Cocaine is an addictive drug that can injure the noses of those who use it. It is a stimulant and causes feelings of power and enablement coupled with a high. The feeling that cocaine produces causes people to keep using it and can make them addicted. Cocaine is most commonly snorted, but crack cocaine may also be smoked. Snorting cocaine involves lining up powdered cocaine and inhaling the line of cocaine forcefully into one of the nostrils by using a small tube (people will often roll up a dollar bill or use a straw). While this common way of using cocaine may seem safe, especially when compared to using IV drugs, there are some dangers that many people are not aware of. Why Do People Snort Cocaine? Cocaine is often snorted because the thin membranes inside the nose have significant blood circulation. Cocaine is quickly absorbed across these thin membranes into the bloodstream, causing cocaine’s effects to begin very quickly. Snorting cocaine can also seem convenient. Because of its effects, cocaine is commonly used at parties or similar settings. Snorting is a quicker way to use cocaine in these types of situations. While the high caused by snorting cocaine starts very quickly, cocaine is also metabolized by the body quickly. This means that the high does not last for long, making it necessary to snort cocaine over and over again to sustain a high for a longer time. What Does Cocaine Do To Your Nose? Cocaine has an immediate effect on the lining of the nose when it is snorted. Once absorbed, cocaine immediately causes the nose’s blood vessels to constrict, reducing circulation in the nose’s membranes. If used repeatedly, the blood flow can become so constricted that it can damage the inside of the nose. Just the act of putting a foreign object up your nose and inhaling can also be harmful. This can lead to damage, irritation and potential infection. Cocaine Cutting Agents & Nasal Damage When you use cocaine, there are almost always other substances mixed in with the cocaine. These are called cutting agents. They’re used to make the cocaine weigh more or dilute the cocaine to make more money off of selling it. Anything can be used as a cutting agent, and while some are harmless, many of them can cause serious damage. Certain cutting agents may be irritating or destructive to the lining of the nose. One commonly used cutting agent is an antiparasitic drug used on animals called Levamisole. Studies have shown that cocaine cut with Levamisole can cause the inside of the nose to die and rot. Other cutting agents may even be poisonous. Initial Side Effects of Snorting Cocaine Several nose-related cocaine side effects can be experienced even on the first use. These initial, less severe side effects are not often seriously dangerous but can be quite unpleasant. Nosebleed from Coke (Epistaxis)Nosebleeds are common for those who use cocaine. Reduced blood flow in the nose’s lining makes the nasal membranes more susceptible to damage. Sticking objects into the nose and inhaling cocaine crystals further irritates and damages the nose’s lining. When blood flow returns, nosebleeds can occur from damaged or irritated areas. Drug-Induced Chronic RhinitisRhinitis is a medical term that refers to inflammation of the nose’s lining. The inflammation is caused by damage when objects are inserted into the nose and the rough cocaine crystals irritate it. Inflammation helps the nose heal from this damage and irritation. If cocaine use is continued, healing will not occur and the inflammation will only get worse. Chronically Runny NoseStarting cocaine use can lead to a constant runny nose, even when not using. While the reason that a chronically runny nose occurs is not fully understood by science, the nose increases its mucus production when its lining is inflamed. Nasal ObstructionThe combination of inflammation, irritation and increased nasal mucus may make a person’s nose feel blocked. While blowing your nose may help to clear excess mucus, the mucus will quickly return, making your nostrils constantly feel blocked. Chronic Sinus InfectionsThe sinuses are hollow areas in the nasal passages. These areas are sterile, meaning there is no bacteria in them. If bacteria do enter the sinuses, the dark, moist environment causes them to grow quickly. Blood flow to the sinuses is low, making it harder for the body to fight sinus infections and causing these infections to linger. Someone who uses cocaine will increase the risk of sinus infections by placing non-sterile objects in their nose and inhaling forcefully. This helps bacteria travel to the sinuses, making sinus infections much more common. Several of the symptoms of cocaine use are similar to sinus infection symptoms, making these infections harder to detect while using cocaine. Treating Nosebleeds from Coke & Other Minor Ailments Treating a nosebleed involves