Substances can be abused in various different ways. Illicit and prescription drugs alike can be swallowed, injected, inhaled, smoked, or snorted. All of these methods eventually deliver the substance into the bloodstream, where it is carried to the brain, but the speed at which this occurs, as well as the amount of the drug that is able to reach the brain, varies between methods of administration.
Swallowing and snorting are both popular methods of administering a drug, but they differ in important ways that can impact the onset of effects, as well as the risks associated with the drug use.
Snorting is the practice of sniffing a powdered substance through the nose. Cocaine, amphetamines, crystal meth, and heroin are most commonly abused in this way. Some people may also crush and snort prescription opioids, such as oxycodone and hydrocodone, in order to bypass a time-release mechanism and get a more rapid and intense high.
Absorption into the Bloodstream
Regardless of the method through which a drug is administered, the substance must be absorbed into the bloodstream before it can reach the brain and produce its effects. Snorting a drug requires the substance to be absorbed through the nasal membrane and into the surrounding blood vessels. Those blood vessels then carry the drug to the heart, where it can be carried throughout the entire body, including all major organs as well as the brain. The drug must then pass through the blood-brain barrier—a highly selective and protective lining of endothelial cells that separates the blood from the brain—before it can interact with receptors in the brain and elicit its effects.
Since snorting drugs allows them to enter the bloodstream fairly quickly, they can affect the brain in a relatively short amount of time. This can increase the abuse potential of a drug, because the “high” produced by the substance occurs almost immediately after the drug is administered. The high also tends to be more intense when a drug, such as cocaine, is snorted.
Physical Effects: Substance abuse can have devastating effects on physical health. Some of these effects depend upon the method of administration. Snorting drugs introduces the powdered substance into the nasal passages, which can negatively impact the respiratory system. Long-term intranasal drug use can lead to chronic nosebleeds and runny nose, as well as a loss of the sense of smell, according to NIDA. Some of these consequences may be reversible once the drug use is stopped, but over time, repeated intranasal drug use can lead to perforation of the nasal septum, which can result in breathing difficulties. Full recovery from the physical effects of snorting drugs may not always be possible.
Many different drugs can be swallowed. Most over-the-counter and prescription medications are administered this way, and many street drugs, such as MDMA capsules, can also be swallowed.
Absorption into the Bloodstream
Drugs that are swallowed must overcome additional hurdles when reaching the brain. When a substance is swallowed, it is dissolved in the stomach and absorbed into the bloodstream via the stomach lining, as well as the small intestine. Once it is in the blood stream, it travels to the liver, where it is metabolized before it goes to the brain. This metabolism by the liver causes a reduction in total drug that is ultimately delivered to the brain. This mechanism is caused the first pass effect or first pass metabolism.
Due to this process, swallowing a drug can have a less noticeable effect that other methods of administration, such as snorting, smoking, or injecting the drug. After the drug goes through this processing, it enters the bloodstream and is pumped through the body and to the brain.
Physical effects of swallowing drugs
Swallowing illicit drugs, particularly street drugs that were not designed to be swallowed safely, can have serious negative impacts on the digestive tract and liver. As discussed, when illicit substances are swallowed, they pass through the digestive tract before being absorbed into the bloodstream. Many substances, such as stimulants like amphetamines and cocaine, cause a localized lack of blood flow to the digestive tract, known as mesenteric ischemia. Insufficient blood flow can lead to tissue death and eventual gangrene. Swallowing drugs also puts additional strain on the liver, because the drug is metabolized within the liver before entering the bloodstream to be carried to the brain. Chronic drug users, particularly those who abuse opioids combined with acetaminophen (Tylenol), can sometimes experience liver failure after years of substance use. Further, Tylenol esophagitis, irritation or injury to the esophagus, can occur if someone doesn’t completely swallow a substance that contains Tylenol (such as Vicodin, an opioid painkiller).
Both snorting and swallowing drugs can have significant negative effects on physical and mental health. Snorting a substance may cause it to be more addictive than swallowing the same substance, but any drug abuse can lead to a substance use disorder. Chronic abuse of medications or street drugs requires medical intervention and behavioral therapy.
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