Rectal use of opiates???!!!

[RNOTODAY]

I had a patient tell me that he takes his oxycontin rectally, because it dissolves faster, and doesnt have to go through his digestive tract? He said he had a gastric bypass, so this works for him, although his doctor didnt order it that way. Has anybody ever heard of this? Is this legit, or just another way to abuse narcotics?????

[RNOTODAY, BSN, RN]

actually, asystole, the patient said percocet AND

oxycontin, the op, the new non crushable ones, hence him saying he cant absorb it through his digestive tract.

[Asystole RN]

actually, asystole, the patient said percocet AND oxycontin, the op, the new non crushable ones, hence him saying he cant absorb it through his digestive tract.

Ah. Well I do not think it is an absorption issue. Personally I would not administer OxyContin OP rectally considering it has a label that clearly states not to, its hard to defend the practice when there are alternatives.

[maelstrom143]

Ah. Well I do not think it is an absorption issue. Personally I would not administer OxyContin OP rectally considering it has a label that clearly states not to, its hard to defend the practice when there are alternatives.

I am in agreement w/Asystole...right dose/right route comes to mind. If patient is administering rectally without it having been ordered that way, doctor needs to be made aware of the issue and med needs to be reviewed.

Never give a med via a route that has not been approved by attending MD &/or pharmacy (our pharmacists are on 24/7 to review meds and call docs for clarifications).

[RNOTODAY, BSN, RN]

Thanks everyone. Just to be clear, I would NEVER give a med any other route than what it was prescribed... I was just wondering if anybody had heard of that as a way of abusing, or was it a legitimate way of administering meds ever...... thanks again guys!!!!

[DemonWings]

I had a doctor tell me once that for his patients that he knew were going to use drugs, he would tell them to take the needle off the heroin (or whatever) and inject it into the rectum, this way they avoid the IV complications such as infection. YIKES, he called it "anal bumping" or something like that.

This was at a county hospital where we had frequent fliers in for multiple abcesses related to their IV drug use. Dont know it I would go as far as to tell them an additional way to use, however I can see his point in preventing the infections we see so often. However, I wonder if it puts them at a greater risk of OD'ing.

[RNOTODAY, BSN, RN]

Now , actually--- that makes sense to me. The abscesses we see in the ORare terrible... some gone so bad and so far that they require skin grafts, theres no skin left to save. so sad.

[MomRN0913]

We do it in hospice when a patient can't tolerate SL administration, in order to avoid the SQ, IM route

[SNB1014, RN]

rectal narcotic administration is absolutely a way that addicts use and abuse their drugs. crushed up and a very thing mucousal lining= good high. hey, i give em credit for thinking outside their nose and arm!

but yeah, we have suppositories for pain meds, so it isnt out of the question for a legitimate administration route. but we must watch which meds we are doing this with, sustained release/controlled, etc, doseage, blah blah!

[cooper.casey198]

Addicts use that method all the time! Prescription pain medicine is absorbed very quickly through your anal cavity's membrane! Much quicker than having to wait for its metabolism through your liver. Hence, the reason why Ecstasy users prefer to admit their fix anally as opposed to orally!