When people mix crack cocaine and alcohol, they are compounding the danger each drug poses and unknowingly forming a complex chemical experiment within their bodies. NIDA-funded researchers have found that the human liver combines crack cocaine and alcohol and manufactures a third substance, cocaethylene, that intensifies crack cocaine's euphoric effects, while possibly increasing the risk of sudden death.

The short term effects of crack cocaine can be felt upon users initial hit of crack. The individual begins to feel the effects of crack cocaine immediately; they experience an increase in energy, temperature, mental alertness, heart rate, constricted blood vessels, as well as a decrease in appetite. These temporary effects of crack cocaine are as short lived as the users high. Because crack cocaine is smoked causing it to travel through the blood up to the brain much faster than cocaine which is snorted, the user experiences these short term effects more intensely. The duration and intensity of these short term effects of crack cocaine are based on the amount of crack cocaine that is used.

The long term effects of crack cocaine affect the user physically, mentally, and emotionally. An individuals long term effects from crack cocaine vary from person to person depending on their length and intensity of abuse. In general, the long term effects of crack cocaine include restlessness, mood change, irritability, auditory hallucinations, extreme paranoia, and eventually and rather quickly, addiction.

The maximum physiological effects of crack cocaine take place approximately two minutes after the users inhalation. Maximum psychotropic effects of crack cocaine are attained approximately one minute after the users inhalation. Similar to intravenous use, the physiological and psychotropic effects of crack cocaine last for approximately 10 to 15 minutes after the users peak effects occur.

Crack cocaine is a strong central nervous system stimulant that interferes with the reabsorption process of dopamine, a chemical messenger associated with pleasure and movement. Dopamine is released as part of the brain's reward system and is involved in the high that characterizes crack cocaine.

Because crack cocaine reaches the brain in a highly concentrated dose, it is an extremely strong stimulant to the heart and lungs. Irregular heart beats, heart attacks, cardiac arrest, convulsions, loss of oxygen to vital organs and stroke have all been seen in crack cocaine users. Psychosis is often seen in crack cocaine users as well. They are paranoid individuals who see and hear things that are not there. The most dangerous risks associated with crack cocaine is overdosing and poisoning. This results in nausea, vomiting, irregular breathing, convulsions, coma and death. These may happen with only small doses of crack cocaine or may even happen at a later time after the drug has been taken.

Almost a quarter (24%) of the cocaine emergency department mentions in 2001 were attributed to crack cocaine, which has increased 35 percent since 1994 and 20 percent since 2000. During 2001, there were 46,964 crack cocaine ED mentions.

The Effects of Crack Cocaine Include:

Early Use

• Magnification of pleasure, euphoria
• Alertness and in some cases - hyper-alertness
• Increased and sometimes a (grandiose) sense of well being
• Decreased anxiety
• Lower social inhibitions: more sociable and talkative
• Heightened energy, self-esteem, sexuality and emotions aroused by interpersonal experiences
• Appetite loss; weight loss

Compulsive Use

• Extreme euphoria - "mental orgasm"
• Uninhibited
• Impaired judgment
• Grandiosity
• Impulsively
• Hyper sexuality
• Hyper vigilance
• Compulsivity
• Extreme psychomotor activation/agitation
• Anxiety; irritability; argumentative
• Transient panic
• Paranoia
• Terror of impending death
• Poor reality testing; delusions
• Extreme weight loss

Physical Effects

• chronic sore throat
• hoarseness
• shortness of breath
• bronchitis
• lung cancer
• emphysema and other lung damage
• respiratory problems such as congestion of the lungs, wheezing, and spitting up black phlegm
• burning of the lips, tongue, and throat
• slowed digestion
• weight loss
• high incidence of dependence
• blood vessel constriction
• increased blood pressure
• increased heart rate
• brain seizures that can result in suffocation
• dilated pupils
• sweating
• rise in blood sugar levels and body temperature
• disability from drug-induced health problems
• suppressed desire for food, sex, friends, family, and social contacts
• heart attack
• stroke
• death

Emotional/Psychological Effects

• sadness and depression
• loss of interest in appearance
• loss of household valuables or unexplained vanishing cash due to the expense of the drug
• sleeplessness
• extreme paranoia
• intense craving of the drug
• schizophrenic-like psychosis with delusions and hallucinations

Crack and Pregnancy

• increased incidence of still births
• increased incidence of miscarriages
• premature (often fatal) labor and delivery
• in males, the cocaine in crack may attach to the sperm causing damage to the cells of the fetus.
• babies exposed to cocaine experience painful and life threatening withdrawal, are irritable, have poor ability to regulate their own body temperature and blood sugar and are at increased risk of having seizures.

Effects of Crack on the Fetus

• seizures or strokes
• cerebral palsy
• mental retardation
• vision and hearing impairments
• urinary tract abnormalities
• autism and learning disabilities