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Welcome to the latest FRANK Action Update. This is a special reference

edition to complement our other publications.

The range of professionals in the FRANK network is very broad, so some issues of the Update may
be more relevant to your work and your client group than others. But we hope that each Update
will bring you useful information and inspiration as you get on with the vital job of raising awareness
about drugs.

Crack cocaine is not everywhere, but in some areas it is a growing problem and the drug, its effects on
the individual, and the ways in which it is tackled, are often misunderstood. Many people wrongly believe
that crack cocaine can be neither tackled nor treated. This often discourages people from taking collective
action or coming forward for individual help. Drug workers and other professionals have had to address crack
cocaine as a relatively new drug issue and many are now beginning to get the knowledge, confidence and
support they need to work effectively with crack cocaine users.

This FRANK Action Update aims to help you understand some of the issues related to crack cocaine.
Containing background information, facts and statistics, it helps to explode some of the damaging myths
surrounding crack cocaine. It gives ideas for action and shows how certain projects have successfully tackled
crack cocaine, while also signposting routes to further help and information. If you are already addressing a
crack cocaine problem in your area, you will probably be familiar with most of the material in this pack.
However, you may find some useful additions to your local action.

FRANK IN ACTION Feedback from the public and local networks about the FRANK campaign 2
VITAL STATISTICS What is crack cocaine? 3
Crack cocaine in the UK 4
The crack cocaine market 6
Physical & psychological effects 8
Challenging a crack cocaine drug market 12
Young people and crack cocaine prevention 13
Common Myths 14
MOVERS AND SHAKERS Snapshots of positive practice on tackling crack cocaine 16
CHECKLISTS FOR ACTION Key needs and requirements in addressing crack cocaine locally 18
IDEAS FOR ACTION Ideas and inspiration for local action 20
USEFUL RESOURCES Useful contacts, publications, resources and websites 23

FRANK FACTS Myth-busting summary

FRANK TIPS Crack cocaine and the media
Communication checklist
MORE FRANK Order your FRANK resources
TELL FRANK Tell us about your FRANK activities and plans

The core audience for this issue are drug workers and other professionals who may be experiencing
an emerging or anticipated crack cocaine problem in their
Action Update – Understanding Crack Cocaine
FRANK Action Update – Understanding Crack Cocaine 1
FRANK is proving an effective way of offering advice and information on drugs
to young people and their parents and now has a range of services on its referral
database to refer people into treatment, advice and counselling.
For news on how FRANK is progressing, and details of future plans, make sure you register at


“I have been using heroin for some years “I just wanted to congratulate you on
and have now been clean for six weeks. producing a truly useful website for drug
I have called FRANK three or four times takers.Whilst I no longer take drugs, I've
and have also spoken to a Scottish taken most of the drugs that you have
advisor in depth about my problems. described on your site and for a change
I just wanted to call back to say thanks people are actually getting unbiased
for being so sympathetic and offering such facts about taking drugs.
an excellent service. A lot of helplines I'm sure that my stepson will be using your
seem really scripted but FRANK is great site just as soon as I encourage him to!”
because you sound genuinely like you email from parent about
care and want to help. If any of my
friends ever need help I will definitely
recommend that they call FRANK.”
Call to the FRANK helpline from a member of the public “Thank you very much for your reply
to my question! It was very useful and
now when I need advice on drugs
FRANK THANKS I know where to come!”
FRANK wants to thank Phoenix House and Turning email from a young person to the FRANK helpline
Point for participating in the photography featured
in this Update.

Phoenix House is a leading provider of specialist Turning Point is the UK’s leading social care
treatment services for drug and alcohol users in organisation working across the areas of drug
the UK. Working within community settings and the and alcohol misuse, mental health and learning
prison service they provide people with services disabilities. As the largest voluntary sector provider
that reflect their needs. They address dependency of drug and alcohol treatment services - including
problems, restoring dignity, self-worth and personal services specifically aimed at stimulant users - they offer
responsibility while introducing stability and new a range of treatment interventions including one to
skills to rebuild lives. one support, counselling and structured day care or
For more information telephone 020 7234 9756 residential support for people in more chaotic situations.
or visit For more information visit

Tell us what you’re doing – and what people are saying locally about FRANK – using the Tell FRANK form
at the back of this Update, or by email to

2 FRANK Action Update – Understanding Crack Cocaine

It is thought that the manufacture of crack cocaine was first achieved
in America in the late 1970s. Initially,‘freebase’ cocaine was popularised
among the well-established bohemian society, but the low cost of a rock
and the attraction of the rapid hit meant that usage quickly spread to street level.
Whilst cocaine has been seen by some as a recreational drug for certain people
with disposable cash,crack cocaine is often viewed as a drug closely linked to those
on low incomes who are far more likely to live in urban areas of deprivation.


Cocaine is cultivated from the coca plant that Crack cocaine is a smokeable form of cocaine,
is widely grown in Bolivia, Peru, Ecuador and made by ‘washing’ and then baking cocaine
Columbia. South America is thought to produce powder into ‘rocks’. When heated, these rocks
some 80% of the world’s cocaine. An estimated ‘crack’ and give off vapour. Inhaling this vapour,
forty tonnes of cocaine reach the UK each year, or ‘smoking a rock’, enables the user to get a
most of it arriving in bulk-shipments via the much larger dose than if they were snorting
Channel ports, with a much smaller quantity cocaine powder. The hit is harder and faster,
arriving via couriers, or ‘mules’, by air. It is thought shorter, more intense – and more difficult to
that in South America local people have been control. Those who inject the drug run the
chewing coca leaves for centuries – either as additional risks associated with this practice.
a herbal remedy or as part of traditional rituals.
Cocaine production appears to be a more
recent phenomenon. Powder cocaine (cocaine hydrochloride)
• Extracted from the leaves of the coca plant
Cocaine was first isolated from the coca • Snorted,sniffed, rubbed onto gums, or injected
plant in 1855 and soon afterwards was being
used in Europe as an antidepressant, a local Freebase cocaine
anaesthetic and a ‘pick-me-up’. Over time, many • Made from powder cocaine, which is
prominent figures advocated the therapeutic ‘washed’ with ether or ammonia. Contains
use of cocaine, including Pope Leo XII, Sigmund fewer impurities than crack cocaine
Freud and Thomas Edison. Abuse of the drug, • Smoked (heated until vapour is released;
however, and wider recognition of its potential vapour then inhaled)
harms, led to it being banned in the USA in 1914,
and in the UK in 1920. Crack cocaine
• Made from powder cocaine, which is ‘washed’
Coca leaves are made into cocaine paste and then baked, using sodium bicarbonate,
using kerosene, limewater and sulphuric or into ‘rocks’or crystals which ‘crack’when heated
hydrochloric acid. This paste is then turned • Smoked (heated until vapour is released;
into white powder in laboratories via further vapour then inhaled), or injected after
chemical processing. being dissolved in water

