The NHS wants cocaine users to stop snorting their noses off

The NHS wants cocaine users to stop snorting their noses off. Although it’s rare to snort your nose into oblivion, apparently it’s on the rise.

​“We haven’t got good numbers on it because it’s quite a difficult thing to record,” Nicholas Calder, an ear, nose and throat consultant and surgeon at NHS Lanarkshire says.

​“Anecdotally we’re seeing a big rise in people undergoing reconstructive surgery on their noses after cocaine abuse in the last few years. Particularly since lockdown, we’re definitely seeing a rise.”

Kelly, a 36-year-old cocaine addict in recovery, told THE FACE about the damage she caused herself. After her husband passed away, she stopped smoking crack and was sober for eight months. “[But] when I relapsed, I figured I didn’t want to smoke crack,” she says of the drug and method that killed her partner. ​“I was going to snort it.”

Her relapse lasted for three-and-a-half years. For the first 19 months she stuck to snorting cocaine before starting to smoke it again. ​“At the beginning of my relapse, it was maybe a couple of eight balls [3.5g] a week,” she says. But it escalated. ​“At the highest point of my usage, and this only lasted for about three or four weeks, I was up to about an ounce of cocaine [28g] every day-and-a-half.” Other than when she was snorting coke, she couldn’t function. ​“I wasn’t sleeping, I wasn’t eating. It was my main form of everything: entertainment, life, fun, sadness, it didn’t matter – I used it for everything. It was my escape from all reality.”

The result of all the snorting was catastrophic for the structural integrity of Kelly’s nasal passages.

“There were a couple of defining moments when I knew that I had really screwed up. The inside [of the nose] started to deteriorate and there were specific times when I knew that I was in trouble based on the amount of blood, the things that were coming out of my nose when I tried to blow it, and the lack of being able to breathe in through it.”

She stopped snorting coke and went back to smoking it, but things only worsened. ​“I had a little bit of a crater in my nose and a lot of the skin was deteriorated on the outside as well,” she says. ​“But as far as the collapse goes, I remember that exact moment. I had quit snorting, I was not capable of holding anything up my nose anymore, but I couldn’t give up the drug.”

Her nose had given in before she did.

“I lost the piece of skin in between the two nostrils,” she says of her septum, which is made of cartilage and bone. ​“It deteriorated because of the cocaine usage. There was nothing for it to hold on to, it was basically just dead skin at that point. My nostril was one big open hole.

Eventually, Kelly sobered up. Emotionally, she’s beginning to work through the loss of her husband through therapy, group support networks and finding a renewed sense of purpose by bravely sharing her story on TikTok (where she posts under the handle @stuartlittle064). And physically, she’s made good progress, too, having had six surgical procedures to fix the damage

“The first surgery was last March. But that one failed because the tip of my nose did not have a blood supply. I’ve had five [more] procedures that are currently being used to fix what I destroyed.” Kelly says her second operation ​“basically used parts of my arm that were good and healthy to put them into my nose to make the tip of my nose healthy so that it could sustain new life.”

I asked Calder if snorting water at the end of a night might have helped her particular case, even in a small way.

“Yes, potentially that would help,” he replies carefully, with some caveats. ​“The problem with that is that if you’re just snorting regular tap water up your nose, it has the potential to introduce infection.

“For patients that we see who have cocaine damage, we recommend they take saline rinses or saltwater rinses,” he says, ​“which you can buy over the counter from the chemist.” He added: ​“Or [we] give them a solution to make at home, which is boiled tap water with some salt and sodium bicarbonate in it. But it is important that it is sterile water. Rinsing out your nose with sterile saltwater is the best harm reduction advice.”

“Eat, sleep, take a nap, take a walk,” Kelly advises when I ask what she would say to someone bingeing on coke and struggling to slow down. ​“I’m not gonna say that you can distract yourself from wanting your drug of choice. However, when it comes to stimulants, stopping them [in the moment] can be as simple as taking a nap and getting nutrition – because you’ve malnourished yourself to the point where you don’t know what you need anymore.”

In sum: don’t just follow your nose.

Are you struggling with drugs? Click here to see a list of organisations that can help, and click here for information about how the NHS can help. If you think there might be a drug-related emergency, do not hesitate to ring 999 – you will never be in trouble for doing this.