Crack cocaine
crack · rock · stones
What does current UK evidence show?
National mortality data record cocaine rather than a separate crack-specific total: 1,233 England and Wales registrations in 2025 and, separately, 589 Scottish drug use deaths in 2025. English treatment data therefore provide essential context for opiate-and-crack and crack-only need.
Overview
Identity, legal classification, form and pharmacological context
- Drug category
- Stimulants
- Common names
- crack, rock, stones
- Typical forms
- Small rocks or solid pieces
- Routes
- Usually smoked; sometimes injected after preparation
- UK legal classification
- Class ACrack is a form of cocaine and is controlled as Class A.Check government source ↗
- Concise pharmacology
- Increases central nervous system activity through substance-specific effects on monoamine signalling.
Main harms
Concise clinical and polydrug picture
Agitation, anxiety, overheating, chest pain, seizures and cardiovascular strain.
Sleep disruption, mood problems, cardiovascular harm and stimulant-related psychosis may develop.
Fatigue, low mood, sleep disturbance and craving can follow sustained use.
Alcohol and cocaine together form cocaethylene; some evidence suggests added cardiotoxicity. Other stimulants can increase cardiovascular strain, while sedatives do not cancel cocaine-related risk.
Smoking crack can injure the airways; injection after preparation adds vein, infection and blood-borne virus risks. Product strength and combinations vary.
Current intelligence status
Assessment, confidence and direction
National mortality data record cocaine rather than a separate crack-specific total: 1,233 England and Wales registrations in 2025 and, separately, 589 Scottish drug use deaths in 2025. English treatment data therefore provide essential context for opiate-and-crack and crack-only need.
Reason: Direct official statistics or confirmed analytical evidence support the defined signal. Interpretation remains limited to each source’s geography, period and method.
Principal source limits: NRS calls this series drug use deaths. Substance implication overlaps and does not prove sole causation. Nitazene testing expanded, including etonitazene in May 2025; 2025 versus 2024 rate difference is not statistically significant. Treatment contact reflects recorded service need and access in England, not population prevalence.
Geography and reference periods are given in each linked source card below. The rating is an editorial evidence judgement, not a probability, clinical risk score or TD priority.The assessment reflects the latest linked evidence and is not a universal severity rating.
Operational implications
Evidence-supported prompts for professional response
Commission crack-specific outreach, wound and respiratory care, trauma-informed treatment and links with housing and safeguarding services.
Record substance, sold identity, route, frequency and combinations; review physical, mental-health and dependence needs.
Use symptom-led assessment and escalate reduced consciousness, seizures, overheating, chest pain or severe agitation.
Link early identification with safeguarding and age-appropriate treatment without presenting population use as individual risk.
Related intelligence
Continue into connected platform evidence
Sources & limitations
Direct evidence links, reference periods and status
Drug-related deaths in Scotland, 2025
Published23 Sep 2026Reference period2025 registrations
NRS calls this series drug use deaths. Substance implication overlaps and does not prove sole causation. Nitazene testing expanded, including etonitazene in May 2025; 2025 versus 2024 rate difference is not statistically significant.Adult substance misuse treatment statistics
Published04 Dec 2025Reference periodEngland · 2024–25
Treatment contact reflects recorded service need and access in England, not population prevalence.Deaths related to drug poisoning in England and Wales: 2025 registrations
Published4 Nov 2026Reference period2025 registrations; 2024 occurrences
Deaths are counted by registration year; 62.7% of the 2025 registrations concern earlier deaths. Substance mentions overlap and do not prove sole causation.National Strategic Assessment 2026
Published17 Mar 2026Reference periodLatest national assessment
An intelligence assessment rather than a population survey or a complete count of incidents.Clinical guidelines for alcohol treatment: harm reduction
Published28 Nov 2025; updated 17 Apr 2026Reference periodClinical guidance
Withdrawal risk and care depend on individual assessment.Cocaine and crack drug profile
PublishedSource page undatedReference periodPharmacology, forms and routes
European clinical and product context; UK mortality data do not distinguish powder from crack.