Route of Administration: Ways We Do Drugs
The human body is complex, and the human mind is creative, thus we have found all kinds of ways to get drugs into our bodies.
The method we choose to use put the drug in our body is called the route of administration. Each method has pros and cons, with varying risk profiles.
For some, safer use may include changing the route of administration to allow a particular body part to heal, i.e., your nose from excess snorting. Changing the route may be necessary due to a medical issue, for example if you typically smoke your drugs, that may not be best for you if you have an upper respiratory infection.
So, let’s explore various routes of administration and hopefully identify some ways to keep you safe.
Numerous drugs are most typically taken orally, such as alcohol, pills, psilocybin mushrooms, etc. Taking drugs orally produces the slowest effect since the drug must travel through the digestive system and liver before reaching the brain. The slower effect can mean less addiction potential, but for some people can cause stomach problems, especially depending on the drug.
Snorting drugs gets gives us a faster effect from the drug than swallowing, but still slower than smoking or injecting. Snorting a drug means it must be a powder substance and should be crushed into a fine substance as possible.
Though snorting is generally safer than injecting, it still carries risk. Snorting regularly can damage the nose, so alternating nostrils is important. Additionally, anything we put inside our nose should be clean and not used by others. Snorting through rolled dollars or doing “key bumps” is a great way to rapidly put all kinds of germs into our bodies. If snorting is your go-to, please be safe and get wrapped straws and keep yours apart from other people.
Take good care of your nose! Ideally after snorting, people rinse the inside of their nose. This can be done by dabbing your fingers in sterile water and sniffing the water up your nose until you feel it run down your throat. After use, especially use that was heavy or prolonged, use vitamin E oil, saline spray, sinus rinse or a water-based lubricant to soothe the inside of your nose and help it heal.
Smoking drugs provides the fastest onset of the high, but also has a shorter duration of the effects. When smoked, the drug enters the capillaries in the lungs and goes directly into the brain. Smoking is usually done through a pipe, stem, or bong. When smoking crack, a filter should be used.
Glass pipes and stems can get very hot, so to reduce the risk of burns to the mouth using a mouthpiece is ideal. If that cannot be obtained, then wrapping the ends with rubber bands or tape can help protect the lips.
With all supplies, it is best if everyone has their own. If sharing is necessary, then wiping it down with alcohol before sharing can help reduce the transmission of germs and disease. Any implement used to smoke with should be cleaned often.
Booty bumping is inserting drugs into the rectum. People choose this option because it can carry less risk than injecting, does not leave marks, and does not cause nasal damage like snorting can. Additionally, the rectum has a high bioavailability, meaning more of the drugs will get into your system than compared to smoking drugs.
“Dabbing” or “stuffing” is when people wrap the drug in rolling paper and simply insert it directly into the rectum. However, the potential for damage is lessened when the drug is mixed with water and inserted via lube injector or a syringe with the needle removed.
Booty bumping can carry risks, namely tearing and infection. Alternating routes of administration can lessen the risks, as can using appropriate lubrication and vitamin E capsules afterward.
Injecting drugs by far carries the most risk, not only with regards to overdose, but also infections, disease transmission, damage to veins. Drugs can be injected intravenously (into the vein), intramuscularly (into the muscle), or via subcutaneous injection (skin popping). Skin popping reduces the risk of overdose a little but brings heightened risk of infections and abscesses.
Injecting requires a lot of supplies, such as syringes, cookers, cottons, sterile water, alcohol swabs, and tourniquets. Ideally people have clean sterile supplies for every step of the process. For each step that is skipped or each component that is unclean, serious risks to health increase.
Location matters! The arms and hands are generally the safest areas to shoot, followed by the legs and feet. Shooting into the neck and groin are highly dangerous and should be avoided at all costs. Regardless of the location, injection sites should be rotated, ideally an inch up from the previous site. Veins need a chance to rest, so sometimes changing your route of administration can be helpful. Veins that are red or tender should be given ample time to heal, which also helps avoid irreversible damage.
The Miscellaneous Methods
While the above are most common and are most relevant to most drugs, there are other methods.
Lingual: this refers to drugs that dissolve on the tongue, for example LSD.
Sublingual: this refers to drugs that are placed under the tongue.
Buccal: drugs that are held in the cheek until dissolved.
Topical or transdermal: these are often patches applied to the skin, i.e., fentanyl patch made for slow release.
Hot railing: glass stem is heated until red hot, then placed over a bump or line (of meth), then the vapors are inhaled through the nose.
Your Safety Matters
To us, nothing matters more than your safety. If you choose to use, we want you to be safe. If you live in Texas and you need support, please reach out. If you aren’t ready or interested in counseling, but you need more information on staying safe, please visit our Safety First page or check out the sources below.
Denning, P., & Little, J. (2017). Over the Influence: The Harm Reduction Guide to Controlling Your Drug and Alcohol Use. The Guilford Press.
About the Author:
Kimberly May, LPC-S, LMFT is a therapist at Substance Use Therapy in Austin, TX. Kimberly works with individuals, couples and families whose lives have been affected by substance use. By utilizing a harm reduction framework, Kimberly works effectively with people in any stage of use. In addition to substance use, she works with other issues such as anger, burn-out, anxiety and grief. Contact today to schedule a no-charge, 30 minute, in-person consultation.