FRANK Action Update – Understanding Crack Cocaine 3



Recognising the need for action, in December Areas that meet a set of indicators of problem
2002 the Government published Tackling Crack crack cocaine use have been classified as High
Cocaine – A National Plan. Crack Areas (HCAs). These indicators comprise
high figures for:
This document sets out the range of
Government actions to tackle the rise in crack • Number of people in treatment
cocaine availability and usage. Essential to this • Number of people arrested by police and
approach has been the identification of 37 testing positive for cocaine or crack cocaine
High Crack Areas (HCAs): communities where • Percentage of people assessed by Arrest
crack cocaine drug markets have been Referral Workers with cocaine or crack
established and are severely damaging cocaine problems
individuals and the local community. • Number of people arrested for cocaine
or crack cocaine supply offences
Police, treatment and community action has • Volume of seizures of crack cocaine
been ongoing. Cocaine is being ‘taken out’ as • Volume of acquisitive crime
traffickers attempt to cross the country’s borders; • Risk indicators including the presence of a
more crack cocaine markets are being targeted street sex market/markets and a presence
and disrupted; more treatment agencies are on the Office of the Deputy Prime Minister’s
taking on and treating crack cocaine users, and (ODPM) deprivation indices
more communities have been galvanised into
taking action against the dealers. CRACK AND CRIMINAL JUSTICE

CJIP is part of the measures in the Updated Drug

Strategy for reducing drug-related crime and
aims to access drug-misusing offenders, moving
them into treatment, away from drug use and
crime. Of the 37 High Crack Areas, 31 are also
CJIP sites.

“Crack cocaine supply and related crime

impacts on some of the most vulnerable and
poor communities, hurting those who get in
the way: those who are trapped by addiction
into prostitution; those who are vulnerable
through mental health and social exclusion.”
Bob Ainsworth, former Home Office Minister
commenting on the launch of Tackling
Crack Cocaine - A National Plan
Supply route of cocaine to the UK

4 FRANK Action Update – Understanding Crack Cocaine


The geographical
location of HCAs MAP LEGEND
and CJIP areas North
East • High Crack
North Middlesborough Areas and CJIP
and the
• High Crack
Areas, non CJIP
Rochdale Bradford

Manchester Sheffield

Derby East
Sandwell Midlands

West East of
Midlands England

Oxford Slough
Bristol Reading

South East
South West



High Crack Areas Harrow Haringey

Forest Redbridge

Birmingham, Bradford, Brent, Brighton & Hove, Hillingdon


Brent Hackney


Barking &

Bristol, Camden, Coventry, Croydon, Derby, Newham Dagenham


Ealing Tower
Ken ersm





Hackney, Hammersmith & Fulham, Haringey,



Islington, Kensington & Chelsea, Lambeth, Greenwich

Leeds, Lewisham, Liverpool, Manchester, Richmond

Middlesborough, Newham, Nottingham, Merton

Oxford, Reading, Rochdale, Salford, Sandwell, Sutton Croydon

Sheffield, Slough, Southwark, Stockport, Stoke-

on-Trent, Tower Hamlets, Trafford, Waltham
Forest, Wandsworth, Westminster.

FRANK Action Update – Understanding Crack Cocaine 5


The vast majority of crack cocaine is Crack cocaine users can find themselves
manufactured in the UK from powder cocaine increasingly cut off from mainstream
imported into the country. The powder cocaine services such as housing and health.
is then ‘washed’ by the dealer, usually in premises As with other problematic drug use, social
near to the intended drug market. The crack exclusion can therefore be a consequence
cocaine produced is then either sold in open as well as a cause.
street markets or in closed local drug markets,
with dealers sometimes making use of ‘crack This often leads to crack cocaine use being
houses’ where users can purchase and then conspicuous in a way that other drug use is
binge upon the drug. Local drug markets that not and gives rise to greater anxiety amongst
sell crack cocaine vary. Some meet the needs the public and greater insistence that
of poly-drug users, offering ‘crack and smack’ something be done.
packages, while others are more geared
towards the exclusive needs of crack cocaine Key activities that can take place to
users, selling crack cocaine only. challenge the problems that crack cocaine
poses within a community:
CRACK COCAINE AND CRIME • Education and care of young people to
inform them on the risks of crack cocaine
A strong local crack cocaine drug market, misuse and offer realistic alternatives to
particularly in areas where crack houses exist, crack cocaine culture
has a major impact upon the local community. • The provision of healthcare and treatment
Due to the short life span of a single rock to address the mental health needs of
of crack cocaine and the desire to binge crack cocaine users, help them control
upon the drug, high levels of income are their cravings and stop using
needed to sustain a crack cocaine habit. • The provision of interventions within the
criminal justice system and by the police
Subsequently, crack cocaine market areas • The needs of sex workers and the
experience high rates of crime in the form management of sex markets to help sex
of street robbery, theft, prostitution and fraud. workers exit the street and prevent young
Such high rates and types of crime severely people entering the sex trade
undermine the quality of life for those living • The regeneration of deprived areas and
in these communities. communities
• The specific targeting and focus of drug
The large amounts of money to be made services by DATs and local partnerships
from crack cocaine dealing make it all the in addressing local hotspots
more attractive to those seeking to profit in
this way. Defending their share of the market
from other dealers can lead to ‘turf wars’ and
a high incidence of violence and gun-crime.

