Possession of powder cocaine has a very different sentencing outcome in a court of law, than possession of crack cocaine. Politicians' War on Drugs played in lead role in casting the drug in the light we see it today. For a great example of this, check out the presidential address George H.W. Bush sent across airwaves from the Oval Office in 1989. “What’s the most pressing problem today?” the then-president asks. “Cocaine, and in particular, crack cocaine.”

“Who’s responsible?” Bush continues. “Everyone who uses drugs, everyone who sells drugs, and everyone who looks the other way.”

He went on to discuss crack itself: “It’s as innocent-looking as candy, but it's turning our cities into battle zones, and it's murdering our children.”

Crack was used as a scapegoat for complex social problems — unemployment, poor education, lack of resources, violence, and the list goes on. It was easy to blame drugs for inner-city woes, which made the War On Drugs appear to be a necessary and helpful solution.

This is not to say that drug use wasn’t widespread during the late '80s and early '90s, because it was. And it is important to note that cocaine is harmful for you in any form. However, demonizing crack is tied to specific beliefs about the users — where they come from, what they look like, and the role they play in society. Is crack really all that different from its more glamorous counterpart, powder cocaine? No. But then again, neither drug is harmless. They are both incredibly damaging. So why does the law look at them so differently?

In search of the truth, ATTN: asked an expert for some help. Jenni Stein, PharmD BCPS, is a clinical pharmacist, who maintains a blog focused on addressing the way addiction is viewed and treated. Stein shared with ATTN: the difference between crack cocaine and powder cocaine and the science behind addiction. She also offered her opinion of how the crack epidemic began, along with how we should be talking about drugs, decriminalization, and addiction.

ATTN: Are crack and powder cocaine the same drug?

Jenni Stein: Yes, they are the same drug. Both are cocaine.

So then what’s the difference between the two? Tell me about crack vs. cocaine.

JS: The actual chemical effects of crack vs. powder cocaine are not different. However, the chemical makeup of crack vs. powder cocaine does slightly differ.

Powder cocaine is the hydrochloride salt form (cocaine HCL). This is how cocaine exists "in nature" from coca leaves. As a salt, it is soluble in water, stable as a powder, and usually snorted through the nose and absorbed through nasal mucosa membranes. It can also be dissolved in water or melted and injected.

Crack cocaine is the free base form of cocaine. There is a longer scientific explanation, but basically, it is not a salt. It is powder cocaine that has been processed with a base, such as baking soda, to remove the HCL. In its “free base” form cocaine is more lipophilic-- meaning it’s able to be rapidly absorbed when smoked.

Can you tell me about the way the drugs are used, and their effects?

JS: Because powder cocaine and crack have different formulations, they are "used" differently, and therefore have different effects. The different effects are 100 percent related to the way they're used (routes of administration), not the chemical formulation beyond the fact that the differing formulations allow for different routes of administration.

A "high" from snorted cocaine will hit you in about 1-5 minutes, be at its peak within 20-30 minutes, and last 1-2 hours. A "high" from inhaled or injected cocaine will hit you in less than a minute, be at its peak within 3-5 minutes, and last 30 minutes to an hour.

The onset and peak occur much faster with inhaled [if smoked] and injected cocaine, and the user experiences the effects of the drug "all at once" — so the user will get higher than if the same amount of cocaine were snorted.

Crack cocaine is inhaled, but powder cocaine can be injected, resulting in the same onset/peak/duration effect that crack produces.

Because inhalation and injection get the user higher (more drug is delivered all at once), and the high happens faster and wears off faster, the behavior is highly self-reinforcing. This lends itself to repetition, or binges, where the user will use or hit over and over to repeat the high that wears off quickly. This pattern of use makes users that inhale or inject more vulnerable to the addictive effects of the drug.

How does cocaine affect your body?

JS: This is complicated! It affects literally every single organ system in your body. It affects at least 5 or 6 different neurotransmitters in your brain, all at once, in different ways.

Again, the differences between crack and powder cocaine are mainly attributable to the route of administration — how you “do” the drug — so smoking crack can have toxic effects to the lungs that are not problems with snorted cocaine. In the same way, snorted cocaine can have effects on the mucous membranes not seen with smoked crack.

What does it feel like to be high?

