[Question #2637] Cocaine sniffing and risk

94 months ago

Dear Doctors,

Hope you can help ease my anxiety on the below. Last weekend me and some friends were at a Bachelor party in Berlin and there was lots of alcohol involved.

At one point during the night a friend of mine (who uses coke on a regular basis) got out some cocaine and put some on the tip of a key and gave me to try some, I do not remember if he did it before I did or after, the point is that the tip of the key was used by two of my friends and myself. I snorted just once and it was very little coke (it was my first time trying).

A couple of hours later I snorted a bit more again, but this time was using the tip of my finger nail as receptacle.

I've been invaded with anxiety ever since worrying that I may have contracted HIV or Hep C from this stupid mistake (I'll definitely will not do it again). I've found some confronting info online but I would really appreciate your honest opinion on this.

Regardless of your answer could you please also tell me which Hep C test I could make after a week or two of exposure? I will definitely not be able to live with this stress and anxiety until potential antibodies show up, I am a father of two and this is taking a huge tool on my mood at home and work.

Thank you so very much!

94 months ago

Hello.

To complement my previous question I checked with my local clinic and they offer HCV AC and HCV RNA(PCR) tests for hep c (I have immunization for hep a and b) and 4th generation for HIV.

Found some info online saying that the HCV RNA (PCR) can provide accurate results in as little as 2 weeks. Is my understanding correct? I want to thank you in advance so very much for replying to this and my previous question, I am in a state where I do not even wsnt to kiss my kids or wife.

Thank you!

Edward W. Hook M.D.

94 months ago

Welcome to our Forum. I'll try to help. Your concerns are misplaced and you really should not be worrying about the events you describe. Your experience is an excellent example of why the internet is a bad place to go for information. Statements made there are often presented out of context or are just plain wrong.

There are a few poorly documented cases in which hepatitis C MAY have been transmitted from person to person when a bloody straw used to inhale the cocaine by an infected person was then used by another person. In such cases the straw acts almost like a needle to break through the lining of the nose allowing material on the straw to enter another person's blood stream. In the case you describe you do not know that the persons who were also using the cocaine had hepatitis C and even if they did, neither the key or your finger nail entered your nose to penetrate the lining of your nose.. In my practice and reading I have not seen any well documented cases in which hepatitis C is spread this way. While there are many reason why it may not be a good idea to use cocaine, your fear of hepatitis C (or HIV) infection from the events you describe are not one of them. I see no medical reason for wasting your time and money in testing for hepatitis C related to the events that you have described.

If you must test for hepatitis C related to the events you describe, there is little research on how quickly a PCR test would become positive after infection and PCR testing is not recommended for initial diagnosis of the infection. It is logical that a PCR test would become positive before an antibody test and by two weeks tests for HIV are typically positive but there are not similar data to give firm estimates of when PCR tests would definitively positive if you had acquired hepatitis C.

Finally, I must point out that your fears of transmitting infection to your children, in the incredibly unlikely circumstance that you were infected, are misplaced. You CANNOT transmitted hepatitis C to anyone by kissing, touching or hugging. Unless you are sharing needles with your children, your fears of infecting them are completely misplaced and unwarranted.

I hope that this information is helpful to you. Please calm down and try to control your unwarranted concerns. EWH

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94 months ago

Dr. Hook,

Thank you so very much for your clear and straightforward answer, it has definitely helped me calm my irrational fears. I know the downsides of the use of cocaine and, believe me, this was the first and last, do not want to put myself in a similAr position ever again.

Before moving on I have just one more follow up question. I know my self andI'll probably go ahead with the testing for my peace of mind (I am a very obsessive person). In the meantime could I resume intimacy with my wife given the extreme unlikelihood of me catchig something from this event? If you were me would you resume? Or should I keep on making excuses until the day I test and get my final conclusive results?

Thank you so very much Dr. Hook, I am really thankful for the service you provide to people under huge amount of anxiety and stress trigerred by some poor decision making.

Edward W. Hook M.D.

94 months ago

There is no reason related to the events that you descrivbe for yo to abstain from unprotected sexual contact with your wife. No need to delay or make excuses. EWH
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