Heroin is an illicit opioid. It can be delivered to the body in a few ways, including smoking, snorting or injecting.  In this article we discuss the specific risks of snorting. Snorting involves taking the heroin which usually comes in a powdered form, and then sniffing it into the nostrils where it is quickly absorbed through the mucous membranes of the nose into the bloodstream.
Why Do People Snort Heroin?
Snorting is one of the fastest methods to deliver heroin to the brain. Injecting heroin is faster, but some people may be averse to using needles or simply don’t have the materials to do an injection. They instead snort heroin to deliver it quickly to the bloodstream to create a high. Snorting usually means the heroin will take effect within seconds to minutes.
What Paraphernalia Is Associated With Snorting Heroin?
It doesn’t take much in terms of paraphernalia to snort drugs. Some people put the drugs directly in their nose, using no tools. Others use a small tube like a straw, snuff bullet, or a rolled up dollar bill/paper. 
What Are the Dangers of Heroin in General?
Heroin alone carries several serious health risks. The high risk of addiction with heroin is common, regardless of the method by which it is ingested. In addition, heroin can cause a life-threatening overdose. The risk of an overdose increases if a person mixes their heroin use with other drugs that may cause respiratory depression. While the risk of overdose is probably higher with injection than it is with snorting, snorting can still very much cause an overdose.
Long-term opioid misuse is associated with gastrointestinal issues like constipation, or even bowel obstruction. It can also be associated with chronic urticaria or itching, cognitive impairment and malnutrition.
What Are the Long-Term Effects & Risks of Snorting Heroin Specifically?
In the long term, snorting heroin can cause damage to the nose, impairing blood vessels and their nasal cartilage. This can lead to severe nose bleeds, chronic inflammation, or even necrosis of the septum or the nasal cavity. In addition, caustic substances can damage the tissues of the nose and increase the risk of infections of the sinus tract. In severe cases, these infections can get into the brain and cause meningitis or even death.
Snorting also puts individuals at risk for blood borne illnesses including HIV and hepatitis C, particularly if sharing snorting materials with others.
Overdose Signs & Symptoms With Snorting Heroin
Common signs of an opioid overdose, including an overdose from snorting heroin, include the following:
- Going limp or only moving very weakly
- A person’s skin becoming pale or clammy
- Fingernails or lips changing color
- Vomiting or gurgling noises, even if the person doesn’t seem to move
- Losing consciousness or experiencing extreme confusion, especially if a person cannot be woken up or made to focus
- Slowed breathing
- Slower heart rate
If a person shows any of the above signs, it is a medical emergency. Call 911 and administer Narcan if available.
What to Do if Someone Is Overdosing on Heroin
If you suspect someone is overdosing on heroin, call 911 immediately. If available, administer the drug naloxone, which reverses the effects of opioids and can stop a life-threatening overdose.
When talking to the 911 operator, answer all of their questions clearly and make sure to give your exact location. If you’re not sure where you are, ask people near you if they know your current address.
If a person’s heart has stopped or they are not breathing, you should begin CPR if you know how. If you’re not sure how to perform CPR, ask if anyone near you knows how to perform it. Oftentimes, the emergency operator will guide you through the steps if you need assistance.
The Use of MAT for OUD
Medication for Addiction Treatment (MAT) is considered the first line treatment for opioid use disorder.  Methadone or Suboxone (a combination of buprenorphine and naloxone) is generally used to treat OUD. These medications are taken on a careful schedule and are designed to reduce a person’s opioid cravings and prevent withdrawal. They are best when used in combination therapy and counseling.
MAT doesn’t cure addiction, but it can help to effectively manage it for life. With the right level of care, people can stop using heroin for good. Both medications and therapy set people up for long-term success in recovery from OUD.
Medically Reviewed By Elena Hill, MD, MPH
Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More
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