Energetic, alert, confident, talkative, excited, less sleepy, unable to fall asleep, nervous, agitated, irritable and paranoid. These are the many ways cocaine users describe how it feels when they take cocaine.

Note that last word: paranoid. It comes from paranoia, defined as a psychological disorder characterised by delusions of persecution or grandeur. There is however, nothing paranoid about the information given below, but it has certainly caused great alarm among people in Australia and New Zealand.

Did you know:

• Snorting cocaine could permanently damage tissues of your nose and cause the nose to collapse. The damage does not end there.
• According to the 2012 United Nations World Drug Report, Aussies and our neighbouring Kiwis are the world’s biggest recreational drug users. Global drug seizure data indicates that we are a major destination for cocaine traffickers.
• Cocaine use in Australia is on the rise, while the use of ecstasy is in decline. Statistics from 2007-2010, on which the UN report was based, indicate that between 1.5% and 1.9% of Aussies were using cocaine by 2010.

Well, now you know.

Most of us think of rhinoplasty or nose reshaping surgery as a procedure to improve our profiles, but many Aussies need nose surgery to undo severe damage caused by snorting cocaine.

So are we now the rhinoplasty capital of the world? According to Dr George Marcells, President of the Australasian Academy of Facial Plastic Surgery and a rhinoplasty specialist himself, we are not there yet. But it is an undeniable fact that more and more Australians are turning up at surgeons’ offices for damage control.

What exactly happens to a cocaine user’s nose?

Snorting cocaine crystals destroys the mucus lining in the nose and the cartilage wall that divides the nasal cavity in the middle of the nose. Without the mucal layer to protect them, your nose tissue, the bones of the nose and the cartilage are all exposed to damage. This can result in severe loss of cartilage, a condition known as septal chrondritis. Exposure also leads to inflammation of the bone and bone marrow of the nose, or what doctors refer to as nasal bone osteomyelitis.

The damage occurs gradually, not overnight. But ultimately, severe loss of cartilage and bone leads to a gradual but eventual total collapse of the nose.

Before it gets to this stage lots of other damage occurs. Chronic nasal cocaine use—which means daily use or heavy weekly use—can cause sinusitis, irritation and bleeding of the membranes of the nose. So it is not just the period of use, but also the frequency and volume of use that matters.

What can corrective nose surgery do?

Corrective nose surgery does two key things for a cocaine user who has suffered a nose collapse. It provides a new lining for the nose and cartilage grafts to replace the lost tissue. Cartilage grafts surgically inserted by a surgeon provide a new bridge and help create and maintain an intact nose.

You can read more about rhinoplasty in the Costhetics procedure article. However, please note that the article focuses on aesthetic surgery of the nose not nose reconstruction.

If you have been a cocaine user and suspect nasal damage, talk to a doctor early. You’ll probably be referred to a surgeon who will examine your nose and nasal structures and give you an idea of the extent of damage.

And of course, to prevent further damage, stop using cocaine.