6 FRANK Action Update – Understanding Crack Cocaine

• Rocks of crack cocaine can cost anything
Crack cocaine and local sex markets are from £5 to £25. A recent survey conducted
known to be strongly associated. Sex workers among London crack cocaine users found
claim that using crack cocaine helps them that on average, users spend £100 a day 2
endure the work they do. Very often, however,
the work they do becomes necessary to • Recent research in London concluded
sustain their crack cocaine dependency. that purity levels of crack cocaine were
Those who seek to exploit sex workers have found to have fallen from 88% in the
found that crack cocaine-dependent mid-1990s to 72% in 2002. The same
individuals are by far the easiest to study found cocaine was only 52% pure3
manipulate and control. Habits are fuelled
and encouraged, and for the sex worker it • In 2000, 5,451 people were cautioned
therefore becomes all the more difficult to or convicted for drug offences involving
break out of this damaging way of life. cocaine, and 1,216 for offences involving
crack cocaine4
Look out for the new Home Office guidance
‘Solutions and Strategies: Drug Problems and • The British Crime Survey 2002/03 estimates
Street Sex Markets (guidance for partnerships that 63,000 people used crack cocaine
and providers)’ on how to tackle local sex within the previous 12 months in 2002 5
markets. This will include information on the
links between sex markets and crack cocaine. • The same survey estimates that 28,000
Download the report from people used crack cocaine within the
last month5

Local agency Druglink and partner agencies,

such as the Police, have identified an
increase in the use of crack cocaine by sex
workers in some areas, with many spending
an average of £100 - £150 a day to support
their habit. This is changing some of the
conditions and habits for these women
including a rise in unprotected sex and
a deterioration in their health.6

FRANK Action Update – Understanding Crack Cocaine 7



In treatment terms, crack cocaine dependency is recognised as being

predominantly psychological rather than physical. Dependency, however,
cares not for such subtle distinctions: be it physical or psychological, the
need to satisfy the craving perpetuates itself.


Whether smoked or injected, crack cocaine
takes effect very quickly. Crack cocaine is a Crack cocaine can be attractive to heroin
stimulant drug whose high is said to be intense, users as it gives them a high that heroin no
immensely pleasurable but relatively brief. longer can. Dual use of both drugs adds
After the intense high, however, comes the a further dimension to what is an already
crash: anxiety, tension, mood swings, paranoia complex situation for both users and those
and depression. This ‘come down’ reinforces seeking to help them.
the craving for more crack cocaine as
users seek a way out of this very low and
uncomfortable state (this also plays a
significant part in crack cocaine users’ use
of other drugs, such as alcohol, cannabis
and sleeping pills, to compensate for the CRACK COCAINE AND
crash). In this way, crack cocaine use can INJECTING
easily become compulsive, with the
tendency to binge being more common. When crack cocaine is injected it can
destroy veins and cause blood poisoning.
A crack cocaine injector who binges on the
drug can severely damage him or herself
through repeated injecting. Sharing needles
CRACK COCAINE AND brings with it the risks of contracting and
ALCOHOL spreading HIV, hepatitis and other diseases.
Pipe sharing may run the risk of blood-borne
For many regular crack cocaine users, diseases such as hepatitis C being spread.
alcohol is a way of coping with the
downside or enhancing the effects of the
drug. The interaction between different
substances and their impact on users
requires all substance use to be considered For more information about drugs and their
and treated in context. effects, log on to

8 FRANK Action Update – Understanding Crack Cocaine

Crack cocaine use has the potential to be
very physically damaging. Crack cocaine users Skin problems
don't develop the same kind of strong physical
withdrawals seen in heroin users, but may be Impaired
very distressed for a period after stopping use. immune Stress on the heart
Ongoing and heavy use of crack cocaine can system
lead to a number of physical health problems. Heart attacks
As with all Class A drug use, sometimes the and strokes
lifestyle that accompanies the drug use can
be more damaging than taking the drug itself. Liver

• Fast heart rate and breathing

• Sweating and shaking
• Agitation, butterflies in the stomach
– feelings of nausea
• Altered mood - may be very low


• Inability to sleep SEXUAL FUNCTIONS
• Loss of appetite
• Stress Crack cocaine and cocaine use can affect
• Skin problems users’ sexual functions. Chronic use of crack
• Impaired immune system cocaine and the lifestyle that goes with it
• Hyperthermia can disrupt hormones, for example causing
• Hallucinations impotence in men and disrupted periods
• Liver damage and infertility in women.
• Stress on the heart
• Heart attacks and strokes

Crack cocaine differs from heroin in its pattern of effects and dependency. Primary crack
cocaine users can fluctuate between displaying little or no outward signs of dependency,
sometimes going several weeks without a purchase, to periods of desperate and chaotic
craving. At the height of a binge, when their need is at its most acute, a crack cocaine
user may be using the drug almost 24 hours a day for several days or even weeks.1

FRANK Action Update – Understanding Crack Cocaine 9



In the six months to March 2001, 24% of new or returning patients in treatment
reported using crack cocaine with 7% considering it their primary drug of use.


Treatment programmes help to manage In the past, crack cocaine users have been
dependency on crack cocaine by using wary of treatment services, which, in their eyes,
psychological approaches focusing on have seemed to cater primarily for heroin users.
triggers, and dealing with lifestyle issues. This They have been reluctant to approach services
helps users understand their drug habit and where accessing appropriate treatment can
provides tools to help them make changes involve weeks or even months of waiting.
to their behaviour. There is little evidence Further more, drug users from ethnic minorities
suggesting drugs are useful in treatment. often consider treatment services to be run
by white people for white people. Without
Psychological approaches that help the treatment uptake, the damaging effect of
user understand and change the way their crack cocaine use could become all the
thoughts and feelngs affect their ability to more harmful and more difficult to overcome.
control their actions, such as cognitive
behavioural therapy 8, have been shown to be These negatives are beginning to be
effective. Complementary therapies, such as addressed. In terms of ethnicity, drug treatment
auricular acupuncture9, have been used by agencies are becoming more reflective of
services to attract and improve involvement in the communities they serve, waiting times are
psychologically based treatment. Some crack reducing and the available range of treatment
cocaine users in treatment report that such increasing. Dedicated crack cocaine and
approaches help them deal with their cravings, stimulant treatment services have also been
and cope with stress, though here is no developed in areas where demand is greatest.
conclusive evidence yet on its effectiveness. Where poly-drug use is seen, treatment services
are responding to the need to address crack
Treatment has been shown to be more cocaine and heroin together.
effective if it adopts a holistic approach.
This means looking at issues such as housing
needs, education and skills, debt management, The National Treatment Agency has
diet and exercise in addition to addressing instigated a range of initiatives to help
psychological dependency. Rapid intake and improve treatment of crack cocaine. See
a proactive outreach approach also have the ‘Commissioning Drug Treatment Systems’
a positive impact. Access to peer support, at and the Drug and Alcohol
24-hour helplines and drop-in services are also National Occupational Standards at
said to contribute to successful treatment.

