When an individual initially presents for treatment for crack cocaine addiction he or she will be screened for drugs, HIV, hepatitis and sexually transmitted disease, after receiving appropriate counselling.Treatment varies, but psychological intervention in conjunction with prescribed medication has proven to be effective.

Trained therapists may use cognitive behaviour therapy (CBT), motivational interviews and the Minnesota method.Motivational interviewing involves helping the individual to examine his or her lifestyle and the changes that need to be made, particularly focusing on stopping or reducing drug use.Emphasis is placed on reducing harm and preventing relapses.The Minnesota method is usually available through residential centres and self-help groups and though it has been found not to be as effective as CBT, some individuals do benefit from its use.The method is based on a ‘Twelve Step’ approach, similar to that used for alcoholism.

Various prescribed medications can be used in conjunction with psychological intervention.Benzodiazepines can be used to treat insomnia and to help addicts ‘come down’, but they should not be used for longer than two weeks.Antidepressants are only useful for those individuals where drug use is associated with depression.Disulfiram is used for secondary care only and may interfere with the pleasure inducing ability of cocaine.Beta-blockers are used to treat anxiety during withdrawal and to help prevent relapse.Dexamfetamine and methadone are used in secondary care only and are beneficial in difficult cases or where there is also opiate addiction.

Harm reduction is an important part of the treatment and residential care may be beneficial.Aftercare involves continued psychological and social support of the individual in order to reduce the risk of relapse.