Renowned author Arthur Conan Doyle has devoted over sixty short stories and novels to the fascinating investigations of Sherlock Holmes. Many excerpts from these works dealt with the glorious detective’s fondness for cocaine and are generally a kind of original evidence of the appearance of cocaine addicts in Europe in the 19th century. Since the mid-1990s, cocaine use has been on the rise in most countries.

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The International Day Against Illicit Drug Use and Trade on Saturday (26.6) is an important opportunity to focus on cocaine which is gaining immense popularity as the most common street drug after cannabis. The number of chronic consumers who visit our unit for endoscopic surgery of the nose, sinuses and skull base is rising at an alarming rate. Many patients indicate that they were not fully aware of the severe consequences of drug use on the various functions of the nose and if they were aware, they might have avoided it altogether.

Apart from being the organ responsible for the sense of smell, the nose is also used to filter, heat and moisten the air during the breathing process. Its nostrils are a gateway to a fascinating world of complex structures, long corridors and vascular-rich mucous membranes, but these openings are also used to sniff (sniff) cocaine among drug users.

Cocaine is an alkaloid extracted from the leaves of the coca plant that grows mainly in the mountainous regions of South America and is used in medicine for local anesthesia in various surgeries. It is an addictive psychoactive drug with tremendous potential for damage to various tissues in the human body. Cocaine contracts the blood vessels and re-branching can cause inflammation, decreased blood supply to the nasal septum, and eventually death of the cells in the tissue which leads to perforation in the septum. A small perforation may cause wheezing and increased production of scabs. With larger septal defects, tissue support is also impaired resulting in severe structural changes in the external shape of the nose (“saddle nose”) and extensive damage to the nasal mucosa which can cause chronic runny nose or extreme dryness, bleeding, loss of sense of smell, inflammation in facial caves and difficulty Significant in nasal breathing.

Similarly, cocaine applied topically to the gums can be devastating to the lining of the mouth and teeth, and with overconsumption, the drug can cause myocardial infarction, arrhythmias, pulmonary edema and death. Although cocaine is perceived for its high price as a drug of the middle and upper class and is sometimes referred to as the “drug of the rich”, some of its severe nose damage is remarkably similar to those caused by infectious diseases such as syphilis or leprosy that are (unjustly) identified with lower status.

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Complete repair of the damage caused to the nose as a result of consuming cocaine is very complex and sometimes even impossible. Therefore, the best treatment to reduce cocaine damage is to raise awareness about the local and systemic dangers of consuming and preventing it.

* Dr. Shay Schneider, AG specialist in the unit for endoscopic surgery of the nose, sinuses and skull base and director of the ARM Center !URGENT ARM – The Multidisciplinary Medical Center for AGA Assuta Medicine, Ramat Hachayal And a senior AGE physician at Soroka University Medical Center

By Editor

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