Cocaine Routes of Administration: Dangers of Snorting, Injecting, and Smoking
Cocaine is a powerful and highly addictive stimulant drug that comes in a powder form and rock form (which is typically referred to as “crack”).1 The method of cocaine use can vary depending on its form, with common routes of administration including snorting, injection, smoking, or rubbing it onto the gums.1
The route of administration can influence the effects and intensity of cocaine.1 However, regardless of the way cocaine is used, the high that is produced can be intense but relatively short. These characteristics contribute to binge use, where a person who uses cocaine continues taking the substance back-to-back to prolong their high and maintain its intensity.
This article will take a deeper dive into the various routes of cocaine administration, the effects and risks associated with them, and how to get help for you or a loved one who may be struggling with a cocaine addiction.
Cocaine Routes of Administration
Any cocaine use exposes users to the risk of developing a stimulant use disorder, the clinical term for cocaine addiction. However, it is important to consider that the way a person consumes cocaine can influence the speed at which a stimulant use disorder can develop, as well as the kinds of short and long-term effects they may experience.
Snorting Cocaine
People can inhale the powdered form of cocaine by snorting it, a practice sometimes referred to as intranasal cocaine use.1 Snorting cocaine is the most common route of administration of powdered cocaine.2
When someone snorts cocaine by inhaling the powder through the nostrils, the drug is absorbed into the bloodstream through the nasal tissues.1 The onset of effects after snorting cocaine is slower compared to other routes of administration, but the high lasts longer, with an average duration of 15-30 minutes.1 While dangerous, intranasal use of cocaine may result in a slower, more gradual progression to a stimulant use disorder that other methods.
Risks of Snorting Cocaine
Intranasal cocaine use is associated with several risks to the nasopharyngeal (or the upper part of the throat) region.2 Regularly snorting cocaine can result in:1,2
- Loss of smell.
- Nosebleeds.
- Difficulty swallowing.
- Hoarseness.
- Mouth sores.
- Tooth erosion.
- Sinusitis (e.g., inflammation of the sinuses).
Snorting cocaine can also lead to irritation or perforation of the nasal septum, the bone and cartilage divider between your nostrils, which can result in chronic runny nose and nasal inflammation.2,3 Studies show these problems can develop as soon as three weeks after regular intranasal cocaine use has begun.2 Additionally, regular use of cocaine can lead to the development of a deviated septum, which means that the nasal septum becomes bent or crooked.4
Injecting Cocaine
Injecting cocaine involves dissolving powdered cocaine in water and injecting it into the veins with an intravenous (IV) needle.1 Cocaine injection provides an immediate release of the drug into the bloodstream, which results in increased intensity of its effects.1 The onset of cocaine’s effects via injection usually starts within seconds and last 5-10 minutes.1 Intravenous cocaine use is usually more closely associated to the rapid development of a stimulant use disorder compared to intranasal use.3
Risks of Injecting Cocaine
Risks of injecting cocaine can include:3,5,6
- Collapsed lung.
- Blood clots.
- Collapsed or scarred veins.
- Damage to the blood vessels.
- Endocarditis (e.g., inflammation of the heart valve).
- Bacterial skin infections.
- Bloodborne diseases (e.g., hepatitis C, HIV/AIDs).
- Lung infections (e.g., tuberculosis).
Smoking Cocaine
Smoking cocaine involves heating the rock crystal form of cocaine, also called freebase cocaine or crack, and inhaling the vapor or smoke into the lungs.5 People may also sprinkle crack on marijuana or tobacco and smoke it like a cigarette.5 Inhalation causes crack to be rapidly absorbed into the bloodstream, with effects beginning within seconds.1,7 As with injection, the effects from smoking cocaine may last only 5-10 minutes.1,5
Several factors contributed to the crack epidemic in the 1980s.1,8 Crack was more economically accessible as it was cheaper to produce and buy. This combined with the instantaneous and intense high contributed to an increase in crack addiction, deaths, and drug-related crimes, particularly within the African American communities of the inner cities.8 While the consequences of crack today are not as substantial as they were in the 1980s, the effects of crack still threaten communities in the U.S. and worldwide. According to the 2023 National Survey on Drug Use and Health (NSDUH), almost 1.3 million people aged 12 and older used crack cocaine in the past year.9
Risks of Smoking Cocaine
Smoking crack cocaine damages the lungs, which can result in:1,5
- Cough.
- Worsened asthma.
- Respiratory distress.
- Pneumonia.
- Bronchitis.
One study found that people who were chronic cocaine smokers also had an increased risk of pulmonary hypertension, a type of high blood pressure that affects arteries in the heart and lungs, and aortic dissection, or tears of the aorta.10
Recognizing the Signs of Cocaine Use
It’s not always easy to tell if someone is using cocaine. For example, you may observe certain signs when a person is high, but the intensity and duration of the effects depend on the route of administration.1
Some common signs of cocaine use include:5
- Extreme energy and happiness.
- Mental alertness
- Hypersensitivity to sound, touch, or visual stimuli.
- Paranoia.
- Irritability.
- Dilated pupils.
- Muscle twitches.
- Restlessness.
Signs that someone may be smoking cocaine can be harder to spot than with other routes of administration. However, you might notice the presence of drug paraphernalia like pipes or rolling papers. You may also notice other signs of addiction, such as problems at home, school, work, or in relationships, or cocaine withdrawal symptoms, such as depression, insomnia, or fatigue.11
Getting Help for Yourself or A Loved One
If you or a loved one is struggling with cocaine misuse or addiction, treatment is available to start the path to recovery.12 While recovery looks different for everyone, it often begins with medical detox, followed by ongoing treatment at an inpatient or residential rehab, or outpatient rehab.
Although there are no medications to treat cocaine addiction, treatment often involves a combination of behavioral therapies (e.g., cognitive-behavioral therapy), and participation in mutual support groups, such as Cocaine Anonymous (CA).5 If needed, treatment can address co-occurring mental or physical health conditions too.13
If you or a loved one are struggling with cocaine misuse or addiction, don’t wait to get help. Contact American Addiction Centers (AAC) at to connect with a caring admissions navigator about your rehab options.