Cocaine is a central nervous system stimulant, so it speeds you up. The effects can be thought of as similar to a huge dose of caffeine. It’s not just a stimulant, it also produces feelings of euphoria, or intense pleasure — feeling amazing, feeling like you can take on the world — and that has to do with the fact that it releases a huge amount of adrenaline. So not only is it stimulating you in the way that caffeine does, but it stimulates you in the way that an adrenaline rush does. It can also be associated with sensory changes, because of its effect on dopamine, but it’s less common to hallucinate with cocaine than it is with other drugs (although it’s within the realm of possibility).

So it produces euphoria (feelings of intense pleasure), and those feelings are reinforcing. For people that are pleasure seeking, or don’t have other sources of pleasure in their life, or maybe the particular high that cocaine produces is the pleasure they like the most — it’s very reinforcing.

How does that reinforcement work?

JS: So there’s two ways that the reinforcement works. One way is from the psychological standpoint. If you find something that’s like medicine, that works for you — that treats your "illness" — you’re more inclined to want to take it again. If you’re depressed and find an antidepressant that works, you want to use it more. You don’t want to stop, even if it’s dangerous. That’s one thing. People who choose cocaine as their drug of choice do so because it’s meeting a certain need for them. That’s sort of from the addiction standpoint.

From the physiological standpoint, the way that it works in the brain is it increases levels of all these neurotransmitters in the synapses of your brain. Basically, if you have a feel-good chemical and it’s supposed to hit your synapse little by little, but you put a whole bunch of it there (like when you do cocaine), it produces a lot of stimulation. What happens, though, is the synapse actually adapts to the higher level of feel-good chemical. So the more you use a drug like cocaine, the more the synapse changes — you reduce the number of receptors for the feel-good chemical that exist in the synapse. When that happens, the same amount of feel-good chemical produces less euphoria. And then, if you don’t have high amounts of that feel-good chemical, you may not be able to feel euphoric at all, because the levels that you’re used to having don’t produce the same amount of stimulation that they used to.

Those are the two things that happen. One is, 'hey this is working for me and I want to continue to have this experience,' and the other is, 'if I don’t continue to use this drug to have this experience, it’s becomes harder for me to have the experience in other ways.'

Also with cocaine, and other drugs that cause rapid tolerance — that’s called tachyphylaxis — you can also recover. So if you spend a lot of time not using, your synapses go back to normal eventually. The damage is not necessarily permanent.

Can things that are not chemical drugs be reinforcing?

JS: Absolutely. It’s a myth to say addiction is caused by the drug. Addiction is a behavioral phenomena that comes from the place of an individual having needs to fill. When somebody finds something that makes them feel the way they want, it has the potential to be used in a way that’s maladaptive. What that means is basically, you can drink and have it feel good, and not become a problem drinker because you recognize that you can use other things to feel good too or you recognize that sometimes using it would make you feel bad. Or, you can not have that happen, where you drink and it makes you feel good and so you double down and think, “If I drink more, I’ll feel even better.” And that’s true for anything.

When it comes to food addiction, for example, people may feel a sense of happiness, fullness, relief, or comfort when they eat — and that’s what does it for them. Some people, fail to recognize that that has limits, and they try to push it beyond the limits, where basically, food becomes their go-to for feeling better, or for anything. And that’s what addiction does to you, it makes you feel like you’re over reliant; you’re dependent on one coping mechanism, which then becomes maladaptive and destructive.

So Oreo cookies’ effects on the brain aren’t the same as cocaine’s effects on the brain, but behaviorally, they could be used in the same ways that someone would use cocaine

Speaking of behavior, I read an interesting piece about the rational choices of crack addicts. Can you talk about the role rational choice plays in drug addiction?

JS: The reason that crack has become a widespread social problem is because in an environment where people don’t have options, crack becomes the rational choice. It is an option — one that allows you to feel good, or feel powerful, or feel successful. It’s an option to feel like you’re taking control in your life for a minute, that’s accessible, when other options are not. Access is key here.

For me, as an upper middle class, white, young adult in between the Millennials and Gen Xers, who was raised to believe that the world was my oyster, crack is not a rational choice. Crack would limit me from achieving my full potential. But, for somebody who was born into poverty, who’s dealt with racism, systemic abuses, perhaps personal abuses, and other inequities; for somebody who has basically been, consciously or unconsciously, made to feel like they are nothing and like they do not have options — crack might be a rational choice. Crack might give them emotional and physical feelings similar to that of somebody like me, who does know that they have options.

So why do you think the crack epidemic occurred? Did this have to do with lack of rational choices?

