Medical uses (
laxative) suppositories for insertion into the rectum. In addition to pharmacological effects, rectal administration has some properties which can be advantageous for the use in medicine. Rectal administration can allow patients to remain in the home setting when the oral route is compromised. Unlike
intravenous lines, which usually need to be placed in an
inpatient environment and require special formulation of
sterile medications, a specialized rectal
catheter can be placed by a clinician, such as a
hospice nurse or home health nurse, in the home. Many oral forms of medications can be crushed and suspended in water to be given via a rectal
catheter. The rectal route of administration is useful for patients with any digestive tract motility problem, such as
dysphagia,
ileus, or
bowel obstruction, that would interfere with the progression of the medication through the tract. This often includes patients
near the end of life (an estimated 1.65 million people are in
hospice care in the US each year). Because using the rectal route enables a rapid, safe, and lower cost alternative to administration of medications, it may also facilitate the care of patients in
long-term care or
palliative care, or as an alternative to
intravenous or
subcutaneous medication delivery in other instances.
Recreational used for rectal administration of
heroin. Colloquially known as boofing or plugging, rectal administration is, besides its application in medicine, also employed by users of
psychoactive substances. As in the medical procedure, the psychoactive drug is injected via the anus and is absorbed by the rectum's
blood vessels. A study shows that awareness of rectal administration as a possible route of administration varies greatly among users of different drugs. The knowledge of rectal administration is highest among groups of users of
alcohol,
stimulants and
opioids, where over 30% of users are aware of it. The reasons for rectal administration are largely the same as with medicinal drugs: Bypassing the first-pass effect, fast onset, and a relatively high bioavailability with some drugs. Rectal administration is sometimes thought of as a safer alternative to
intravenous injection of psychoactive substances, which carries a significant risk of infections and illnesses like
pulmonary granulomatosis. However, rectal administration of psychoactive drugs has risks associated with it also. Some psychoactive substances like
substituted amphetamines can induce a strong
vasoconstriction in the rectal vasculature and lead to
intestinal ischemia. before administering them rectally. Possible impurities or falsely marketed substances greatly increase the risk of administering illicit drugs rectally. == Mechanism and effects ==