Nose Damage from Drug Use: Impact of Snorting Drugs on the Nasal Passages

Some of the Ways in Which People Take Drugs

As previously mentioned, substances may be swallowed, smoked, injected, or snorted. Depending on the route of administration, individuals may feel the effects of the substances differently. For instance, injecting or smoking a substance typically produces a quicker onset and more intense high. Snorting a substance, on the other hand, might take slightly longer for the drug to reach the bloodstream, though the subsequent drug effects may last relatively longer.¹

Types of Drugs That Are Commonly Snorted

Individuals might favor a certain method of administration based on the type of drug being used. For example, individuals often snort substances that are available in a powder form, such as cocaine, meth, and heroin.²

Other commonly snorted drugs include:²

• Ketamine.
• MDMA, also known as ecstasy or Molly.
• Phencyclidine, also known as PCP or angel dust.
• Synthetic cathinones, also known as bath salts.

Some prescription drugs in pill or capsule form may also be snorted, though additional effort must be made to first crush a tablet or empty a capsule to then be inhaled through the nasal passage. Prescription drugs with reported intranasal misuse include:²

• Benzodiazepines like alprazolam (Xanax) or diazepam (Valium).
• Sleep medications such as zolpidem (Ambien).
• Opioids, such as hydrocodone (Vicodin) and oxycodone (OxyContin).
• Stimulants, like dextroamphetamine (Adderall) and methylphenidate (Concerta and Ritalin).

Additionally, inhalants, such as paint thinners, degreasers, gasoline, lighter fluid, glue, spray paint, and more are commonly inhaled through the nose.²

Risks and Adverse Effects of Snorting Drugs

Some medications delivered intranasally can be beneficial when used for medical treatment. The nose can absorb these therapeutic drugs into the bloodstream quickly and effectively.³

However, snorting drugs in a powder or particulate form for non-medical or recreational purposes is associated with risks beyond whatever adverse effects the specific substance imposes on your health. Some of these acute and chronic medical complications include irritation of the nostrils, nasal passages, and sinus structures, which can lead to sinusitis (sinus inflammation and/or infection), irritation of the nasal mucosa, necrosis, and perforation of the nasal septum (i.e., loss of tissue, or a hole in the bony cartilage in the middle of the nose).¹

Case reports identify other, rarer risks of snorting drugs. These include subcutaneous emphysema, which occurs when air gets into the tissues under the skin, and pneumomediastinum, a condition in which air gets trapped within the chest cavity (but outside the lungs). Both conditions can lead to serious complications, including:⁴

• Compressed airway.
• Pneumopericardium, a condition in which air ends up in the fluid-filled sac that surrounds the heart and roots of the major blood vessels that extend from the heart.
• Tears in the esophagus.
• Ruptures in the windpipe (trachea).

Long-Term Adverse Effects of Snorting Drugs

Repeatedly snorting substances can also increase the risk of developing dependence and addiction. When used, many types of addictive drugs are associated with large surges of the neurotransmitter dopamine, which may ultimately “teach” or encourage the individual to repeat the drug taking behavior again and again.⁵

The relative risk of developing dependence and addiction can be influenced by not only the type of substance being used, but by the specific method of such use. Snorting a drug affects the amount of the substance delivered to the brain, the speed with which it is delivered, and the intensity of the drug’s effects—all of which can impact the development of a substance use disorder.⁶

Chronically snorting substances can have other long-term effects on our health, including:^1,7-9

• Loss of sense of smell.
• Frequent nosebleeds.
• Difficulty swallowing.
• Hoarseness in the throat.
• Nasal mucosal inflammation and chronic runny nose.
• Fungal infections or necrotic tissue injury in the sinuses.
• Hypersensitivity pneumonitis, or allergic inflammation within the lungs.
• Fibrotic lung disease in association with chronic lung inflammation.

What Is Cocaine Nose?

As previously mentioned, snorting particular drugs can have certain substance-specific effects in the nose. Chronic cocaine use, for instance, may lead to a condition colloquially referred to as “cocaine nose.”¹⁰ Regular, repeated use can cause extensive damage to the mucosa, a type of tissue that lines the nasal passages, that results in the collapse of the nose and obstruction of the nasal airway.¹⁰

Is Drug-Related Damage to the Nose Reversible?

In some cases, damage done to the nose due to snorting drugs may be treatable with medications or surgical interventions.¹¹ As previously mentioned, a perforated septum can develop after frequent snorting of drugs.¹ Surgery may be able to aesthetically repair a collapsed septum.¹⁰

Can Snorting Drugs Lead to Overdose?

Yes, snorting drugs can lead to an overdose. The risk depends greatly on the drug, the amount, and individual-specific factors, too. Any route of administration can potentially lead to absorption of toxic amounts of a substance and overdose. Additionally, snorting large amounts of cocaine, for instance, can cause heart attacks, strokes, or seizures—all of which can result in sudden death.¹

Furthermore, individuals who snort a combination of substances—intentionally or not—have an increased risk of overdose.¹ The combination of cocaine and heroin, for instance, is very dangerous. Individuals often mix these drugs because the stimulating effects of cocaine are offset by the sedating effects of heroin. However, this can lead individuals to take a higher dose of heroin. Because cocaine’s effects wear off sooner, this can lead to a heroin overdose.¹

Furthermore, because it takes very little fentanyl, a powerful opioid drug, to produce a high, many drug dealers mix it with cocaine, meth, heroin, ecstasy, and counterfeit pills—all of which may be used intranasally—to create a potent substance that costs them less to make.¹² Unfortunately, nearly 67% of drug-related overdose deaths in the United States involved synthetic opioids (primarily fentanyl) in 2021.¹³

Treatment for Drug Misuse and Addiction

If you or someone you love is snorting drugs or struggling with addiction, treatment can help you—or them—recover. There are many different treatment options available, but research shows that the most effective treatment is individualized to your unique needs and may involve one or more levels of care, including:¹⁴

• Medical detox.
• Inpatient rehab.
• Outpatient programs.

A treatment center that provides a range of care, like any of American Addiction Centers’ (AAC) programs, allows you to transition between levels of care as you progress through your recovery.

Depending on the substance or substances snorted, treatment may begin with detoxification, but that’s typically not sufficient for sustained recovery. It’s usually the first step in a comprehensive inpatient or outpatient program that includes a combination of psychoeducation; individual and group counseling; mutual-help groups; and evidence-based behavioral therapies to help you find motivation for change, build skills to remain abstinent from drugs, learn and implement coping skills for your daily life, and improve your relationships with others.¹⁴

Some of the most commonly used behavioral therapies that have proven to be effective in addiction treatment include:¹⁴

• Cognitive-behavioral therapy.
• Contingency management.

All of AAC’s facilities offer a range of payment options, including financing plans. Additionally, our treatment centers are in-network with many major health insurance providers, which may cover all or at least part of your addiction treatment.

To verify your insurance, click on the link above and fill out the form. We can tell you your level of coverage and review any out-of-pocket costs.

Reaching out for help is the first step in the recovery process. Call AAC at anytime 24/7 to speak to one of our compassionate and knowledgeable admissions navigators, who can listen to your story, answer your questions, explain your options, and get you started on the path to recovery, which can change your life.