"butter bullets"--narcotics mixed with butter for rectal administration

When I give a pill or two of course I just use lubrication from a water based thing like lubriderm.
But if a patient has 300 or 400 mg of morphine or 40mg plus of methadone (they are horse pills!) which requires administration then I think about an easy way to give it! The families where I work are usually OK with rectal administration ONLY if the patient is actively dying or near coma... (we all prefer a non rectal route of course). Ivs are so darn expensive and we try to use oral when possible as well....
SO if you take a little butter and put the pills in it (or crush for huge methadone tablets) make it shaped like a suppository and place it in the freezer then it easily slips in. It is easier then administer 5 or 7 pills in rectally as they get so slippering and families wig out over it. The family can administer every 8 or 12 hours and give roxanol or whatever PRN. The amt of salt is negligible and these are actively dying patients so salt is not an issue. Our hospice has done this for years. Again, this is only in the last days of life and would never be considered at other time. Just wondering if anyone has seen any literature about it....maybe it is our own hospice thing!
Thank you for responding!

They work well. The thing is the FDA has not given it its stamp of approval. Methadone is well documented to work rectally. But not in butter--although quite frankly unless they have a allergy to milk I cannot imagine it being any different then "surgical lube".If your pharmacy will put the tablets in a capsule for rectal administration then go with it. Some of the higher doses will obviously not work in capsule size, like you understand. When going above 4o mg of methadone I admit they look like monsters. At least they have a cooling effect! I too have used the capsules with pain meds inside but the capsules have to be the kind that easily "melt" into the rectal vault. Cheers.