The 7 Stages of Crack Cocaine Use

0 to 7 Stages of Crack Cocaine Use and Withdrawal Pattern

0) Currently using: Auditory hallucinations, hypertensive, hyper vigilant. During usage a person may think they hear sirens, cars pulling up outside, music, people talking, etc. Some people will experience tactile hallucinations such as skin crawling or seeing bugs on their skin. They will be extremely alert to the point of paranoia — perhaps suspicious of any movement around the area where they are using. It is common to hide out in the area where use is occurring and refuse to answer the door.

1) Panic stage: 1-3 hours after last use. During this phase money for more is the prime concern. In this phase a person may look for something around their house to sell or pawn or may consider where they may beg, borrow or steal something to sell for cocaine. Looking for lint on the rug hoping something has fallen is common at this point. In this acute withdrawal period, people have been known to try to rob crowded public places (mall stores, convenience stores, fast food restaurants) to obtain goods to sell or money for more crack. The withdrawal is so intense and craving so high that the person has little ability to think or reason logically.

2) Crash Stage: 3-24 hours after last use. Depression; remorse (suicidal); brain is in desperate need of rest but the chemicals (serotonin) necessary for sleep have been depleted and it is difficult, at first, to sleep. In this phase one wonders why they spent all their paycheck, used funds that did not belong to them, pawned valuable household items for less than actual value, stole from persons they truly care about, etc. Often, under the influence of cocaine-induced depression, one makes promises to never do it again in this phase and believes it. Highest risk for suicide is during this period.

3) Honeymoon Stage: 1-5 days after last use. Characterized by feeling very good. The craving is not noticeable or is easily manageable during this phase. The drug effects seem to be wearing off and one is starting to regain confidence in their ability to handle the addiction. During this phase it is common to hear a person say, “I don’t even think about it, I’m not going to have any problem with it. I do not even want it anymore.” A delusive way of thinking that ignores their past cycles and paves the way for the next binge. The chemical messengers of the brain (serotonin/dopamine) necessary to enjoy crack are still depleted and behind this lack of interest in crack. This is a dangerous stage as it is easy to think there is not a problem and therefore, why worry about it? People let down their guard during this phase and commonly use defense mechanisms, e.g., rationalizing and minimizing, to convince themselves this time they are cured and so have no need of further support or treatment. There is a high risk for people in treatment to leave during this phase as they no longer feel, or are aware of, the physical and emotional affects of the original crisis.

4) Return of Craving: 5-14 days after last use. Tremendous upsurge of acute drug hunger, depression, anger. The body has produced enough serotonin/dopamine for the person to want to use more cocaine but not enough to affect stability of mood and emotions. During this phase one may experience vivid dreams, fantasies, and acute drug hunger. Thoughts may cycle around using until a person feels like giving in to the obsession to use. Defense mechanisms (rationalization, intellectualization, denial, minimizing) begin to make a strong comeback after being knocked down by the original crisis.

5) Emotional Augmentation: 14-28 days start – up to 1-2 years. Over-response to the normal stress and events of everyday life. At the top of the mood swing one is unusually happy and at the bottom one is unusually sad. The state of making mountains out of molehills. This is related to biochemical responses induced by strong emotions that stimulate areas where mood and mind altering drugs act on the brain. The body is now seriously undertaking the repairs of areas damaged by drug use and is replacing important chemicals needed to regulate mood and emotions. As a result, one is slightly off balance chemically without being consciously aware of it. There there is a strong need for accurate feedback on one’s behavior from an objective support group. (Recommend AA or NA or another type recovery support group.) This cannot be stressed too highly for long term success in recovery. Also, low impact exercise – walking, jogging, bicycling, low impact aerobics – and a well-balanced diet will shorten this phase and reduce the severity of the symptoms. Irritability, depression, anxiety, mood swings, memory loss, difficulty concentrating, short attention span, nightmares, insomnia, fatigue, and headaches are some of the normal recovery symptoms of the emotional augmentation stage.

6) Covert Cravings: 28-35 days. Secrets and bad judgments characterize this phase. Craving is not as strong on a regular basis but one may have periodic strong cravings and not want to admit it for various reasons. Thinking it is a sign of weakness, poor moral character, that they are not working a good program, that they simply should not be having cravings. Generally, the cravings are of a low level, e.g. euphoric recall (glorifying war stories), vivid dreams that trigger cravings upon awakening, or just general mild drug hunger. Without someone to talk with concerning these normal protracted withdrawal symptoms, they can evolve into high level cravings, e.g. acute drug hunger, drug seeking behavior, obsession and on to compulsion. Again the need for a support system is strongly recommended.

7) Cue Conditioning: 35 days upward. Cue conditioning – referred to as triggers – could be money, anger, disappointment, music, a film, or extreme joy. Anything strongly associated with using could cue/trigger a craving. The strength of these cue cravings will diminish in time but continue on for years although becoming few and far between. They can catch a person off guard and evolve into higher level cravings. Again, a long term support plan for sobriety AA/NA or recovery support group is recommended to alleviate these natural manifestations.

It is a normal part of recovery to have strong cravings due to acute withdrawal 3-7 days and then continued cravings at a lower level well into protracted withdrawal 6 months-2 years. Time and severity of protracted withdrawal depend upon type, amount, and frequency of drug used. Again, a program of good nutrition and low impact exercise can alleviate these normal recovery symptoms.

Please note that behavioral symptoms: compulsion, obsession, loss of control over time, place, amount used and continued use despite adverse consequences are secondary symptoms of the disease process. With continued treatment of the disease with abstinence and a good support system, these behavioral symptoms will diminish to normal discussions over time.