10 FRANK Action Update – Understanding Crack Cocaine

Crack cocaine use can affect any community. Police seizures and other research
have illustrated that crack cocaine is available throughout the country. The size,
nature and associated criminality of the local drug market, and the contribution
of crack to this, largely determine the required actions to challenge the market
itself and the harm it does to the community.

Deprivation, social economic decline and Tackling crack cocaine in deprived
associated problems, plus the existence of communities then becomes part of the
an established drug market, are all factors much wider challenge of tackling the social
likely to either create or sustain a strong and economic decline of that community.
element of crack cocaine within a local Failing to tackle the drug market and the
drug market. consequences of the drug market is likely
to undermine the potential success of any
Minority ethnic communities are effort to regenerate the community.
disproportionately represented in areas
of deprivation. This, combined with social
perspectives drawn from America, has
created the false impression that ‘crack
is black.’ In fact, the vast majority of crack
cocaine users in this country are white,
but the strong link between urban areas
of deprivation and the existence of crack
cocaine markets have helped sustain this “By demonizing a substance, you not only
false impression. demonize the user but also diminish the
chance for effective and appropriate
What is true to say is that crack cocaine has public health and public order responses.”
impacted disproportionately upon minority
ethnic communities. Kazim Khan, Bristol Conference
on Crack Cocaine
Where demand is high and drugs are
available, the impact on the community is
especially pronounced. Users purchase drugs
locally then can go on to commit crimes such
as theft and aggressive begging in order to
buy more drugs. This has a knock on effect
for the whole community.

FRANK Action Update – Understanding Crack Cocaine 11



Crack cocaine in a community does not exist in isolation. It is likely to be

linked to many other aspects of decline - all of which need to be taken into
consideration if the needs of that community are to be successfully addressed.

This means partnership; partnership between intended for the UK market, it has been set a
Police, Local Authorities, Housing Associations, target of increasing take-out rates from 21%
Community Groups, Faith Leaders, Drug Action to 26%. Recent figures for 2003/2004 show that
Teams (DATs), Crime and Disorder Reduction progress is being made, with CIDA well on track
Partnerships and Neighbourhood Renewal to achieving this target.
Agencies. Each agency involved needs to
plan their action in a crack cocaine affected Evidence suggests clear associations of middle
community with the full and active involvement market drug dealers involved in the distribution of
of each of the other partner agencies. crack cocaine with smuggled tobacco, alcohol
and guns. There is growing evidence to show that
POLICING CRACK COCAINE these distribution networks have clear associations
with other serious and organised crime.
Since the launch of the National Crack Cocaine
Plan, focused effort has gone into tackling crack The impact of crack cocaine dealing upon a
cocaine markets in the UK. At every level of community can be substantially mitigated by
trafficking and selling, Police, Customs and Excise action to close open street markets and crack
and other agencies have worked to disrupt the houses. New powers are now available to enable
flow of crack cocaine. Disrupting Crack police and local authorities to work together
Cocaine Markets – A Practice Guide (DSD 2003) to close crack houses in their communities. Users
was published to complement the National will be affected by the closure - action to address
Crack Cocaine Plan and to sustain the renewed their treatment, housing and other needs can
focus on tackling crack cocaine drug markets. further support the enforcement. In particular,
vulnerable tenants who have been forced to
At international levels, inter-agency co-operation let their premises be used for the selling of class
has strengthened efforts to restrict the free A drugs can be helped by this action and by
movement of cocaine across international implementing a planned programme of care
borders. In the UK, the Cabinet Office to meet their needs.
Committee, Concerted Inter-Agency Drugs
Action (CIDA) - which consists of the heads of Many local authorities have worked with
MI6, MI5, the Customs and Excise investigation their local police force to put together a
branch, the National Criminal Intelligence protocol for tackling the issue of crack houses.
Service, the police National Crime Squad, and A good example is the one put together by
the Association of Chief Police Officers - takes Safer Southwark which recently won a good
primary responsibility to counteract cocaine practice award from the Home Office (see
being trafficked and imported into the UK. page 17 of this Update for further details).
With reference to the proportion of cocaine

