including reduced intelligence and social skills. It was later found that this was a gross exaggeration. However, the fact that most of these children appear normal should not be overinterpreted as indicating that there is no cause for concern. Using sophisticated technologies, scientists are now finding that exposure to cocaine during fetal development may lead to subtle, yet significant, later deficits in some children, including deficits in some aspects of cognitive performance, information-processing, and attention to tasks—abilities that are important for success in school."

Some people previously believed that crack cocaine caused infant death as sudden infant death syndrome (SIDS), but when investigators began looking at the incidence of SIDS in the children of women who used crack cocaine, they found it to be no higher than in children of women who smoked cigarettes. There are also warnings about the threat of breastfeeding, including concerns that crack cocaine may be present in the breast milk of mothers using the drug.

The March of Dimes advises the following regarding cocaine use during pregnancy:

"Cocaine use during pregnancy can affect a pregnant woman and her unborn baby in many ways. During the early months of pregnancy, it may increase the risk of miscarriage. Later in pregnancy, it can trigger preterm labor (labor that occurs before 37 weeks of pregnancy) or cause the baby to grow poorly. As a result, cocaine-exposed babies are more likely than unexposed babies to be born with low birthweight (less than 5-1/2 pounds). Low-birthweight babies are 20 times more likely to die in their first month of life than normal-weight babies, and face an increased risk of lifelong disabilities such as mental retardation and cerebral palsy. Cocaine-exposed babies also tend to have smaller heads, which generally reflect smaller brains. Some studies suggest that cocaine-exposed babies are at increased risk of birth defects, including urinary-tract defects and, possibly, heart defects. Cocaine also may cause an unborn baby to have a stroke, irreversible brain damage, or a heart attack."

Legal status
Cocaine is listed as a Schedule I drug in the United Nations 1961 Single Convention on Narcotic Drugs, making it illegal for non-state-sanctioned production, manufacture, export, import, distribution, trade, use and possession.

In the United States cocaine is a Schedule II drug under the Controlled Substances Act since it has high abuse potential but also carries a medicinal purpose. Under the DEA listing of schedule I substances, crack is not considered separate from cocaine since they are essentially the same drug compound in different forms. In the United Kingdom it is a Class A drug. In the Netherlands it is a List 1 drug of the Opium Law.

Law enforcement running drug stings to catch purchasers of crack cocaine often use macadamia nuts to simulate the drug. When chopped, these nuts resemble crack cocaine in color.

There has been some controversy over the disproportionate sentences mandated by the Federal Sentencing Guidelines for crack cocaine (versus powder cocaine) since 1987. Whereas it is a 5-year minimum sentence for trafficking 500g of powdered cocaine, the same sentence can be imposed for mere possession of 5 grams of crack cocaine, a 100:1 ratio. There is no mandatory minimum sentence for mere possession of powder cocaine. The United States Sentencing Commission has recommended that this disparity be rectified and existing sentences reduced. Some claim that this disparity amounts to institutional racism, as crack cocaine is more common in inner-city black communities, and powder cocaine in white suburban communities. The Supreme Court ruled in Kimbrough v. United States (2007) that the Guidelines for cocaine are advisory only, and that a judge may consider the disparity between the Guidelines' treatment of crack and powder cocaine offenses when sentencing a defendant.