Safer snorting information
This fact sheet provides information for service providers on how to educate and support clients to reduce harms associated with snorting drugs. Drugs that can dissolve well in water can be snorted because they are easily absorbed through the nasal membrane. Examples include powder cocaine, crystal meth and some prescription tablets.
Snorting drugs can lead to a range of health issues, such as bleeding from small vessels in the nose, sinus infections, damage to the nasal septum and passing respiratory infections such as colds as well as blood-borne infections such as hepatitis B and C. Snorting drugs also carries a risk of overdose or drug toxicity.
By using personal snorting supplies, not sharing supplies and following other safer snorting practices, people who snort drugs can significantly reduce their risk of health issues. Providing access to harm reduction supplies and education helps support people to use drugs as safely as possible. It also opens the door to build relationships and provide referrals to other health and social services, including treatment services.
Safer snorting supplies
Using safer snorting supplies and not sharing these items prevents transmission of infections like hepatitis B and C. All supplies are for personal use and should not be shared with others. Blood can remain on used supplies and can pass infections when shared, even if blood is not visible.
The following supplies are recommended to reduce risks and promote safer snorting practices:
- Alcohol swabs: Used to clean fingers and preparation surfaces
- Straw or straight stem: Used to snort drugs
- Sterile water: Used to rinse nose after snorting
Safer practices for snorting drugs
Service providers working with people who snort drugs should offer education on how to snort more safely. Here are some general safer snorting tips to reduce the risk of injury, infections and other health harms:
Hands and preparation surfaces should be cleaned with soap and water or alcohol swabs to reduce the risk of introducing germs that can cause infections.
Drugs should be crushed as finely as possible, if not already in powder form. This reduces damage and irritation in the nostrils.
To help prevent introducing bacteria that can cause infections, anything that touches the drugs should be new or cleaned. When arranging the powder into a line, a clean piece of cardstock paper or a piece of hard plastic wiped with an alcohol swab can be used.
Using colored straws or marking a straw or stem with a permanent marker, tape or an elastic can help identify personal snorting supplies to avoid sharing. To prevent infections, snorting with paper money or other items that could contain germs or bacteria should be avoided.
The inside of the nose should be rinsed after snorting by snorting a few drops of sterile water. This helps to reduce damage and irritation in the nasal passage. Using vitamin E oil or saline spray can help soothe the inside of the nose and help it heal.
Switching the nostril used to snort on a regular basis can reduce damage and irritation in the nostrils.
Snorting supplies should be replaced if they have been used by another person. Placing them in a sharps container or hard plastic bottle and dropping it off at a harm reduction service ensures proper disposal.
Important info about safer snorting
Mixing different substances
There are risks with mixing drugs. Mixing different drugs can cause stronger or different effects than using either drug alone. Mixing stimulants like cocaine with opioids like fentanyl or heroin increases the risk of heart attack, stroke and overdose. Different drugs also stay in the body for different amounts of time. It is important for people to always start with a small amount and use caution when using multiple doses or mixing drugs.
Stimulant overamping
Signs of overamping from stimulant use may include rapid heart rate or chest pain, rigid or jerking limbs, skin feeling hot or sweaty, anxiety, agitation and hallucinations. If someone is overamping, they may need support to calm down, cool down and rest. Emergency medical attention is required if someone has crushing chest pain or seizures, if they go unconscious or if they are not breathing. Naloxone works only on opioids and does not reverse stimulant overamping, but it is safe to use and may help if an opioid overdose is suspected.
Overdose (drug toxicity)
When someone is using drugs purchased from the illegal supply, there is a higher chance of overdose or toxicity. People can try to prevent or prepare for an overdose by:
using with other people or at a supervised consumption site
starting with a small amount and increasing slowly
getting their drugs tested, if possible
carrying naloxone and knowing how to use it
Naloxone temporarily reverses an opioid overdose. A person may be having an opioid overdose if they are unresponsive or unconscious, have slow or no breathing, are snoring or making choking or gurgling sounds, have cold or clammy skin, and/or have blue or grey lips and nails.
Resources
Responding to an opioid overdose, responding to stimulant overuse and overdose – CATIE, Toward the Heart BCCDC Harm Reduction Services
Harm Reduction Fundamentals: A toolkit for service providers – CATIE
Connecting: A guide to using harm reduction supplies as engagement tools – Ontario Harm Reduction Distribution Program
Best Practice Recommendations for Canadian Harm Reduction Programs – Working Group on Best Practice for Harm Reduction Programs in Canada
Acknowledgements
This resource is adapted from Connecting: A Guide to Using Harm Reduction Supplies as Engagement Tools by the Ontario Harm Reduction Distribution Program (OHRDP). CATIE also thanks the reviewers who contributed their expertise to this resource.