Professional and recreational drug users alike utilise a number of different routes of administration when ingesting their drugs, which allows them to affect certain variables of a drug’s resulting experience: things like the bioavailability (how much of a drug will be absorbed), onset, duration and dose required. This is often a trade-off, as different ROAs come with different advantages and disadvantages; 2c-b for example has quite an unpredictable onset time taken orally, while nasally the onset is very predictable at the cost of being legendarily painful.

One route of administration which is gaining popularity in the modern drug scene, but remains with some stigma and a lot of misinformation, is that of rectal administration or “plugging” – medically this can take a few forms, though in the context of recreational drug use this is usually the insertion of a drug solution into the rectal cavity, where the mucous membrane will allow blood vessels to absorb the drug directly – also known as an enema.

The enema’s earliest recorded use was by the Ancient Egyptians in 1500BC, and these among many other ancient societies used enemas of pure water to cleanse the body of toxins and waste. The Greeks later used them to treat fever and intestinal worms, and the practice has been a common and regular part of medical practice throughout the world since – Spain in 1000AD called the practice ‘playing the bagpipes.’ In the 19th century, tobacco smoke enemas were a common practice in Europe, used primarily to treat gut pain and in some cases in an attempt to resuscitate patients who were close to drowning. Today, both water and drug-solution enemas remain relatively common in medicine; for drug administration particularly, it is indicated when a patient cannot swallow and as an alternative to intravenous or subcutaneous injections.

The history of the use of enemas to administrate psychoactive drugs outside of a medical perspective begins similarly early, with art from the Ancient Mayans depicting the ritual use of rectally applied psychedelics, along with similar sources from ancient African and American civilisations. However, it does not share with the medical enema the long and varied intermediate history of use between that of ancient societies and today, and has thus largely escaped rediscovery by recreational drug users until relatively recently.

It is similar to intranasal, intravenous and inhalation routes of administration in that the drug bypasses first-pass metabolism, which means the drug will enter the bloodstream in greater concentration and with less alteration from the body. For this reason, along with the lack of discomfort from nasal administration, the lack of stigma associated with intravenous use and the lack of requirement for a freebase form of a substance for smoking (in many cases) means that for some drug users the rectal route of administration is becoming preferred. Dosages and bioavailability for plugging are often similar or equivalent to insufflating, however there are often differences, so specific information on rectal administration for each drug should be sought; when in doubt, start low and titrate the dose up slowly.

While being a relatively effective method of administration, there are certain problems and considerations when plugging drugs. Since the drugs bypass first-pass metabolism, they also bypass initial filtering and the body’s safeguards against overdose, meaning that an overdose can be a lot more dangerous – this is particularly obvious for alcohol, whereby taking it orally allows the body to vomit up the excess alcohol in the case of having taken too much, but will be absorbed straight into the bloodstream taken rectally. Additionally, caustic substances such as ethylphenidate will damage the mucous lining of the rectal cavity. Good hygiene practices are also recommended, to avoid problems with disease.

If you want to find out more about plugging, check out our Plugging Guide on TripSit Wiki.