Intranasal cocaine use and its complications associated with nasal damage and visual disturbances


Ieva Klinavičiūtė1, Rūta Pangonytė-Kiuberienė1, Miglė Puodžiūnaitė1 

1Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania


Cocaine is the most common intranasally used psychoactive substance. Due to its high affinity to the receptors of central and peripheral nervous system and having an effect on both the dopaminergic and opioid pathways it causes psychomotor agitation, euphoria, and increased concentration to specific tasks during acute use. Cocaine is also able to induce local anesthesia by inhibiting the activity of potassium-sodium channels, thus inhibiting the initiation of normal nerve impulses. In the nasal mucosa cocaine acts as a vasoconstrictor. Over a long period of time, cocaine abuse results in constant vasoconstriction causing nasal ischemia, often resulting in perforation of the septum or the appearance of necrotic ulcers. Inhibiting osteoclasts can also lead to destruction of the middle and upper nasal shells. Long-term cocaine use is also associated with visual disturbances due to ciliary artery occlusion, optic nerve compression, or infiltration.


Key words: cocaine, nasal damage, visual disturbances.