Crack and fentanyl abuse on the rise in Germany

Crack, the street name given to a solid form of cocaine, is quickly becoming a serious problem in Germany.

Its looks harmless enough, like light-colored rock candy, which is why users call it "white" or "stones." When heated to 96 degrees Celsius (205 degrees Fahrenheit), it crackles, hence the name. The mixture of cocaine, baking soda and water delivers a "kick" in less than 10 seconds, faster than any other drug.

Crack is extremely addictive and can be devastating for those who use it.

"Crack is smokable cocaine that delivers a kick. When used on consecutive days, it can produce psychotic states," said social worker Michael Harbaum.

Harbaum has worked at the Düsseldorfer Drogenhilfe (Dusseldorf Drugs Help Center) in western Germany for the last 20 years. His first job there was running the drug consumption room, where illicit drugs can be used under the supervision of trained staff.

He now manages the center and has seen the number of people using crack in the drug consumption room skyrocket from a few hundred in 2017 to more than 31,000 in 2023.

"Crack has a very powerful effect. It acts very fast, but it also wears off very fast. So, people feel a pressure to consume it again very quickly," said Harbaum.

"This is a very dangerous situation. Just imagine the substance being consumed every half hour. That leaves barely any recovery time –– no time to eat or care for hygiene."

Drug-related fatalities steadily rising

Germany saw almost 2,000 drug-related deaths in 2022, the highest number in two decades. The main cause was either heroin or other long-term drug abuse. Fatalities from cocaine and crack overdoses rose to more than 400.

Addiction researcher Daniel Deimel has been working to develop new courses of action to deal with the consumption of crack.

"Crack has been problematic in large cities like Frankfurt, Hamburg and Hanover for around 20 years," he told DW. "But it has been spreading in western Germany since 2016 in major cities, but also in German states like Saarland, because Europe is being flooded with high-purity cocaine.

"The drug market is growing because Colombian cocaine production has been growing substantially. The market and producers have diversified," he added.

Cocaine is increasingly entering Europe via seaports, such as in Antwerp in Belgium, Rotterdam in the Netherlands and the German port of Hamburg.

Deimel believes demand will remain high.

"We are living in a high-performance society. Cocaine is now used by many middle-class people — its use has been normalized to some degree. It has shed its cliched image of the 1980s and 1990s as a drug of the rich, of artists and media professionals."

Deimel studied the drug scene in the city of Cologne last year and found that almost all cocaine users had smoked crack at some point. Many of them were homeless. Many users reported massive psychological problems, including paranoia, in connection with crack consumption.

The biggest problem is that crack has no antidote, said Deimel.

"Well-developed addiction medicine interventions already exist for heroin, such as methadone, which is used as a substitution-assisted treatment. But no drug has yet proven effective against crack addiction. We really need more research on this. We also need a 24/7 emergency help center," he said.

Unlike heroin, crack has no antidote

Harbaum's team in Dusseldorf recently opened a new accommodation facility for up to 11 addicted people at the city's central train station. It has social workers and security staff, as well as lockable single rooms.

Experts say more facilities like this are urgently needed, because in addition to crack, the next wave of highly dangerous drugs in the form of synthetic opioids like fentanyl is already arriving.

Fentanyl is a painkiller for people who are dying, or suffering from cancer, and is being mixed with heroin. A six-month test project in 17 drug consumption rooms in Germany, carried out by the German AIDS Association, showed that 3.6% of heroin samples provided contained traces of fentanyl.

"Synthetic opioids are entering the market and mixed with heroin,"said Deimel. "The problem is that these substances are substantially more potent and more lethal. With fentanyl, 2 mg is enough –– that's the size of the tip of a pencil."

Burkhard Blienert, commissioner for addiction and drug issues, believes there should be more low-threshold services to reach users.

"In addition to drug consumption rooms, there could also be drug-checking, rapid tests in drug consumption rooms, low-threshold substitution offers, and laypeople should know naloxone," he told DW.

Naloxone is a medication used to reverse or reduce the effects of opioids. It is injected and restores breathing after an opioid overdose.

A range of effective measures have been tried and tested in Europe, he pointed out, but they aren't necessarily available where they are needed.

"Given the truly dangerous developments with crack and synthetic opiates, we can't afford to keep debating whether drug consumption rooms and drug-checking should be offered or not," he said.

This article was originally written in German.

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