JS: As a clinician, I like to ask this question: Where are the gaps in our societal structures that create circumstances where people feel driven to self-medicate? And I think with the crack epidemic of the '80s there are a lot of really obvious ones. Like widespread poverty, racism creating limited options for people in certain areas, lack of access to education, lack of access to healthcare, lack of access to safe housing and good food — all of those things would drive anybody to feel bad. And when you have medicine that’s available to you on the street that you can afford that makes you feel good, it’s not shocking that you might take it. Cocaine is a drug just like any other drug, and if you force people to self-medicate because you don’t provide them access to actual social support, then you get things like a crack epidemic.

It is a symptom of a really deeply rooted widespread social problem, and what we chose to do as a society was criminalize rather than actually fix. So instead of saying, "a lot of people are using crack because their life is total shit and we can do something about that," instead we said, "well, now we can put them in prisons and we don’t have to deal with them anymore." And it didn’t make it better. It made all the reasons that the problem started in the first place, worse.

Was the focus on crack, and those who use it, warranted?

JS: I don’t think we should have ignored it, but I don’t think we should have criminalized it at all. I think we absolutely should have seen that crack use was a symptom of poverty and social and economic disparity and addressed those issues. That’s what people should have thought about when we realized there was a problem with crack. Because it was a real problem. It’s still a real problem. But should we focus on criminalizing the people who are using crack? Absolutely not. We should have recognized, and we should still recognize, that it’s a symptom a much larger social problem that’s critically important to address otherwise we might have social collapse.

So when we talk about drugs and drug use, how did criminalization come into play?

JS: I believe criminalizing drug use is the worst possible thing we could do, because it completely fails to address the reasons for it. It criminalizes the majority of the U.S. population, and that makes the enforcement of it necessarily arbitrary.

The people who are being arrested for crack use are not in any way, necessarily, "worse" than the people who have used powder cocaine, that have smoked marijuana, that take ecstasy. But the fact that all of those things are illegal allows law enforcement to selectively target whoever they want to be criminals, and it’s a huge, huge problem.

Speaking of problems, why was crack use so widespread?

It’s a consequence of the War On Drugs. You can look at prohibition, and see the same thing happen. Everybody likes to drink, but when it’s illegal to buy, sell, and drink it, what do you do? Make it easier to hide — because people are still going to drink it. And that’s what happened. During prohibition, people started making more concentrated, higher proof alcohols. We went from a society where people would drink beer as a beverage, to having gin and whiskey and moonshine because those versions, essentially, fit more alcohol in a smaller space, it’s easier to transport, and it’s easier to mix with things, or hide. The fact that we drink hard liquor in our society is largely because of prohibition. It became more popular when there was a drive to make alcohol more concentrated and hideable. And crack cocaine is exactly the same.

Cocaine went from being in your soda, to being prohibited. Then, not only did it become more desirable, but there was a desire to make it more potent — so it could be transported in larger quantities and so people could get more bang for their buck. So, instead of being most commonly consumed in beverages, it went to being snorted as powder. And then it was discovered that it could be made even more potent and more concentrated by being made into crack. And that’s a consequence of criminalization. [One] reason we have crack, is because we made cocaine something that’s illegal.

Considering the role race plays in the way we think about crack, do you think activism comes into play at all when having conversations like this?

JS: I think that the Black Lives Matter movement plays a huge role in addressing this from both sides, because it does point out the disparities in the way people are treated in this country, but it also really gets to the root of the problem. The reason that these issues exist in the first place is because we as a society act like, honestly, like Black lives don’t matter. We act like certain people don’t need to have welfare or don’t deserve to have the same educational opportunities or don’t deserve the same job opportunities or even the same dating considerations. And that is so deeply rooted, that we end up with all these end result consequences manifested in things like drug problems and addiction rates. These become the issues we focus on, but in doing so we sometimes forget the point, which is that a Black person or a Latino person or a Native person or any person that is a minority in our society matters just as much as me.

If you could give us one piece of advice here, what would it be?

JS: I don’t want to downplay the dangers of these highly toxic, super concentrated, dangerous drugs. We shouldn’t have them everywhere on the street. But the way to get them off the street is not by making them criminalized, it’s by making the things that people actually want to do, like drinking a beer or getting a buzz, easier to do. Responsible adult should be allowed to do with their body what they want to do, without having to be criminalized. And once you’ve been criminalized why not go all the way, right? So let’s not downplay the dangers of cocaine, or crack, but instead, talk about the reason why we have so much of it.

This article was published in collaboration with the Drug Policy Alliance. To learn more about these issues, visit www.drugpolicy.org.