Administration: Chewing, Snorting, Swallowing, Inhaling, Smoking, Injecting

Most people who are addicted to substances learn quickly that the way in which a substance enters the body often determines how effectively it produces a “high.”  For prescription medicines, a patient may feel no or fewer effects from an extended-release drug compared to the immediate-release version of the same.  But oral consumption is considered to be one of the slowest methods of administration, and many addicts jump to other, “faster” methods.  This article discusses the different ways that an addict may consume certain substances and how each works.

Swallowing – Swallowing is usually a “starter method” for most addicts who are using prescription drugs (opiates, stimulants, benzodiazepines, barbiturates, and others) and other illegal substances that can be acquired in tablet, capsule, or powder form like Ecstasy, ketamine, bath salts, and many others.  This method differs from chewing because the substances are not necessarily activated by being ground with the teeth.  Because the drug must be digested by the stomach and intestines before entering the blood stream, it is considered to be the slowest route of administration.

Chewing – Chewing is a practice primarily associated with plant-based substances like tobacco and marijuana.  When a person chews (or in the case of snuff, holds the substance in the mouth), the addictive chemicals in these drugs can be passed to the blood stream via tissues in the mouth.  Again, because there are multiple steps before the drug enters the blood and is conveyed to the brain, chewing may produce some euphoric effects, but does not usually do so with the speed of other methods.  Addicts who chew may have signs of damage to the lining of their cheeks and discolored and/or decaying teeth. (Note that tooth damage can also be a sign of meth addiction via any route of administration.)

Snorting – Any drug in powder form (including prescription medicines that have been crushed by an addict as well as cocaine and meth) can be snorted although it is not a preferred method for users of certain substances.  This method produces results with moderate speed because the drug is already in powder form and absorbed by mucosa in the nose. People who snort drugs may have damage to their septum (nasal tissues) as well as nose bleeds; they may own paraphernalia like straws, rolled pieces of paper (dollar bills are popular), razor blades, and mirrors.

Smoking and Inhaling – Inhaling substances – including drugs that are smoked and “inhalants,” which are inhaled directly – can give a substance user a high quickly; only IV injection (described below) is faster.  Substances that are smoked include marijuana, tobacco, and crack. The large surface area of the alveoli in the lungs makes it possible for the lungs to absorb the smoke or substance rapidly and transfer it to the blood vessels that surround each alveolus.  Addicts who smoke substances may have lighters, matches, pipes, bongs, and various other types of paraphernalia.  Inhalants often look like household or industrial products, such as aerosols (deodorant, vegetable oil sprays) and volatile solvents (gasoline, paint thinners).

Intravenous (and Other) Injection – Intravenous (IV) injection involves preparing a drug (e.g., mixing it with a solution, heating it, etc.) and using a syringe to inject the substance directly into the blood stream.  The person often experiences a high within seconds.  Although all addictions are serious, IV injection is often a sign of a developed addiction because the addict has dismissed the potentially serious consequences as well as the social stigma associated with this method.  Among the drugs that are frequently administered via IV injection are heroin and cocaine.  A user may miss a vein and inject the drug into the muscle. Some users direct the drug into the area below the skin; this is called subcutaneous injection or “skin-popping.”  People who are injecting substances will possess needles, rubber bands or bandanas (as tourniquets), alcohol solution or swabs for sterilizing the site, and possibly spoons and lighters for preparing the drug if applicable.  Physical signs of injection may include abscesses (infected areas of the skin by the injection site) as well as track marks; these darkened areas of the veins are really scars that have resulted from repeated injections in the same place.  If a person has begun injecting into veins in the hand, neck, buttocks, or other less easily accessible areas, the addiction may be quite advanced.

Note that snorting, inhaling, and IV injection – because they require additional tools for their administration – have the added risk of the addict contracting HIV/AIDS, hepatitis, and other conditions. This becomes a problem when addicts forget, misplace, or damage their own tools – or when they intend to use substance administration as a bonding, social activity – and share paraphernalia with infected users occurs.