Snorting is a common form of drug abuse in which people take a powdered or crushed-up drug and forcefully breathe in up into the nasal cavity.

Drugs that users often snort include cocaine, heroin, amphetamines, and prescription opioids. Snorting can lead to damage to the nasal cavity, nosebleeds, sinus infections, wheezing, and potential overdose.

Some users may progress to snorting from swallowing drugs to intensify the high. Snorting is often a sign of a developing addiction. However, smoking and IV drug use cause the drug to reach the brain faster.

Which drugs are snorted?

Drugs that are commonly snorted include:1,2

  • Heroin.
  • Amphetamines (Adderall, Concerta).
  • Flunitrazepam (Rohypnol).
  • Ecstasy (MDMA).
  • Ketamine.
  • Benzodiazepines (Xanax, Librium, Ativan).
  • Sleeping pills (Lunesta, Sonata, Ambien).
  • Prescription opioids (Vicodin, Actiq, OxyContin).
  • Bath salts.

 

Some illicit drugs come in a powdered form, but it’s also typical for users to take prescription medications and crush them up to be snorted. Some users prefer to snort the drug because swallowing a drug requires it to be digested and absorbed into the bloodstream slowly via the stomach lining and intestines.3

Snorting a drug can be an indication that a drug addiction is forming. Those who feel the need to graduate from taking a drug orally to snorting it have likely already built up a significant tolerance and are losing control of their drug use. In particular, people who snort prescription opioids may have built up a tolerance and feel the need to intensify the high by delivering it more rapidly to the brain.4

People can also graduate to more rapid methods of drug use as their addiction develops. They may seek out an even more immediate high. For example, someone who snorts cocaine, amphetamines, or methamphetamine may begin to inject them to feel the effects of the drug more quickly.5

What are the risks of snorting?

Snorting any drug comes with unique health problems that develop over time. Risks to health include:

  • Damage to the lining of the nostrils, nasal cavity, and septum.3
  • Loss of sense of smell.2
  • Nosebleeds.2
  • Trouble swallowing.2
  • Sinus infections.6
  • Wheezing, especially in people with asthma.7
  • Tooth decay (methamphetamine).8

 
In addition to these risks, users who snort drugs may contract or transmit diseases such as hepatitis C through shared equipment such as a straw or rolled-up dollar bill. The drug, as well as substances the drug may be cut with, can cause blood vessels to rupture or cuts and tears in nasal passages. The blood from these cuts can be transferred to the snorting device, and other people who use the device can come in contact with the blood. These people can contract the virus.9

What administration method works faster: snorting or smoking?

Smoking or injecting a drug typically gets the substance into the bloodstream faster than snorting. When a drug is smoked, it is quickly absorbed into the bloodstream through the lungs and then to the brain. The effects are almost instant. Injecting a drug puts the substance straight into the bloodstream, where it travels to the brain. Effects occur within 3 to 5 seconds.3

When someone snorts a drug, 30% to 60% of the drug enters the bloodstream through the mucus membrane in the nose and through the stomach. Users normally feel the effects of the drug within 15 minutes.3

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Which drugs are the most harmful to snort?

Snorting any drug is dangerous. Some are more dangerous than others. But they all carry risks.

Overdose is always a risk with heroin and other street drugs because the person can never be sure of the purity of the drug or whether it is cut with other substances. From 2002 to 2017, there was a 7.6-fold increase in the total number of heroin overdose deaths. It is estimated that there were about 16,000 heroin overdose deaths in 2017.10

Increasingly, heroin and cocaine have been cut with fentanyl, an opioid more powerful than heroin. Fentanyl can not only increase the strength of the dose but also lead to overdose among users who are not aware that they are taking fentanyl.11

Similarly, users who buy powder or capsules that are sold as Molly—the supposedly pure form of Ecstasy—may actually be purchasing bath salts, which can cause paranoia, hallucinations, and violent behavior.12

Cocaine use can lead to sudden death, even in first-time users. One study found that it can quadruple the risk of sudden death in people between the ages of 19 and 49. It can also lead to cardiac arrest or seizures.13,14

What happens when someone snorts prescription opiates?