The above information was provided to a friend of a friend of mine in 2000 while he was in detox for crack cocaine addiction, and she recently emailed me a copy when she learned I was going to write about crack and homelessness. Thanks, friend. :)

>> See also, “What You Need To Hear About Crack Cocaine”

Yes! Weekly: Camp closures bring sudden change to Greensboro’s homeless.

The latest on downtown homeless camp closings in Greensboro:

If there is a concerted effort to close down multiple longstanding homeless camps on the outskirts of Greensboro’s downtown then nobody’s talking. Like any good conspiracy theory, there are threads of suspicion that run off in numerous directions without any real motivating nexus.

But in conversations with homeless advocates, law enforcement and neighbors who’ve lived in harmony with discrete camps for years on end a pattern emerges that suggests some force – like one small pebble dropping into a pool of water – has sent ripples of change across more than a dozen homeless camps near downtown.

Property owners have sudden changes of heart about allowing homeless people to camp on vacant or wooded lots. Rumors of camp closures, in addition to actual forced evictions, move small pockets of homeless people, causing large camps – like the one at Freeman Mill Road and Spring Garden Street near the entrance to the Downtown Greenway – to swell. Others peel off, looking for more serene camps like the one just beside Chestnut Street in the Aycock Historic District, bringing unwanted attention to people who’ve lived out of sight and mostly out of mind from the surrounding community.

via Camp closures bring sudden change to Greensboro’s homeless..

Cold Weather Crisis Shelters in Greensboro

IMG_20140124_234325_790January has been an unusually cold month. Temperatures in the single digits and below are dangerously cold for the many homeless people who live outside in Greensboro. But staying in an emergency shelter — Greensboro Urban Ministry’s Weaver House or WE (winter emergency) shelters in churches — is not an option for most of them. Some can’t stay in the shelters because of eligibility rules: time limits on stays; ID required; no sex offenders; etc. Some are banned because of previous behavior issues — often related to addiction or mental health disorders. Some can’t stay at Weaver House or in WE shelters because they have pets or have a lot of belongings that they can’t take with them. Some won’t stay in shelters because they’ve had a previous negative experience with staff; they have traumatic brain injury, addiction or mental health issues which make it difficult for them to comply with rules; they can’t stay together with a spouse or partner; they don’t feel cared for in an institutional setting; etc. And so they sleep outside in tents, under bridges, in abandoned buildings, on park benches, on sidewalks, in parking decks — wherever they can. And when temperatures are dangerously cold, they are at risk.

IMG_20140124_233830_258Recognizing this risk, Gift Community and Awaken City churches in downtown Greensboro have opened up their meeting spaces during dangerously cold weather to serve as cold weather crisis shelters for homeless people who live outside. The crisis shelters are operated differently from traditional shelters. We call them “no barrier” shelters. They are open from 7pm until 7am on any night that the temperature or wind chill is in single digits and guests may come in at any time during those hours. Any homeless person who lives outside in Greensboro is welcome to come in and stay with us. There is no registration process and there are no eligibility rules.

IMG_20140124_192741_313Homeless people — we just call them friends — come in and get a sleeping bag and cot. The crisis shelters serve men and women in one space so that couples and groups of friends can stay together, with separate space for women who prefer it. A hot meal is served every evening and breakfast is served every morning. Snacks, water, coffee and soft drinks are available at any time. People are free to go out and smoke at any time throughout the night. Donors drop by with hats, scarves, gloves, socks and more.

One church has TVs. The other has video games, nightly card games and a volunteer who shows movies on her laptop. The atmosphere at both crisis shelters is low-key, laid-back and most of all, caring and supportive. No one is paid to be there. The volunteers are there because they want to be and look forward to getting there every night. The homeless people who sleep in the crisis shelters have stepped in and become volunteers themselves — some taking leadership roles — helping with welcoming new people into the shelter, caring for those not feeling well, setting up and taking down cots, cleaning alongside volunteers, and more. With everyone eating, talking and serving alongside each other, it’s hard to tell who’s homeless and who’s not, which we think is just great. People are people. A lot of times it  feels like family to me, which is exactly how it should be.

StreetWatch homeless outreach team is assisting in coordinating and stocking the shelters, raising funds, and communicating with the public and with partners assisting with the shelters. (We’re also doing pre-assessments to help find out what supports and services our friends may need to help end their homelessness.) 16 Cents Ministry is providing transportation. Missio dei:gso church is providing volunteers and funding. Greensboro Police Department is providing assistance and coordinating overnight transportation. Many others are volunteering and providing financial contributions and donating needed items. You can help.

Think Before You Help: “Walking a Mile: How We Help Matters”

All help is not created equal. Before you help the homeless, consider this:

Earlier this year First Baptist Church of Fort Lauderdale, Fla., collected 700 pairs of shoes for a local homeless shelter. People came forward and placed their shoes on the altar, with many going home in socks or bare feet.

What an incredible outpouring of generosity from a church working to make a difference in their community. High fives all around.

It’s great to hear stories like this, but sometimes you start to ask questions:

  • That’s a lot of shoes. I wonder if the homeless shelter was equipped to handle the storage and distribution of that many shoes?
  • How would you distribute that many shoes?
  • Did they have the right sizes?
  • What kind of shoes do you buy for a homeless person? Sturdy, comfortable walking shoes for being on your feet all day, or dress shoes to complete an interview outfit?
  • Are shoes really what the shelter needed most? What if instead of shoes, those 700 people donated $20 each. $14,000 could go a long way. Or what if all 700 people volunteered? What does that shelter really need?

>> Continue reading… Walking a Mile: How We Help Matters at Church Marketing Sucks.