Tox Tuesday: Rise of crack cocaine use in the U.K. harkens back to previous crises

Courtesy the U.S. Drug Enforcement Agency

Many people associate high usage of crack cocaine with the 1980s and 90s, when an epidemic swept the United States, devastating urban neighborhoods and ending more lives than can be easily calculated.

And although nowadays opioids have taken over as the class of drugs causing concern in much of the world, crack cocaine has not disappeared from the scene. Far from it, in fact. Its usage has “skyrocketed” in the United Kingdom, according to a report published by Public Health England (PHE) and the Home Office.

The report found that users of the drug increased by 8.5% between 2011 and 2017, information that was compiled based on interviews with specialist drug workers, drug users and local police offices. The number of users spiked between 2011–2012 and 2014–2015, and has remained at a high level since.

“This report will come as no surprise to those working on the frontline, who will have seen firsthand this surge in crack use in their communities,” said Rosanna O’Connor, Director for Drugs, Alcohol, Tobacco and Justice at PHE.

Driving the increase

Why have more people begun using crack cocaine now, of all times? Authorities noted two main reasons: increased supply and improved marketing tactics.

Global production of cocaine has surged since 2013 — by 65%, according to the United Nations Office of Drugs and Crime. With increased supply (meaning decreased prices), drug dealers have reevaluated the way they reach out to new customer bases, using more sophisticated marketing techniques. Dealers are reported to target people who already use heroin while also opening to new markets, like younger crowds that have not used drugs before. They also travel from larger cities to access smaller towns.

Also of note: As decades have slowly passed since crack’s initial damaging wave in the 80s, stigma against the drug may have decreased. This potentially makes it easier to attract new users.

What is crack cocaine?

Crack cocaine is cocaine that has been processed with baking soda or ammonia to make it more potent and easily smokable. It was developed in the 1970s, gained prominence in the 1980s, and is the most potent – and dangerous – form of cocaine. Smoking allows a substance to reach the brain more quickly than other means.

Courtesy U.S. Drug Enforcement Agency

The drug is a powerful central nervous stimulant that causes excess amounts of dopamine in the brain, which creates a sensation of elation and pleasure. Using it even once modifies the brain’s reward system. Highs last 5–15 minutes, followed by immediate cravings for more. Long-term effects can include mood issues, psychosis, heart attacks, heart disease, strokes, respiratory failure, brain seizures, reproductive damage and, of course, increased chances of death.

When crack cocaine first reached epidemic levels over 30 years ago, it was enormously damaging, especially in the United States, contributing to higher crime and violence rates. In Baltimore, Maryland, cocaine was a major contributor to the city’s 300+ yearly murders, DrugRehab.com reports. In 1994, nearly 40,000 people were arrested on drug charges in this city alone.

The effects of the crisis were far-reaching in unexpected ways. In his book, “The Tipping Point,” Malcom Gladwell discusses a drastic rise in syphilis rates that coincided with the arrival of crack in Baltimore. Gladwell lists several theories for this. Crack increased risk-taking behavior in the people who used it, making it easier to contract sexually transmitted diseases. Crack also overwhelmed the health system, making it hard to provide medical outreach to affected communities. Baltimore’s mid-90s project to demolish dilapidated row houses created a mini-diaspora, causing potential disease carriers to migrate to new areas of the city.

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