12 FRANK Action Update – Understanding Crack Cocaine


Sport can offer a practical and effective In October 2003, Cranstoun Drugs Services
means of engaging with young people and teamed up with Chelsea FC’s ‘football in the
can play a valuable part in drug prevention community’ programme to run a three-year
and education. Positive Futures is a national coaching project for marginalized young
sports-based social inclusion programme for people in the borough. Aimed at teenagers
young people, aged 10-19, offering opportunities at risk of exclusion from school and from
to engage in employment, education and involvement in crime and drugs, the scheme
training. 31 out of the 37 High Crack Areas delivers coaching and awareness-raising
have dedicated local Positive Futures schemes. sessions three times a week at local schools
and parks.
Positive Futures brings together the support
of a number of government departments Drugs and youth worker Desmond McDonald,
and agencies, including the Home Office, who co-runs the Wandsworth scheme, says
Department of Health, Department of Culture, that, as an Arsenal fan, having to wear a
Media and Sport, Connexions (Department Chelsea kit every day is one of the few
for Education and Skills), Sport England, Youth down sides to his job. But this, as he admits,
Justice Board and the Football Foundation. is a small price to pay for such high-profile
involvement in three of the most deprived
Based in the top 20% most deprived areas in wards in Battersea: “We get more and more
the country (according to the Index of Multiple young people coming to us because we’re
Deprivation), there are 107 Positive Futures from Chelsea. And if a club as rich as Chelsea
projects throughout England and Wales. In is prepared to plough something back into
each area, the programme is delivered through the community, it helps us get through.”
partnerships between local agencies, such
as charities, sports clubs, Drug Action Teams, During the sessions, informal discussions
schools, police, youth and social services. on drugs, crime and anti-racism are held
during breaks in the football coaching.
Local programmes include: Football is the hook, but the overall goal
• Outreach and detached work to contact is to steer young people away from the
young people dangers of drugs and crime and towards
• Coaching skills across a range of sports linked more positive futures.
to playing opportunities
• Mentoring, volunteering and work experience Desmond feels it’s about getting their
• Drug awareness and education programmes trust.“If they see us coming from Chelsea,
• Curricular and extra curricular activity coaching and playing football with them,
in schools and Pupil Referral Units they trust us a bit more. We’re trying to show
• Pathways to further education, training all the kids that it doesn’t matter where they
and employment come from, they can avoid the pitfalls of
drugs and crime if they want to.”
For more info, go to

FRANK Action Update – Understanding Crack Cocaine 13


There are many damaging myths surrounding crack cocaine. These myths,
often stemming from a lack of knowledge and poor communication, and
often perpetuated by the media, can undermine effective delivery of treatment,
frustrate community action, and get in the way of the facts. This has led to
widespread misinformation and misunderstanding about crack cocaine in the UK.


The drug trade hits disadvantaged
communities hardest and more often. Crack cocaine dependency is treatable.
Deprivation and multiple drug use, not race, Although there are no confirmed
are the best predictors of problematic crack pharmacological interventions for crack
cocaine use. cocaine dependence, psychological
interventions such as cognitive behavioural
therapy (in which crack cocaine users are
helped to understand how the drug works,
how to avoid triggers, cravings, and relapses)
CRACK COCAINE IS INSTANTLY have been proven to be effective. As in
ADDICTIVE all drug treatment, adopting a whole life
approach rather than a narrow medical
Crack cocaine is highly psychologically one is the key to success.
addictive, causing strong cravings, and it also
causes a withdrawal syndrome (such as low “Treating crack cocaine dependence
mood and agitation) particularly with prolongd is neither difficult, nor does it necessarily
or heavy use. Unlike those dependent on heroin require totally new skills.”
(who experience prominent physical withdrawal National Treatment Agency
symptoms), periods of abstinence are normal for
crack cocaine users. It is at such times that crack
cocaine users may seek treatment.

Effective treatments for drug users are widely

ONLY POOR PEOPLE BECOME available. It is true that many services need
DEPENDENT ON CRACK COCAINE to adjust in order to meet the needs of crack
cocaine users better. However, with current
Crack cocaine is more usually linked with training schemes and the utilisation of drug
poverty however its use is not confined to workers’ existing therapeutic skills, services
deprived areas and occurs across the social are continually improving.
spectrum. As with all drugs, maintaining a See page 10 for more information on
habit is a costly exercise. developing treatment.

14 FRANK Action Update – Understanding Crack Cocaine

In fact, crack cocaine has been used in Britain
since the early 1980’s. In many ways taking The term ‘crack house’ is used very loosely.
crack cocaine is simply another way of taking It can mean a building housing one or more
cocaine – albeit at a much higher dose level. crack dealer and sex worker, or a house used
What is new is the trend of crack cocaine being for parties where crack cocaine may be
used by established opiate users, and powder used. However, crack houses are not the only
cocaine users moving on to crack cocaine. places where crack cocaine is sold. Crack
cocaine is also sold on the street, on the
‘open market’, or delivered to people’s
CRACK COCAINE IS AN homes, on the ‘closed market’.

Originally, specialist agencies such as COCA BABIES BORN TO CRACK COCAINE

found that their work took them to large cities USING MOTHERS ARE BRAIN-DAMAGED
such as Liverpool, Manchester, London and
Nottingham. Now, they operate in towns and In the late 1980s/early 1990s, it was widely
communities all over the country. Crack reported that babies born to crack cocaine
cocaine use may be more concentrated in using mothers would refuse to suckle and
large, deprived urban areas, but it is certainly feed, and would invariably experience long-
not restricted to them. term brain damage. It has since been shown
that the scare-stories surrounding ‘crack baby
syndrome’ were overblown, and more to do
with public and professional reactions to
CRACK COCAINE CAUSES VIOLENCE crack cocaine being used during pregnancy,
than with factual evidence. However, crack
Crack cocaine does not, in itself, cause cocaine and cocaine use during pregnancy
users to become violent. Unlike alcohol, is particularly inadvisable, and may cause
crack cocaine does not provoke violence miscarriage, low birth weight, premature birth
through consumption alone. But the or disturbed behaviour in newborn babies.
desperation and craving that comes with
crack cocaine can lead to violent behaviour,
in the form of aggressive begging or recourse For information on treatment, see
to crime in order to fund a habit. Crack ‘Commissioning Drug Treatment Systems’
cocaine dealing, particularly on open-market from the National Treatment Agency at
‘turf’, can also lead to violence, including
intimidation of bystanders or local residents.
However, overall, alcohol is statistically much For further information on crack cocaine,
more associated with violence and violent its effects and social impacts contact COCA
crimes, while experienced crack cocaine (Conference on Cocaine and Crack Cocaine)
workers report that heroin users are generally at
more likely to become violent in treatment
centres. A small number of crack cocaine And don’t forget to log on to
users can become psychotic and this can for the latest news and
be associated with aggression. policy information.

