Cocaine snorting

Chevalier X, Rostoker G, Larget-Piet B, Gherardi R. Schoenlein-Henoch pupura with necrotizing vasculitis after cocaine snorting. Clin Nephrol 1995 43 348-349. 

Crack is the free base of cocaine and can be smoked, inhaled or injected giving a faster rate of onset than cocaine (snorted). 

Nasal Administration. The nasal mucosa is relative permeable to small molecular weight compounds. The most notorious example is cocaine. Cocaine that is snorted is both rapidly and extensively absorbed. Small peptides have also been successfully administered nasally, although the bioavailability is low. However, where the availability is not critical, nasal administration of peptides has been successful. The best example is... 

Nasal (NS) Through the nose. Cocaine is snorted up the nose and then absorbed through blood capillaries in the thin nasal membrane. 

The hydrochloride salt is inhaled or injected. It can be converted to cocaine base (crack or rock) and smoked to achieve almost instant absorption and intense euphoria. Tolerance to the high develops quickly. The high from snorting can last 15 to 30 minutes the high from smoking can last 5 to 10 minutes. 

The importance of pharmacokinetics should not be underestimated. The effects of psychoactive drugs are determined not only by their pharmacodynamic mechanisms, but also by how much of the drug reaches the brain, and how fast it does so. A cardinal example of this involves the behavioral differences between chewing coca leaves, snorting cocaine... 

LSD appears to have an extremely high safety margin. Tim Scully reports (personal communication) survival after an accidental overdose of 100 mg in one individual (who thought she was snorting cocaine) and another who consumed 50-75 mg by mouth. Both recovered fully. 

Cocaine does not penetrate the intact skin, but is readily absorbed from the mucus membranes, creating the need to snort it. This accounts for the ulceration of the nasal septum after cocaine has been snorted for long periods. 

So we have a situation where people assume that because someone passes a drug test, then they must be safe. The fact is, an airline pilot can snort a line of cocaine five minutes before a drug test and pass no problem then step into the cockpit for a couple hour flight and be severely impaired. 

While some stimulants, such as amphetamine and methylphenidate, are taken orally, others are either volatilized for inhalation or snorted as the solid (nasal insufflation). It is necessary to convert cocaine and methamphetamine to their free base so that they can be volatilized. Methamphetamine and cocaine are also abused via the intravenous route. 

Cocaine is found in several forms. It can be extracted from the coca leaf to form coca paste (basuco, pitillo), which is not water soluble but can be smoked. The paste can be further treated to form cocaine hydrochloride (cocaine powder), which can be dissolved in water and injected, or can be snorted into the nostril. 

Cocaine is a local vasoconstrictor, and snorting of cocaine intra-nasally reduces the amount of blood flow to the area, resulting in a reduced rate of drug absorption and slower onset of action. Often in cocaine abusers, the reduced blood supply to the nasal septum leads to the development of a perforation between the nasal passages. The effects of cocaine last approximately 40 minutes, while the effects of other stimulants usually last several hours, as each has a different half-life. 

Cocaine hydrochloride is a water-soluble salt that can be injected or absorbed by any mucosal membrane (eg, nasal snorting). When heated in an alkaline solution, it is transformed into the free base, "crack cocaine," which can then be smoked. Inhaled crack cocaine is rapidly absorbed in the lungs and penetrates swiftly into the brain, producing an almost instantaneous "rush."... 

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