Studies have found nasal ulceration, severe breathing problems, and increased risk of addiction and physical dependence from snorting prescription opioids.

Snorting prescription opioids causes the drugs to affect the brain and body much faster, typically within 15 minutes, whereas it can over an hour for the drug to take an effect if it’s swallowed.3,15

This method increases the chance of overdose. When people crush up and snort prescription medications such as oxycodone, they bypass the extended-release mechanism of the drug and take all of the medication at once. The medications contain higher doses because they are meant to be released over long periods.4

Further, one study found that snorting prescription opioids, particularly hydrocodone, can lead to hypersensitivity pneumonitis, an immune response to inhaled toxic or foreign substances. Symptoms include coughing, fever, and weight loss, and the reaction can lead to respiratory failure. The same study also stated that long-term abuse could also lead to scarring of lung tissue and breathing problems.16

Other studies have found nasal ulceration, severe breathing problems, and increased risk of addiction and physical dependence from snorting prescription opioids.17

Can snorting drugs reduce the immune system’s effectiveness?

Yes. Meth and cocaine especially impact the immune system, although the exact mechanisms are unclear. It appears that cocaine can interact with the aging process to impair the immune system, while methamphetamine can harm the immune system and increase the likelihood of opportunistic diseases.8,18

Heroin can also impair the immune system.6

If you or someone you care about has developed a problem with snorting drugs, don’t be afraid to reach out for help. A rehabilitation or 12-step program can help you stop using and learn how to live without drugs.

Sources

[1]. National Institute on Drug Abuse. (2011). Commonly Abused Drugs.

[2]. National Institute on Drug Abuse. (2018). Commonly Abused Drugs Charts.

[3]. McGill University. Routes of Administration.

[4]. National Institute on Drug Abuse. (2015). What is the Federal Government Doing to Combat the Opioid Abuse Epidemic?

[5]. University of Utah Genetic Science Learning Center. Drug Delivery Methods.

[6]. American Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

[7]. Restrepo, C., Carrillo, J., Martinez, S., Ojeda, P., Rivera, A., Hatta, A. (2007). Pulmonary Complications from Cocaine and Cocaine-based Substances: Imaging Manifestations. RadioGraphics, 27(4).

[8]. Salamanca, S., Sorrentino, E., Nosanchuk, J., Martinez, L. (2014). Impact of methamphetamine on infection and immunity. Frontiers in Neuroscience, 8, 445.

[9]. CATIE. (2011). Hepatitis C: An In-Depth Guide.

[10]. National Institute on Drug Abuse. (2018). Overdose Death Rates.

[11]. National Institute on Drug Abuse. (2016). DrugFacts: Fentanyl.

[12]. National Institute on Drug Abuse. (2018). DrugFacts: MDMA.

[13]. National Institute on Drug Abuse. (2016).What are the short-term effects of cocaine use?

[14]. University of the Basque Country. (2014).Cocaine consumption quadruples the risk of sudden death in people between 19 and 49.ScienceDaily.

[15]. Australian Department of Health. (2004). Speed of drug effect.

[16]. Pathak, L.K and Vijayaraghavan, V. (2016). Hydrocodone snorting leading to hypersensitivity pneumonitis. Baylor University Medical Center Proceedings, 29(3), 288-289.

[17]. Young, A., Havens, J., and Leukefeld, C.G. (2010). Route of administration for illicit prescription opioids: a comparison of rural and urban drug users. Harm Reduction Journal, 7(24).

[18]. Colombo, L.L., Lopez, M.C., Chen, G.J., and Watson, R.R. (1999). Effect of short-term cocaine administration on the immune system of young and old C57BL/6 female mice. Immunopharmacology and Immunotoxicology, 21(4), 755-769.