FRANK Action Update – Understanding Crack Cocaine 15

In this section, we profile some of the EDUCATION, IDENTITY AND
excellent local drugs awareness initiatives DIFFERENCE: ACCESS POINTS
on crack cocaine. INTO TREATMENT
LIFELINE KIRKLEES Birmingham HIAH delivers drug outreach and
treatment services for young people across the
Lifeline Kirklees is one of eleven new drug city. The overriding goal of the agency’s work is
treatment services piloting crack cocaine to breakdown barriers to information, help and
treatment. Recognising a growing need to treat support, and to close the gaps between service
clients with crack cocaine misuse problems, tiers to provide seamless movement into treatment.
the agency is expanding its existing services
in line with the National Treatment Agency’s Working alongside Birmingham DAT, HIAH has
treatment manual. The crack cocaine service is proactively tried to reach marginalized
being piloted through its newly commissioned members of the community. Local youth services
open access Triage service,‘Way Ahead’ and have been refurbished and provided with on-
an outreach service for black and minority site facilities. The aim is to ensure that young
ethnic communities,‘Making Things Equal’. people can be reached within their localities
and to provide counselling and treatment –
Way Ahead now provides an appointment- for crack cocaine, interventions could include
free drop-in service, where clients can receive acupuncture and other complementary
advice quickly. This rapid access is particularly therapies. The service has also been working
valuable for crack cocaine users, who often with local schools to ensure that pupils can
only seek help when they hit a crisis. Way gain access to support and treatment at the
Ahead, which has received funding to recruit earliest onset of their drug-use. Further plans
a Stimulant Development Worker, provides include additional services with crèche
support and advice through one-to-one schemes for young mothers, who are often
and group counselling, and a programme reluctant to come forward for help, and
of activities and complementary therapies. development of other support programmes.

The Making Things Equal project works HIAH also run innovative awareness-raising
with local residents and community leaders courses. The Complete Drug Course (CDC)
to educate black and minority ethnic offers drug education training, and acts as a
communities about drug misuse and drug strong enticement into treatment, with many
treatment. The project has helped to target participants often being drug users themselves.
hidden populations of crack cocaine users The ID and Difference course, meanwhile,
and encourage them into treatment. addresses issues of identity, aspiration and
influence, encouraging participants to consider
Staff have also taken part in an NTA-run who they are, how they think and act, looking
training programme designed to improve particularly to make inroads into black and
staff skills and knowledge. minority ethnic communities. Each course is
discussion-group based, with accompanying
course packs and education materials.
For further info, contact: Maggie Hanson (Team
Leader, Way Ahead & Making Things Equal) For further info, contact: Grantley Haynes Tel: 0121 616 6162

16 FRANK Action Update – Understanding Crack Cocaine

Not solely dedicated to crack cocaine but to
the effects of all drugs, WAM work with children The Southwark Crack House Protocol is a
and young people across Nottinghamshire joint agreement between Southwark police,
who may be affected by the substance use Southwark council, registered social landlords
of others. Offering play therapy to 5-13 year and voluntary groups. The protocol aims to
olds, and one-to-one support for young people provide local residents with respite from the
up to the age of 19, WAM provides crucial criminal activity and anti-social behaviour
interventions for those who suffer neglect, harm associated with crack houses, and to reduce
or emotional disturbance because of the the impact of drug misuse and dealing.
substance use of family members or friends.
The initiative comprises a range of interventions
WAM have a team of skilled Support Workers and, while the specific objective is the closure
and a Play Therapist, and offer children and of crack houses, seeks to balance enforcement
young people confidential support via with support to vulnerable users. Eviction,
telephone, text and email. WAM also work in prosecution and repossession of premises (and
partnership with their sister service,‘Hetty’s’, to actions to prevent them becoming illegally
deliver interactive sessions with young people reoccupied), go hand in hand with help or
serving custodial sentences and attending diversion for vulnerable tenants. The protocol
drug treatment programmes. Sessions are ensures that drug treatment workers are
designed to improve understanding and available in police custody suites to see people
communication between young people and brought in following drug raids.
their families/carers, to reduce homelessness.
The co-ordinated response of the participating
In addition to providing countywide peer and agencies is essential to the project’s success.
school support, WAM have produced a short The raiding and closing of crack houses, for
film ‘What About Me?’ examining the impact instance, requires action by both police and
of illegal drug use on family life. The video of landlords. This cross-agency approach offers
the film is used throughout the county to raise an anti-crack cocaine programme that is both
awareness among young people, and as a fair and effective. Neighbours and other local
training tool for partnership agencies and tenants are already seeing a marked decrease
community groups. Distribution of the film to in crack cocaine related crime as the number
young people is carefully monitored, and has of raids and crack-house closures increase.
support packages of time and materials built
into every delivery. The Southwark Crack House protocol is part
of the Safer Southwark Partnership, which
WAM work in partnership with, and enhance, was commended at the Local Government
existing local services (Social Services, drug Chronicle Awards in March 2004. The Crack
services, Health & Education services) that House protocol was also hailed a success at
may already have contact with families, or the Home Office Tackling Drugs Supply Awards
who may need to be involved as part of a in 2004, coming top in the category of “best
‘Care Plan’ for the family unit. practice in tackling crack cocaine markets”.

For further info, contact: Nicola Crisp For further info, go to:
Tel: 01623 635326

FRANK Action Update – Understanding Crack Cocaine 17


Given the misconceptions and myths surrounding crack cocaine and its
treatment, services need to be designed in a way that immediately appeals
to crack cocaine users. If you are thinking of setting up or commissioning
services in your area, here are some things you should consider:


• Immediate access: crack cocaine users
often seek help in a crisis; easy and The quality of the drug worker-user relationship
immediate access to support, advice and is highly influential. Staff drawn from relevant
referral via drop-in centres, peer support parts of the community can support effective
networks and 24-hour telephone helplines working with users. All staff need to ensure
are solutions recommended by users and they are aware of, and comfortable working
found effective in practice with, issues relating to street culture.
• Many users could be in employment or
education: attending services during the Good drug workers should show:
day may not be an option. Services that • empathy
are available in the evenings and at • knowledge of crack cocaine
weekends would be able to fill this gap • honesty
• Services also need to appeal to all • a non-judgemental approach to users
communities, and should not appear to • an appreciation of how crack cocaine
favour one group of people over another fits into the lifestyle of the individual user
• Outreach has proven invaluable to those
services offering a dedicated crack
cocaine treatment service, particularly
amongst BME groups and among those
working in the sex industry
• Early treatment experience makes a big
difference to users’ later commitment to
• Anecdotal evidence suggests that the
• Users may not want anyone to know availability of complementary treatments
about their visit. Anonymous, discreet such as auricular acupuncture helps to
venues are preferable attract and then retain users
• Accessible and suitable services could • Relapse prevention is essential. Lifestyle
capitalise on the gradual disenchantment issues are key contributing factors to the
with a crack cocaine-focused lifestyle tendency of users to relapse and should
experienced by users be considered in a holistic context

18 FRANK Action Update – Understanding Crack Cocaine

Before you can deliver crack cocaine related information and messages in
your area, and before you can begin to advertise treatment and services,
you need to identify your audience.


