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Steps to safer snorting

This resource provides information on safer drug snorting. Drugs that dissolve well in water are easily snorted because they can be 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, including bleeding from small vessels in the nose, sinus infections, damage to the nasal septum and passing respiratory illnesses such as coughs and colds as well as blood-borne infections such as hepatitis B and C. Snorting drugs can also lead to overdose or drug poisoning.

Using personal snorting supplies, not sharing, and following other safer snorting practices helps to lower the chance of health issues. Providing education on safer use along with a range of free harm reduction supplies can support people to use their drugs as safely as possible.

Getting ready to snort drugs

Using new safer snorting supplies is the best way to reduce harms. Safer snorting supplies are for personal use and should not be shared with others. This is because blood can remain on used supplies and can pass infections when shared, even if blood is not visible.

The following harm reduction supplies are recommended for snorting drugs:

  • alcohol swabs
  • straw or straight stem
  • sterile water (to rinse nose after snorting)
  • foil (to use as a clean snorting surface)

Safer practices for snorting drugs

Service providers working with people who snort drugs should offer education on how to snort drugs more safely by sharing the following steps and information.

How to snort drugs:

  • Wash hands and preparation surface with soap and water before handling harm reduction supplies. This can prevent infections caused by viruses and bacteria. Hand sanitizer or alcohol swabs can be used if soap and water are not available.
  • Crush drugs as finely as possible, if not already in powder form. Here are some possible ways to crush drugs for snorting:
    • Use a pill crusher that has been wiped clean with an alcohol swab (and allowed to dry).
    • Use a folded piece of paper and a lighter (or something hard). Fold the paper and place the drugs in the middle. Use a lighter or other tool to rub and crush the drugs through the paper. Always use a new piece of paper. This can reduce the risk of overdose from cross contamination when preparing drugs.
  • Arrange the powder in a line on a cleaned surface or a new piece of foil. This can help prevent bacteria from getting on the drugs.
  • Cut the line using a clean piece of cardstock paper or a piece of hard plastic (like a bank card) that has been wiped with an alcohol swab.
  • Insert a straw into the nose high enough to reduce the amount of drug that gets trapped in the nose hairs. This can also reduce nasal irritation.
  • Slowly inhale the powder into the nose, then exhale out of the mouth.
  • After snorting the drugs, rinse the inside of the nose by snorting a few drops of sterile water. This will help reduce irritation and will help move along any drugs left behind in the nasal passage. It can also reduce the chance of nasal damage.

Important info about safer snorting

Using personal snorting supplies

Snorting supplies are for personal use and should not be shared with other people. Using coloured straws or marking a straw with a permanent marker, some tape or an elastic can help identify personal snorting supplies to avoid sharing. Avoid snorting with paper money or other items that could contain germs or bacteria, as that can cause a sinus infection. Dispose of safer snorting supplies in a sharps container or other hard plastic bottle. Drop it off at a local harm reduction organization for disposal.

Nasal care

Certain practices can help protect the inside of the nose, prevent irritation and reduce the chance of nasal damage, including:

  • crushing pills, rocks or crystals as finely as possible before snorting (this will increase the amount of drug that is absorbed and lower the chance of damage to the nose caused by snorting)
  • rinsing the nose with sterile water after snorting
  • switching the nostril used to snort on a regular basis
  • using vitamin E oil or saline spray to soothe the inside of the nose and help it heal

Mixing different substances

There are risks with mixing drugs. Mixing different drugs can cause stronger or different effects than either drug alone. Mixing 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 to always start with a small amount, increase slowly 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, try to help the person 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 only works 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 poisoning

When someone is using drugs purchased from the illegal or street supply, there is a higher risk of overdose or poisoning. 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 drugs tested, if possible
  • carrying naloxone and knowing how to use it

Naloxone 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

Safer substance use video series – CATIE

Safer snorting – CATIE

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

Acknowledgement

This resource is adapted from CATIE’s Safer Substance Use Video Series and Connecting: A Guide to Using Harm Reduction Supplies as Engagement Tools by the Ontario Harm Reduction Distribution Program (OHRDP). CATIE thanks the reviewers who contributed their expertise to this resource.