Snorting cocaine can irritate and damage the nose. In extreme cases, such as the ones you may have seen online, the wall that separates the left and right nasal passages (the 'septum') can perforate, making a hole. This can lead the appearance that the two nostrils have become one.
Understanding how the nose is constructed and the characteristics of cocaine will help explain why this happens.
The nasal passages are very delicate and blood vessels in this area are extremely close to the surface. This explains why the drug reaches the brain quickly when snorted. When coke is sniffed mucous production increases. This helps to protect the delicate nasal membranes from ‘foreign bodies’ including cocaine. Apart from a runny nose, some users may find it difficult to breathe through their nose properly as it becomes increasingly stuffy, while others may start to experience nosebleeds. This can lead to the nasal septum dividing the nostrils developing a hole and possibly causing the nose to collapse.
Why does cocaine cause this? Medically speaking cocaine is a vasoconstrictor. This means that the blood vessels constrict, leading to the blood supply being reduced and less oxygen delivered to the nasal passages. This process can cause the delicate nasal passages to shrink and perforate. Put simply, the cocaine puts a 'chemical tourniquet' on the blood supply to the septum leading it to become 'weaker' and more susceptible to damage.
This kind of damage is not the norm. Most cocaine users will not experience this problem. That said, it can happen in extreme cases and is just one of the risks associated with snorting any drug, including cocaine.
First published: April 2018
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