Cocaine Snorting & Nose Damage

Damage sustained by regularly snorting cocaine can be severe and cause significant structural issues as well as an increased risk of respiratory complications. These include structural damage to the septum, soft palate, hard palate, and, in extreme cases, total septal collapse. Respiratory problems include lung and sinus infections and breathing difficulties.

Nosebleeds

Epistaxis, commonly known as nosebleeds, is one of the most common side effects of long-term cocaine use. Cocaine is an illicit substance, and the manufacturers often cut other chemical agents into their products. Many of these chemicals can damage skin, cartilage, and other tissue on contact.

When cocaine comes into contact with tissues in the nose, throat, and mouth, it is absorbed into the bloodstream. However, cocaine is a potent vasoconstrictor. Consequently, as it is absorbed, it constricts and sometimes breaks the blood vessels. This damage can cause the affected tissue to become irritated and hemorrhage, leading to frequent nosebleeds.

Perforated & Deviated Septum

If cocaine repeatedly damages the mucosal tissue covering the cartilage and bone barrier between the nasal passages, known as the septum, it can become exposed. Once this occurs, cocaine use can directly damage the septum until a hole or perforation is formed between the nasal passages. Frequent cocaine use can also cause the septum to shift or deviate to one side, known as a deviated septum. Both a perforated and a deviated septum can impact breathing and sense of smell, cause chronic pain, and may require surgery to be repaired.

Septal Collapse & Saddle Nose Deformity

If the septum sustains enough damage, it can dissolve and collapse altogether, leading to facial deformity. Without a septum to support itself, the nose caves in and forms a saddle shape—a condition commonly referred to as “saddle nose.” As with a perforated septum, saddle nose deformity can be painful, cause breathing issues, and often require extensive plastic surgery.

Soft & Hard Palate Perforation

The hard palate, or the roof of the mouth, is a bony structure that sits just below the nasal passages. The soft palate is a soft, fleshy membrane just behind the hard palate that forms a barrier between the nose, mouth, and upper throat.

As with the septum, when the delicate mucosal tissue on the bottom of the nasal passages is eroded, further cocaine use can directly damage the soft and hard palate. This can cause a perforation through the bone of the hard palate into the mouth or dissolve the soft palate completely. In addition, the use of cocaine after soft or hard palate perforation has formed can cause or exacerbate dental issues.

Constant damage from cocaine use can also kill the tissue in the back of the throat. In extreme cases, cocaine can damage the clivus, a cranial bone behind the throat. (4)

Signs & Symptoms of Soft & Hard Palate Perforation Include:

• Chronic pain.
• Sore throat.
• Bad taste in mouth.
• Chronic bad breath.
• Dental damage.
• Gingivitis.
• Nasally voice.
• Breathing issues.
• Difficulty swallowing.
• Expulsion of food and drink through the nose.

Nose, Sinus, & Lung Infections

Chronic cocaine use dramatically increases the risk of infections in the nasal and sinus cavities. Again, when cocaine comes into contact with these tissues, it can reduce blood supply to the area or eliminate it completely. Over time, this will cause these tissues to die, or necrose. Open, necrotic tissue injuries, such as septal or palatal perforations, can rapidly lead to infections that can be severe and difficult to treat. (5) The act of snorting cocaine can also cause it to disperse into the sinus cavities, where it can become lodged, cause damage, and result in sinus infections.

The nose and sinuses perform other roles besides transferring air into the lungs. The lungs function best when supplied with warm, humid, clean air. For this reason, the nose is designed to draw in air and circulate it through the sinuses to warm and moisturize it. Moreover, tiny hairs called cilia line the nasal passages and sinuses and filter out contaminants and particulates from the air to protect the lungs. Cocaine-induced damage can disrupt these essential functions, rendering the lungs susceptible to infections like pneumonia.

Breathing Complications

When snorted, cocaine is mainly absorbed into the bloodstream through nasal mucosal tissue. Some of it is also swallowed and absorbed through the esophagus and stomach lining. However, some of it enters the lungs directly. As with nasal mucosal tissue, cocaine can damage the lungs’ alveoli (air sacs), which extract oxygen from the air. Over time, damage of this sort can lead to severe respiratory issues. (6)

Respiratory Complications of Cocaine Use Include:

• Asthma.
• Chronic cough.
• Shortness of breath.
• Chest pain.
• COPD.
• Pulmonary edema.
• Pulmonary hemorrhages.
• Hemoptysis (coughing up blood).
• Pulmonary barotrauma.
• Collapsed lung.