Nasal symptoms associated with cocaine abuse during adolescence

A questionnaire on cocaine-use patterns and associated adverse effects on the nasal passages was completed by 464 adolescents. The respondents were abusers of various nonintravenous drugs enrolled in seven modified outpatient treatment facilities for alcohol and other drug abuse in five geographic regions of the country. Three hundred thirty-six respondents (72%) noted that they had used cocaine one or more times prior to their entry into the treatment program. The 336 recovering cocaine users were divided into three groups: those who had used cocaine fewer than 25 times (203 [60%]); those who had used cocaine between 25 and 99 times (107 [32%]); and those who had used the drug daily plus at least 100 times total use of the drug (26 [8%]). Statistically, we found a highly significant difference between the first group and the other two groups for cocaine-associated symptoms, such as frequent sniffing, "sinus" problems, and diminished olfaction. Approximately 30% of those who had "snorted" cocaine at least 25 times but less than daily, vs 47% of those who used the drug daily, recalled that they had nasal membrane irritation with nasal crusts or scabs, recurrent nosebleeds, or both. The astute otolaryngologist should consider cocaine abuse as a cause of puzzling or recalcitrant rhinitis, even during teenage years.