In order to be proactive in assessing levels
Needs assessments may be a useful way of of use and problematic use, local or regional
identifying specific audiences in need of surveys could be commissioned to provide
information. Because most existing information initial snapshots. Questions that you may like
has been gathered through treatment services to ask respondents include:
and the criminal justice system, there may be • If they have used crack cocaine
significant hidden crack cocaine problems and • If they know one or more people who have
hidden crack cocaine using populations in your used crack cocaine
area. Here are some ideas to get you started • If they have now stopped or are continuing
on identifying needs in your area. to use crack cocaine
• If they use cocaine powder or formerly did so
In the pursuit of networks that may reach deeper HIDDEN USERS
into communities and hidden user populations,
standard practice should bring drug workers into SUPPORT FROM KNOWN USERS
contact with the following groups: The NTA suggests a research technique -
‘snowballing’. This is where known users are
• Crack cocaine and cocaine users and/ engaged to contact hidden users and give
or user representation groups information and encouragement to seek
• Families and friends of crack cocaine treatment.
and cocaine users
• Local communities affected by crack MINORITY GROUPS
cocaine and cocaine use Some minority communities (minority ethnic
• GPs groups, women, gay and lesbian communities,
• Generic mental health services homeless people, disabled people, people
• Criminal justice agencies/services with mental health problems) may be
• Services for homeless people reluctant to access services. Conducting a
• Services working in the sex industry comprehensive needs assessment with these
• Social services. communities is a useful way of ensuring that
there are no hidden crack cocaine using
Work closely with these networks to enlist populations. See FRANK Action Update
their help in identifying potential groups and Understanding Diversity for information on
individuals who could benefit from crack communicating with diverse communities.
cocaine treatment and services.

FRANK Action Update – Understanding Crack Cocaine 19



A local partnership is a process by
When setting up local partnerships, there are
which an agency works together certain things you need to consider. Working
with other agencies or organisations together requires initial commitment to:
to achieve better outcomes for the
• A shared agenda
local community. Such partnerships • A respect for the needs of all partners
operate according to the needs involved
of local stakeholders, and involve • Effective leadership at all levels
• Plan for the contributions and benefits
bringing together, or making better
of all the partners
use of, local resources.
You will also need to:
In some instances, local agencies are obliged
to adopt a partnership approach to community • Identify specific goals/targets of partnership
problems. The Crime and Disorder Act 1998 working
(section 5), for example, places a statutory duty • Regularly assess partnership performance
on local authorities, police, health authorities • Regularly review the relationship between
and probation committees to work together to partnership activities and community
tackle problems of crime and disorder. However, needs/priorities
when dealing with complex issues such as drugs,
collaboration between statutory bodies and the Finally, throughout your ‘partnership journey’,
voluntary and community sectors is not only remember to keep focused on:
mandatory, it is also highly desirable.
• Priority target groups of users and other
Benefits of local partnerships: stakeholders
• Provide platforms for the sharing of • ‘Core’ activities: not everything will need
experience and expertise to be ‘joined-up’
• Assist economies of scale and scope – • Improving and fine-tuning all activities you
enabling agencies and organisations to intend to keep
make more effective use of collective • Phasing out all activities that are low priority
resources and skills • Putting the customer/client first
• Open up opportunities for mutual learning • Tackling issues at the right level
• Help focus on outcomes for service users, • Understanding and accepting differences,
rather than providers on basis of mutual trust
• Enable better co-ordination on complex • Building on each other’s strengths
issues, meaning less confusion for all • Communicating what you’re doing clearly
• Bring more meaningful participation and regularly to all those involved
from all stakeholders
• Provide fast dispersion of innovative ideas Before setting up a new partnership, contact
and ease of communication your DAT to check any that already exist.

20 FRANK Action Update – Understanding Crack Cocaine

YOUNG PEOPLE efforts on busting those myths can help people
become more aware.
With its effects being so damaging to people
and communities, there is a strong case for Organise a discussion group or education
including crack cocaine in basic drugs session for people at their place of work.
education in all areas. Indeed, it is essential in Focusing solely on crack cocaine use may
identified High Crack Areas. Education around be seen as alarmist, so you may find it more
the dangers and risks could help prevent young appropriate to incorporate education on crack
people becoming involved with the drug. cocaine within a general overview of drugs
and their effects. Make use of the myth busting
Contact local schools: make sure that factsheet in this Update to create understanding.
headteachers are aware of local patterns Contact the Human Resources departments at
of drug use, particularly if specific drugs are local firms to see if they would be interested.
a problem in your community; teachers need
to be able to make use of this information Arrange a general health awareness day and
and build it into their planning and delivery invite professionals to have stalls or give talks on
of school-based drug education programmes. health issues. You can then incorporate drugs
The important thing is to help schools and information (including crack cocaine) in a more
teachers develop their own expertise and general way and be on hand to give advice
drug education programmes that reflect to anyone who would like further information.
the needs of the local community.

Develop information materials highlighting PROFESSIONALS

the effects and dangers of using crack
cocaine and display them in areas where One of the key elements of communicating
young people hang out. Community Centres issues around crack cocaine is to create
may be willing to help. Communicating the understanding of its physiological properties
dangers of dabbling in crack cocaine at and this is particularly important for
visible street level (such as on, leaflets, beer professionals who may come into contact
mats, posters) can help to get across with users other than by way of drug services.
effective preventative messages. The word
‘crack cocaine’ needs to be prominent, and Organise discussion groups targeting groups
the FRANK phone number large enough of professionals (Police, shop workers,
to be read at a distance. emergency services staff) to help them
understand the best way to handle crack
cocaine users. Focus on links between the
COMMUNITIES user's craving, anxiety and withdrawal effects,
and the feelings of compulsion to use; to help
Given the myths that surround the drug, people professionals understand how to avoid, or
living in a community affected by crack manage, conflict in some user. Face to face
cocaine may be particularly concerned and meetings or attendance at meetings can
have little understanding of what it is and its also be useful as they allow opportunities for
effects. Concentrating your communications raising awareness and stimulating discussion.