applying pressure to the bleeding area. This may or may not be possible, depending on where the bleeding is occurring. If pressing the nostrils together does not stop the nosebleed, you may have to let it stop by itself or seek medical attention. If you have a nosebleed that lasts more than an hour or if you are concerned about the amount of blood being lost, seek medical help. Treating a nosebleed caused by cocaine use is only a temporary fix. These nosebleeds will continue and get worse and worse if cocaine use is continued. The best way to treat nosebleeds from cocaine use is to stop using cocaine. Severe Nasal Side Effects of Snorting Cocaine While inflammation and irritation in the nose’s lining can be irritating and unpleasant, there are far worse things that using cocaine can do to your nose over time. The following symptoms generally occur after chronic cocaine use, but the wrong cutting agent can make them happen with just a few uses. Anosmia (Loss of Smell) As cocaine damages the nose’s lining, it also damages the odor receptors. These receptors will not grow back. Once they are destroyed, the damage will be permanent. The tongue can only detect five core tastes, so the rest of taste comes from smells. Someone who loses their sense of smell will also have difficulty tasting things. Cocaine-Induced Vasculitis Cocaine-induced vasculitis is inflammation of the nose’s blood vessels beyond the lining. This type of inflammation is much more serious than rhinitis and can lead to permanent problems with the nose’s blood circulation. Two main problems are associated with cocaine-induced vasculitis: Cocaine-induced Midline Destructive Lesions (CIMDL): CIMDL occurs when tissue in the nose starts to die and rot from a lack of blood flow. This can lead to holes in between the nostrils or between the nasal cavity and the mouth. Antineutrophil cytoplasmic antibodies (ANCA)-Associated Vasculitis – ANCA-associated vasculitis is blood vessel inflammation caused by harmful proteins in the blood. The substances cocaine is cut with are usually the cause. It may lead to other problems in the body. Nasal Necrosis, Perforation, & Saddle Nose Nasal necrosis occurs when the nose’s tissues start to rot after they have died from a lack of blood flow. This can cause CIMDL, but it can also cause other tissues to die. The intranasal septum (the part of the nose between the nostrils) can die, creating a hole between the nostrils. The roof of the mouth can also be affected, creating holes between the nasal cavity and the mouth. In severe cases, a saddle nose may occur, where the inside of the nose becomes so destroyed that the nose collapses. Signs Of Nasal Necrosis & Severe Nasal Damage It may be difficult to tell that nasal damage is occurring because most of the damage occurs internally, where you cannot see it. Some signs may include: Brown or black tissues when you blow your nose Loss of smell A bad smell from the area (this will occur after the sense of smell is lost, so others will be the ones detecting this) Deformation of the nose You can also have a healthcare professional examine your nasal passages to see if they are damaged. Do not allow anyone without medical training to do this as it can harm your nose further. Repairing Severe Cocaine-Induced Nasal Injuries Most severe nasal injuries caused by cocaine will be permanent. You will likely need to see an otorhinolaryngologist (doctor specializing in head and neck conditions). This specialist may be able to help restore blood circulation and reduce the amount of damage caused. Any tissue areas that have already died will be permanently damaged and cannot be repaired. Any sense of smell that is lost will also likely be permanent. Dead tissues will require plastic surgery to replace and make the nose appear normal again. Finding Help for Cocaine Addiction While cocaine can severely impact the nose, this is only one of many systems that cocaine can affect, like the heart. Cocaine symptoms can be life-threatening, so someone who is using cocaine should try to stop as soon as possible. If you or someone you know is using cocaine and is having difficulty stopping, seeking professional help may be needed. Our expert team can help understand treatment options and how you can benefit from rehab. Reach out today to start on your road to recovery. SourcesO’Malley, Gerald & O’Malley, Rika. “Cocaine.” Merck Manuals. May 2020. Accessed October 30, 2020. 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Accessed October 30, 2020. Villa, Peter. “Midfacial Complications of Prolonged Cocaine Snort.” Journal of Canadian Dental Association. 1999. Accessed October 30, 2020. Guyuron, Bahman & Afrooz, Paul. “Correction of cocaine-related nasal defects.” Plastic and Reconstructive Surgery. March 2008. Accessed October 30, 2020. Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.