Routes Of Administration For Drug Use And Abuse

People misuse drugs and alcohol through a range of methods, some far more common than others. While smoking, snorting, and oral use are widely recognized routes, less common methods like rectal administration can carry risks that are just as serious, and indicate that someone is facing severe drug addiction.

The method a person chooses often comes down to a few factors, including how easily the use can be hidden, how intense the high feels, and how quickly it takes effect. Not every drug can be used the same way, and switching to a new method can introduce risks that weren’t part of the original pattern of use.

Oral Administration

Probably considered the most common method of consumption, swallowing delivers drugs and alcohol to the stomach, through the lining of the digestive tract, and into the bloodstream. This is the slowest method of ingesting, but for some drugs, it is the only method.

Some of the drugs that can be consumed orally, or swallowed, include:

• alcohol
• edibles (marijuana put inside food items)
• prescription pills (i.e. Vicodin, Adderall, etc.)
• club drugs (DMT, MDMA, molly, ecstasy)
• mushrooms (psilocybin)

Swallowing, or orally consuming, drugs or alcohol can cause damage to different organ systems, including the kidneys and liver. Additionally, there is a high risk of overdose or alcohol poisoning because of the delay or slower distribution to the bloodstream.

Smoking Drugs

Another common method of drug abuse is to smoke the drug. This typically involves heating the substance to the point where it starts to burn and inhaling the smoke.

Once it is inside the lungs, it quickly enters the bloodstream and is delivered to the brain and other organ systems.

Drugs that can be inhaled or smoked include:

• marijuana
• crack
• meth
• tobacco
• PCP
• heroin

Smoking can cause issues with breathing, and make existing breathing problems worse. Inhaling substances can place a person at higher risk for lung diseases, such as pneumonia and even cancer.

Even the process of heating the drugs can be dangerous. Many individuals heat drugs on tin or aluminum foil before smoking which can lead to even more negative health effects.

Snorting Drugs (Insufflation)

Snorting drugs, also known as insufflation or intranasal drug use, induces a quick high. Inside the nasal cavity, the thin membrane is filled with small blood vessels that quickly absorbs the substance, allowing for almost immediate release into the bloodstream.

Cocaine is the most recognized drug that can be snorted, however, there are a number of additional substances that can be insufflated.

Most anything can be crushed and snorted, including:

• Adderall
• Ambien
• Ativan
• Benadryl
• Caffeine
• Cocaine
• Dilaudid
• DMT
• Focalin
• Gabapentin
• Heroin
• Hydrocodone
• Klonopin
• Kratom
• Lyrica
• Melatonin
• Meth
• Molly/Ecstasy (MDMA)
• Oxycodone
• Ritalin
• Seroquel
• Suboxone
• Tramadol
• Vyvanse
• Wellbutrin
• Xanax
• Zoloft

Insufflation puts a person at high risk for developing pneumonia, as snorting drugs may allow these substances to get into the lungs, resulting in infections and bacterial growth.

Shooting (Injecting) Drugs

Intravenous (IV) drug abuse may be the quickest way to get high since the drug is placed directly in the bloodstream with injection. Substances abused by shooting are dissolved in a liquid (usually water or alcohol), drawn into a syringe with a needle, and injected into the vein. Shooting drugs is also considered one of the most dangerous methods of drug use since it can quickly lead to addiction and accidental overdose.

A few of the drugs that can be abused by shooting up are:

• cocaine
• heroin
• methamphetamine
• crack
• benzodiazepines
• barbiturates
• steroids
• oxycodone
• Demerol

There are a number of dangerous side effects of intravenous drug use, both short-term and long-term. These include infections, diseases, organ and tissue damage, weakened immune systems, and many more. Approximately one in 10 individuals with HIV are IV drug abusers, according to data from 2016.

Skin Popping

A less common form of injecting drugs is called ‘skin popping’. Using this method, a person pulls the skin upward and injects the drug under the surface of the skin. This method is more often found in individuals who have been abusing substances through IV methods, and have damaged the veins to the point that they are unusable.

Any water-soluble drug can be abused using this method, including cocaine and opioids. Infections and skin abscesses are a common side effect of skin popping, including staph infections and osteomyelitis.

Plugging Drugs

Administering drugs rectally is another method of drug abuse. There are several different terms for this method, such as boofing, plugging, and butt-chugging (usually involves alcohol). A person places the substance in the rectum and sometimes uses a tampon to hold the substances inside the anal cavity.

Drugs commonly misused by plugging include:

• Adderall
• Alcohol
• Ambien
• Cocaine
• Heroin
• Klonopin
• Kratom
• MDMA/Molly (Ecstasy)
• Methadone
• Methamphetamine
• Morphine
• Oxycodone
• Ritalin
• Suboxone
• Tramadol
• Valium
• Xanax

The thin tissue in the walls of the anal cavity is believed to deliver substances quickly to the bloodstream, resulting in a quick euphoric feeling. However, there have not been studies that explored the bioavailability of these substances administered rectally versus other methods of drug abuse.

There are a number of potential adverse and dangerous effects of plugging drugs, and with expanding research on the topic, more negative outcomes continue to be discovered.

Suppository Drug Use

Abusing a drug by using it as a suppository and inserting it into the vagina or rectum has become a more common method of substance abuse as well.

Huffing And Transdermal Misuse

Abusing inhalants, known as huffing, is the practice of inhaling the fumes of substances like paint thinners, gasoline, aerosol cans, whipped cream cans, and certain glues. Additionally, a person may soak a rag in one of the liquids and huff the fumes of the towel.

Abusing a drug transdermally means using a patch to adhere the drug to the skin and then it is absorbed through the skin. Illegal drugs or illicit prescription drugs have been abused this way as well.

Consequences Of Different Methods Of Drug Abuse Administration

Individuals struggling with addiction often find themselves trying to find a way to get high faster or with more intensity. They may start off smoking or snorting a drug, but eventually, the obsession to get as high as possible may cause a compulsion to try new ways to get high. This can result in dangerous outcomes, including accidental overdose and death.

Even if a person does not overdose, different methods of administration come with their own set of risks. For example, smoking increases the risk of adverse effects on the lungs, including developing lung cancer. Shooting up can increase the risk of infection, snorting can destroy parts inside the nasal cavity, and plugging can damage the rectum.

Trends In Drug Use

More than 1 million people in the U.S. have died from a drug overdose since 2000, though recent data shows meaningful improvement. Overdose deaths fell to an estimated 73,000 in the 12-month period ending August 2025, down about 21% from the previous year and continuing the longest sustained decline in decades.

Despite this progress, substance use disorders remain widespread. In 2024, about 48.4 million people aged 12 or older, or roughly 16.8% of the U.S. population in that age group, met the criteria for a substance use disorder, spanning both alcohol and drug use. Yet only about 1 in 5 people who needed substance use treatment that year actually received it, highlighting a persistent gap between need and access to care.