Cocaine Nose: Nosebleeds, Nasal Perforation and Deviated Septum

Cocaine is a dangerous substance that is typically used as a recreational drug. As a stimulant, cocaine causes a high and also boosts mood and energy. These pleasurable effects can ultimately cause someone to develop a cocaine addiction. 

Cocaine is usually snorted, which can lead to a variety of different nasal problems. Those who use cocaine should be aware of the different nose problems the drug can cause.

Snorting Cocaine

Cocaine is most commonly used by snorting it. This is typically done by arranging the powdered cocaine into vertical lines and then using a straw to inhale the lines. When cocaine is snorted, it quickly absorbs through the membranes in the nose, entering the bloodstream and causing its effect in the brain.

Why Do People Snort Cocaine?

When people snort cocaine, the drug is immediately absorbed into the mucous membranes that line the nose, and it rapidly enters the blood vessels that lie underneath. Snorting cocaine is a quick and easy way to get it into one’s system. Snorting may also be less complicated than other methods, such as injecting.

What Does Snorting Cocaine Feel Like?

Snorting cocaine causes a euphoric feeling coupled with physical and mental stimulation. Cocaine can also cause physical changes due to its stimulative effect, such as sweating, restlessness, increased body temperature, muscle tremors and heart palpitations. The actual process of snorting cocaine may cause a burning sensation, irritation or stuffiness in the nose. It can also cause sneezing or a runny nose.

Where Does Cocaine Go When You Snort It?

When snorted, cocaine adheres to the moist membranes that line the nose. It is quickly absorbed across these membranes into the bloodstream. In the bloodstream, cocaine attaches to receptors on brain cells called monoamine reuptake transporters. This ultimately increases the activity of multiple chemicals in the brain, including dopamine, epinephrine, norepinephrine and serotonin. Cocaine is metabolized in the body quite quickly, as half the cocaine present in the blood is broken down each hour.

What Happens When You Snort Cocaine?

Cocaine is a stimulant, meaning that it stimulates the body’s nervous system and speeds up biological processes. This can lead to a wide variety of symptoms, all of which are due to the stimulating effects of cocaine. Symptoms of cocaine use include:

• Hypersensitivity
• Irritability
• Paranoia
• Heightened mental alertness
• Extreme energy
• Dilated pupils
• Nausea
• Elevated temperature
• Rapid pulse
• Restlessness
• Muscle tremors

Once the symptoms of cocaine use wear off, the stress the body has been through typically leads to a crash. When a crash occurs, the person who used cocaine may sleep for a long period of time.

What Is Cocaine Nose?

Cocaine nose is an informal term for a group of potential nose-related problems that can be caused by cocaine use. Cocaine is a vasoconstrictor, meaning it causes blood vessels to tighten and get smaller. This effect reduces blood flow to blood vessels that are exposed to cocaine. 

In someone who uses cocaine frequently, this vasoconstrictor effect can decrease blood circulation in the nose to the point where nose tissue starts to become fragile or even die. Cocaine nose mainly causes internal damage to the nose, so it may look fine from the outside. However, cocaine can damage the structure of the nose so much that medical problems can occur or the nose can collapse, causing a severe cosmetic defect.

Cocaine Nose Damage

Nose damage caused by cocaine can occur gradually. Early on, someone may have nose damage but not have any symptoms at all. Sometimes, stuffy nose or other side effects of cocaine use may be mistaken for allergies or a cold. People who snort cocaine should take any symptoms seriously and seek medical attention whenever any persistent nose symptoms occur.

Cocaine Nosebleeds

Cocaine is sometimes used by doctors to treat nosebleeds, but the drug can also cause nosebleeds to occur. The reason for this seemingly contradictory effect is the vasoconstriction that cocaine causes. When used only once, cocaine temporarily restricts blood supply to the membranes in the nose, stopping nosebleeds. When used over prolonged periods of time, however, cocaine causes damage to the lining of the nose, causing it to be more fragile and bleed more easily.

Cocaine nosebleeds are more serious than ordinary nosebleeds, as they indicate that progressive damage is occurring in the nose. The lining of your nose can normally heal itself, but if the circulation to the lining of the nose is restricted, it can become more prone to injuries that build on each other. This makes these injuries progressive instead of just a single nosebleed that will go away by itself. 

Nasal Perforation

Nasal perforation, also called nasal septal perforation, is a serious complication of cocaine use that can significantly affect nasal health. Nasal perforation occurs when frequent cocaine use causes tissues within the nose to die. 

As tissue dies, the piece of cartilage that separates the two nostrils (the nasal septum) becomes damaged. Continuing tissue death can result in so much damage that a hole develops in the nasal septum. This leads to deformities of the nose and complications like difficulty breathing through the nose and infections.

Deviated Septum

A deviated septum can occur naturally due to the shape of your nose at birth, but it can also develop when damage occurs to the nasal septum. Cocaine can damage the nasal septum by weakening its tissue. A deviated septum caused by cocaine will often be much more severe than one that occurs naturally.

A deviated nasal septum means the cartilage that separates your two nostrils shifts toward one side, making one nostril larger and one smaller. This can lead to difficulty breathing through the nose, sinus infections, snoring and mouth breathing. A deviated nasal septum can also cause an abnormal appearance that alters the entire appearance of your face.

Other Risks Associated With Snorting Cocaine

Cocaine use can also increase the risk of many other nasal problems. The increased fragility of the nasal lining combined with frequently inserting objects into the nose can increase the risk of infection. This is especially a concern when sharing equipment that is used to snort cocaine. Many nasal problems caused by cocaine use can progress to a complete collapse of the nose, causing it to flatten and become more even with the front of the face.

However, collapse of the nose is not the most severe facial problem that cocaine use can create. In some cases, long-term cocaine use can disrupt circulation to the point where it causes bone loss in the nose and cheekbones. This can lead to serious problems in the facial area and result in permanent deformity.

Treating and Preventing Cocaine Nose Damage

If someone is snorting cocaine, there is really no way to avoid potential nose damage over time. The only way to prevent cocaine nose damage and other health concerns is to stop using cocaine.

Treating cocaine nose damage is relatively straightforward. Cocaine is what causes decreased circulation and eventually tissue death, so the first step is to stop cocaine use. The tissues in the nose must then be given time to heal and regain normal circulation. Over time, it will become obvious which tissues will heal with restored circulation and which tissues are irreversibly damaged. At that point, treatment will primarily involve surgery to correct permanent defects.

Getting Help for Cocaine Addiction

Ohio’s rate of fatal cocaine overdoses is around 225% higher than the national average, but life-saving resources are available. The Recovery Village Columbus is dedicated to helping Ohioans live healthy lives free from the effects of addiction. Our state-of-the-art facility offers both inpatient and outpatient treatment as well as a wide variety of resources that help promote an effective and lifelong recovery. Contact us today to learn more about cocaine addiction treatment programs that can work well for your needs.

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By – Benjamin Caleb Williams, RN

Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more