Transitioning Routes of Administration
The term “Routes of Administration” (ROA) means the ways you take your drugs. This could include injecting, snorting, smoking, swallowing, or boofing. Changing the way you consume your drugs is an important harm reduction strategy to help keep your body healthy.
There is no “best” route of administration. Each of them have pros and cons, and some of them only work with certain drugs. The best route for you will depend on how your body is doing, your drug of choice, and how you are feeling. Sometimes, the best option for you will change.
It’s important to remember that some routes can make the dose you are used to feel stronger or have a higher overdose risk. When you switch routes of administration, start with a lower dose than usual to gauge how the dose affects you through a new route.
Remember, you have options! Knowing what they are can help you decide what works best for you and your body. It’s always good to have the supplies you need for different routes of administration so that you can make safe choices depending on the situations you find yourself in.
ROA Pros
Injecting
This includes both intravenous and intramuscular injection. Always use your own sterile equipmen t and rotate injection sites.
Efficiency. You have to use a smaller dose to get the safe effect.
Speed . The high comes on the quickest through injection.
Cons
More intense cravings. The quick effects sometimes make it harder to stop using.
Risk of infection. Injection has the highest risk of HIV or HCV transmission, along with potential damage to veins, abscesses, or endocarditis.
Fear. Many people are afraid of injecting or the sight of blood.
Short-lived high. The effects do not last as long as other ROA, which means you may need to use more frequently to stay well.
Higher risk of overdose. Because of its speed and intensity, injecting comes with a higher risk of overdose. Be sure to carry naloxone and have an overdose response plan — this goes for all ROAs, but is particularly important to consider here!
When to Transition ROA
No access to sterile supplies. Using your own new, sterile syringe for every shot is the most important way to avoid infection. If you can’t find clean rigs, consider using another ROA.
Damaged veins or persistent abscesses. If you have damaged veins or other injection related complications, injection may take too long or be very painful. Injecting in the feet, groin, or neck is especially dangerous. If these are the only places you can hit, consider switching it up to give your body a chance to rest and heal.
Boofing
Absorbing the drug through your rectum, also known as booty bumping, or plugging. Don’t share equipment and get vaccinated for Hepatitis A.
Medium rush. The rush is not as intense as injecting but is more intense than smoking for most.
Medium duration. Your high will last longer than injecting, but not as long as eating the drug. That might be the perfect length of time for you!
Uncomfortable. You might be embarrassed or uncomfortable with putting something in your butt.
Needing to empty out. For best effects, you should go to the bathroom before using. Try to empty out your colon as much as possible! This isn’t always possible for folks, especially if you are using every day.
Stomach aches, rectal pain, and bloody stool. If you experience any of these signs, it might be time to give your booty a break.
Snorting
Always use your own razor and straw for preparing drugs for inhalation. Crush powder as fine as possible and alternate your nostrils between hits!
Speed. Highs from snorting come on fast, but not as fast as smoking or injecting. Discreet. You don’t need a lot of equipment or space to safely prepare your dose.
Short-lived. If you don’t want to be high for a long time, snorting can be an effective option.
Swallowing
Crush and swallow pills, or mix them into a drink. Always mix your own drink, so that you know how strong it is.
Easy and discreet. You can eat or swallow your drugs almost anywhere!
Carries the least addictive potential. Because it takes longer than any other ROA to kick in, there isn’t as much instant gratification. Lasts a long time. This is a pro and a con for many people! If you want to use infrequently, the long duration of a high from swallowing your drugs might be a positive for you.
Low risk of infection or disease transmission.
Smoking
Make sure everyone has their own mouthpiece. If you have to share glass without a mouthpiece, wipe it down with an alcohol swab or clean it with warm water and soap.
Speed. Behind injecting, this is the second fastest route of administration.
Shortest duration. This has the shortest duration high, but still comes with a more intense rush than a shorter duration ROA like snorting. If you just want a quick high, smoking can be a good option.
Recent damage to the nose or frequent nose bleeds. If your nose has already experienced trauma, or frequent sinus infections, including fresh nose piercings, snorting may be particularly uncomfortable. If you have frequent nosebleeds unrelated to your drug use, snorting will exacerbate them.
Unpleasant drip. Many people find the post-nasal drip associated with snorting drugs unpleasant. This icky taste in the back of your throat might be a turn-off for you.
No rush. Since it takes so long to kick in (usually around 30-60 minutes), there isn’t a rush associated with eating. Swallowing drugs on an empty stomach might help them kick in faster but might also give you a stomach ache.
Difficult to dose for. Because it takes so long to kick in, it can be tempting to take more than your usual dose while you’re waiting for the drugs to hit. Then before you know it, you’re feeling too high!
Lasts a long time. For many people who are eating drugs, the high lasts uncomfortably long, even an entire day.
Inefficient. You get less bang for your buck — you will be high for a shorter amount of time than with the same amount of drugs and a different ROA.
Lung damage. Smoking anything can contribute to scarred lungs, coughing, and difficulty breathing.
Burns and cuts. Hot glass, especially when used without a mouthpiece, can cause uncomfortable burns and cuts on your lips. If you’re sharing glass, these cuts can sometimes lead to HCV transmission.
Damaged septum or nasal passages. If you find you are experiencing persistent irritation, give your nostrils a break! Consistent snorting for too long can lead to holes in the cartilage in your septum and structural damage to your nose. Ongoing congestion. If you’re all stuffed up all the time and you aren’t sick, it might have to do with this ROA. Give yourself a break!
Stomach ache. Eating drugs can cause stomach pain. Having a nutrient dense meal beforehand can help!
Short on time. If you don’t have the time to dedicate an entire day to being high, eating might not be the best option for you.
Using too frequently. If your high isn’t lasting long enough, you may want to switch to an ROA that lasts longer, like boofing.
Breathing issues. If you are consistently struggling to breathe or feeling pain or tightness in your chest, give your lungs a rest!
Is your nose bleeding from over-snorting? Maybe it’s time to change it up. Can’t hit a vein? It might be good to give your body a break from injecting. Are you getting stomach aches or pooping blood from booty bumping? Smoking could be a better option. You need to get well but don’t have a discreet place to inject? Eating your drugs could help! Remember, you can always switch back and forth according to what you’re needing at the moment.