Snorting cocaine is technically called insufflation and can cause cocaine nose damage. The purpose is to get the drug into the body without having it go through the stomach where acid destroys the drug. The lining of the nose and sinuses are thin and charged with blood. This makes it possible to absorb the cocaine directly into the bloodstream. It also leads to cocaine nose damage, either temporary or permanent.
Cocaine nose damage is a result of vasoconstriction. This property is similar to other types of drugs which are used to constrict blood vessels in the nose and sinuses-- for instance, when treating a cold. When the cocaine starts to wear off, there will be a rebound effect where the sinuses and nose produce fluids. This is why cocaine users often have drainage and the “sniffles.” They aren’t suffering from a cold or allergy; their blood vessels are just reacting to the previous constriction.
When there is no swelling from an infection, constricting the blood vessels lessens blood flow too much. Without enough blood, the thin membrane starts to die. As the cells in the nasal lining die, bleeding may occur. This is the first sign users see. The condition of cocaine nose damage then progresses and the delicate layer of cells disappear, usually in a small area that steadily increases. Once this happens, the cartilage underneath is exposed.
The structure of the nose is built on top of cartilage. This is a living tissue that is fed by the layer of cells above it. Cartilage is softer and more pliable than bone, but serves the purpose of keeping the nose in the proper shape. As the lining erodes and the cartilage no longer gets nutrients and moisture, it begins to break down. Very small holes in the nasal lining may heal if cocaine is stopped, but greater cocaine nose damage or holes in the cartilage itself may never heal.
Because the cartilage supports the shape of the nose, serious loss will lead to a collapse of the bridge of the nose itself. Openings may also cause difficulty in breathing. The only option at this point is plastic, or reconstructive, surgery. Some surgeons will install a piece of plastic to replace the missing septum.
The same process of cocaine nose damage can happen higher up in the nasal cavity and sinuses may be destroyed as well.