Basuco, a cheap and highly addictive smokable cocaine byproduct, continues impacting vulnerable communities in Medellín, Colombia. Often associated with poverty, homelessness, trauma, and social instability, basuco addiction has become a major public health concern throughout parts of the city. This article explores why basuco is so addictive, how it differs from crack cocaine, the connection between drug abuse and poverty, and the long-term effects on physical and mental health. It also examines harm reduction efforts, recovery resources, and the social challenges facing marginalized populations in Medellín today.