FRANK Action Update – Understanding Crack Cocaine 21


DECISION MAKERS Different methods that have previously been

used to attract users to services include:
Decision-makers and opinion formers need
to understand better the nature of crack • Discreetly advertised and run services – large
cocaine and its use, as well as being made banners above a project, or services based
aware of the misleading nature of crack in official buildings, can deter users
cocaine myths, and the dangers of basing • Posters – can be displayed in a variety of
policy on them. locations. Again, phone numbers should be
large enough to read at a distance
Ways to reach decision-makers and opinion • Project information leaflets – developed
formers may include: advice and information services will
demonstrate an understanding of crack
• Briefings through the established cocaine and instil users’ trust
stakeholder relationships and DAT networks • Radio – local or community radio stations
• Visits to a treatment centre dealing with are usually open to advertising services and
stimulants or crack cocaine can help reach a large number of people
• Hearing from users, ex-users or treatment • Outreach – specialist outreach and
workers about the problems of and peripatetic teams can help to engage
solutions to crack cocaine use with users and increase their awareness
• Hearing from key agencies involved in
closing crack houses, open markets and The Government Office for London has
dealing with environmental crime established a directory of drug services that
• Hearing from a third-party advocate about deal with crack cocaine (details available from
the benefits that effective action brings Many areas have
treatment directories; check if crack cocaine
A well-organised visit is probably the best treatment is highlighted in these. Or, why not set
way to reach such people. Remember, they up a directory of services for your own region?
will be pressed for time and unlikely to read
through all the documentation so be clear
about the message you wish to get across. Networking and word of mouth can also
be effective ways to promote local treatment
services. Ex-users can be a way into the using
TREATMENT community, but care has to be taken that
ex-users, through contact with current users,
One of the myths surrounding crack cocaine do not relapse and re-enter the cycle of
is that there is no treatment available to users. craving and dependency.
If you have set up services in your area, make
sure that it is well publicised. Check to see
if local services that you know of are listed See the ‘Crack cocaine and the media’
on and that their details fact sheet in this Update for tips on
are up to date. communicating with the press. For more
advice and ideas on communicating about
You could use the local media, listings and drugs, see the selection of FRANK Action
directories, as well as advertising via street Updates at
posters and take-home media, such as bus or order using the More FRANK form at the
tickets, leaflets and flyers. back of this pack.

22 FRANK Action Update – Understanding Crack Cocaine


UK charity working solely in the field of drug UK Centre of expertise on drugs. Conduct
and alcohol treatment. Manages a range of research and seek to improve knowledge on
projects across the country. drugs-related issues and have an extensive
020 7251 5860 library of drug information. Tel 020 7928 1211
Charity supporting families affected by drugs NATIONAL TREATMENT AGENCY (NTA)
and alcohol. Range of resources including Special Health Authority set up to improve
publications and videos, a family newsletter, the availability, capacity and effectiveness of
email group and online messageboard. treatment for drug misuse in England. Also has
Tel 020 7928 8898 research and publications and is evaluating pilot sites for crack services.
Information and news on health issues, PHOENIX HOUSE
from the BBC National charity providing specialist treatment services for drug and alcohol users across the
United Kingdom.
COCA (Conference on Cocaine and Crack)
Forum for drug workers offering support and
information. Helps services and workers TREATMENT WORKS
develop appropriate interventions and Website developed by some of the biggest
professional working practices. independent providers of drug and alcohol treatment in the UK working together to
improve awareness of and access to the
A not-for-profit charity providing a range of high
quality, cost efficient and effective models of
treatment and rehabilitation in the community, TURNING POINT
in prisons and in residential centres. Social care charity with services across England & Wales working in the areas of
drug and alcohol misuse, mental health
DEPARTMENT OF HEALTH and learning disability.
Publications Order Line: 08701 555 455

FRANK Action Update – Understanding Crack Cocaine 23


Tackling crack cocaine Stimulating Drug Prevention in Local
– a national plan ref (DSD 14) Communities
Home Office Lynne Smith DPAS
Home Office Order Line 0870 241 4680 Available from Home Office drug publications
Download from
Anti Social Behaviour, Notes of Guidence
Updated Drug Strategy 2002 ref (DSD9) to Close Class A drug Premises
Home Office Download from
Home Office Order Line 0870 241 4680
Download from Communities/1074606449
Disrupting Crack Markets; A Practice Guide
Commissioning Drug Treatment Systems: Download from
resource pack for commissioners
Available from the National Treatment Agency
website publications section
This listing is for information only. Inclusion does not imply endorsement of organisations or resources listed.

On the rocks: a follow-up study of crack

users in London.
Harcapos A., Dennis, D., Turnbull P.J, Hough M.
London: Criminal Policy Research Unit South
Bank University, 2003 (ISBN 0 946786 364)
Report of an independent study funded by the
Community Fund and the National Treatment
Agency looking at drug service use amongst
crack cocaine users in the UK. The full report
can be ordered from the CPRU, London South
Bank University REFERENCES:
1. Tackling Crack Cocaine – A National Plan
Tel: 020 7815 8458 2. On the Rocks, South Bank University 3. Drugscope 2002
4. Home Office Statistic
5. The British Crime Survey 2002/03
Drug & Alcohol Findings 6. Swindon DAT
Published by Drugscope & Alcohol Concern (see
Magazine devoted to UK relevant research on 7. National Treatment Agency 2002
8. British Association for Behavioural and Cognitive
the effectiveness of interventions to treat,
Psychotherapies (BABCP)
prevent or reduce drug and alcohol problems 9. The Society of Auricular Acupuncturists

24 FRANK Action Update – Understanding Crack Cocaine