Nasal Damage: What are the dangers of cocaine use?

Cocaine is the most commonly used illicit stimulant in both the United States and Europe. More than 4% of young British adults have used cocaine in the last year. Nearly 20% of U.S. adults have tried it at least once. It’s still mostly a drug of young people but it is the only drug for which rates of use are rising in adults over 40. These are so-called “silver snorters.”

Cocaine is derived from the leaves of the Ery-throxylon plant, a plant native to South America. The leaves can be toasted and mixed into a paste that can be chewed, but because it is rapidly hydrolyzed in the stomach, users prefer to inhale a powdered form which is cocaine hydrochloride. To maximise profit, dealers add bulking or “cutting” agents. These can make up as much as 80% of the powder. These agents include phenacetin, caffeine, lidocaine (to mimic the numbing effect of cocaine), and, increasingly, levamisole.

The use of cocaine can cause serious cosmetic and functional disabilities of the nose. So as cocaine use becomes more prevalent, can ENT surgeons expect to be faced with an increasing number of patients with cocaine-related nasal deformity?

Joining us are Professor Alwyn D’Souza (Consultant Otolaryngologist and Facial Plastic Surgeon at University Hospital Lewisham, King’s College in London, and President of the European Academy of Facial Plastic Surgery) and Dr Adam Chaker (EUFOREA CRS and EPOS Panel Member, and Rhinologist at the Department of Otorhinolaryngology of the Technical University of Munich, in Germany).