How Much Cocaine Do You Have to Do for Your Nose to Fall Apart?

Plus: experts warn that one popular "harm reduction" technique may be more harmful than helpful.
October 2, 2020, 8:55am
cocaine nose fall apart
Actor Paul Kaye with fake cocaine on his nose. Photo: Chris Jackson/Getty Images

It’s been a while since the world witnessed a “celebrity’s nose collapses from doing too much cocaine” scandal, which is no bad thing. It was always cruel to use the ravages of addiction as fodder for tabloid gossip.

Still, in the 1990s and 200s, thanks to notorious examples such as Danniella Westbrook and Tara Palmer-Tomkinson, it became one of the most pervasive scare-stories about the drug. Nostril collapse was the coke equivalent of “ecstasy will make you drink eight pints of water and then die”, or “don’t take acid because you’ll convince yourself you can fly and jump out a window”.

If you’ve ever taken cocaine, you’ve probably experienced some degree of mild nose damage, even if that’s just being so bunged up you can’t get to sleep and have to breath with your mouth wide open. But how worried should you actually be about this? How much cocaine do you have to use to cause serious damage? And are there any ways you can reduce the harm done to your nostrils (other than by simply not doing coke)?

There is some good news – or at least, not terrible news. According to Nick Hickmott, Early Intervention Lead at drug and alcohol charity We Are With You, you have to be caning it pretty hard and pretty regularly to experience severe or long-lasting damage. But that’s not to say that people who only use casually are in the clear.

“While cartilage damage in the nose usually occurs in people who have experienced years of cocaine abuse at a high frequency,” Nick says, “heavy use could lead to this kind of problem over a period of a few months. There is no doubt that cocaine does slowly damage the nose, and the more you use, the higher the risk and the greater the damage.”

Harry Shapiro, director of drug information charity Drugwise, agrees that it’s unlikely, if not impossible, for occasional users to experience nostril collapse: “I think it’s just a question of frequency, really. If you look at someone like Danniella Westbrook, these people were seriously caning it. They’re in the right industry and probably have the necessary disposable income. For the person who has the occasional toot at the weekend, serious nostril damage is unlikely.”

In other words, while cocaine use is extremely common, many of us simply can’t afford to use it to the extent that this would be a potential problem.

That said, even if someone who uses cocaine casually is unlikely to experience serious damage, there are still preventative measures you can and should be taking. Even after a mild session, having a sore nose the next day is extremely irritating, and there’s nothing like a surprise nosebleed in McDonald’s that’ll make you feel more like some tragic loser in a Bret Easton Ellis novel.

According to a spokesperson from drug charity Release, there are some easy-to-follow tips which should help to mitigate the damage.

“The best way is to cut down, or stop altogether,” they say, “but there are things you can do, such as using a less abrasive tool (a soft-ended metal tube is much better than a rolled-up banknote, for example), regular nasal douching (washing out your nose, ideally with a mild salt water solution), and making sure you blow your nose thoroughly at the end of a session.”

It’s also worth making sure that you crush up the cocaine to as fine a powder as possible when you’re cutting lines, in order to avoid snorting big chunks of powder. You should also just be doing this anyway, as it’s simply more pleasant.

Lots of cocaine users swear by snorting salt water through a straw at the end of the night, in order to clean the nasal passage. But unlike a gentle douching, this is something you should definitely avoid. “We don’t recommend doing this,” says Nick, “because deliberately inhaling water through your nose risks aspirating that water into your lungs, which is extremely dangerous.”

Nostril damage can also cause other problems. “If you’re experiencing nosebleeds after taking cocaine,” says Nick, “then there are open sores which are being irritated by the powder being drawn abrasively past and into them. If these continue, then they are failing to heal and there is a chance of infection. Cocaine users should always be wary of the risk of blood borne viruses, such as Hepatitis C, which can be avoided by not sharing notes or straws.”

Bringing your own metal straw with you and avoiding sharing with anyone is a good way to do this. Admittedly, it might also make you look like a bit of a dick, but it’s worth it. Plus, using a recyclable straw is great for the environment – but probably not enough to offset the ecological destruction wrought by the production and supply of cocaine.

Obviously, the best way to avoid nose damage altogether (or any other kind of damage, not least to your heart) is to take cocaine as infrequently as possible – but if you are partial to getting the occasional bag in, then following these steps should help to stop you becoming the subject of a tabloid scandal yourself anytime soon.