Drug class | Specific drug | Route of administration (ROA) | Approx. bioavailability | Onset | Main route-specific dangers / harm reduction |
Opioid | Heroin (diacetylmorphine) | IV | ~100% | Very rapid | Highest overdose risk from rapid CNS delivery; vein damage, abscesses, endocarditis and blood-borne infections. |
Opioid | Heroin | Intranasal | Variable / poorly established | Rapid | Nasal irritation and bleeding; variable absorption and unpredictable illicit-drug potency. |
Opioid | Heroin | Smoked/inhaled | Highly variable | Very rapid | Rapid systemic delivery; respiratory irritation and burns; overdose remains possible. |
Opioid | Fentanyl | IV | ~100% | Very rapid | Extremely potent; small variations in exposure can cause respiratory depression. Injection adds infection and vascular risks. |
Opioid | Fentanyl | Intranasal | ~89% for some pharmaceutical formulations | Rapid | High systemic availability; nasal irritation/ulceration; illicit formulations are unpredictable. |
Opioid | Fentanyl | Buccal/transmucosal | Formulation-dependent | Rapid–moderate | Substantial mucosal absorption; accidental exposure and formulation manipulation can produce uncontrolled dosing. |
Opioid | Fentanyl | Transdermal | Formulation-dependent | Slow | Prolonged exposure; heating or manipulating patches can cause potentially dangerous uncontrolled drug release. |
Opioid | Morphine | Oral | ~20–30% | Slow | First-pass metabolism and delayed effects can encourage premature redosing; respiratory depression. |
Opioid | Morphine | IV | ~100% | Very rapid | Abrupt respiratory depression; vein damage, infection and endocarditis risk. |
Opioid | Morphine | Intranasal | ~10–30% | Moderate–rapid | Nasal injury and variable absorption; substantially lower bioavailability than IV. |
Opioid | Oxycodone | Oral | ~60–90% | Moderate | Delayed respiratory depression and accumulation; modified-release products are particularly dangerous if manipulated. |
Opioid | Oxycodone | Intranasal | Formulation-dependent | Rapid | Nasal injury and faster systemic delivery; altered-release formulations may produce unpredictable exposure. |
Opioid | Buprenorphine | Sublingual | ~28–51% | Moderate | Prolonged opioid effect; dangerous sedation when combined with other CNS depressants. |
Opioid | Buprenorphine | Buccal | ~46–65% | Moderate | High transmucosal absorption; formulation-specific pharmacokinetics. |
Opioid | Buprenorphine | IV | ~100% | Very rapid | Injection-related infection and vascular injury; formulations containing naloxone may behave differently when injected. |
Opioid | Buprenorphine | Intranasal | ~38–44% in some studies | Rapid | Nasal injury and faster absorption; not equivalent to approved formulations. |
Benzodiazepine | Diazepam | Oral | ~90–100% | Moderate | Sedation, impaired coordination and respiratory depression, particularly with opioids or alcohol. |
Benzodiazepine | Diazepam | IV | ~100% | Very rapid | Abrupt profound sedation and respiratory depression, particularly with opioids. |
Benzodiazepine | Alprazolam | Oral | ~80–90% | Moderate | Amnesia, impaired judgement, dependence and dangerous CNS depression with other depressants. |
Benzodiazepine | Alprazolam | Sublingual | High / formulation-dependent | Faster | Potentially faster CNS exposure; mucosal irritation; increased impairment. |
Benzodiazepine | Lorazepam | Oral | ~85–95% | Moderate | Sedation, amnesia and falls; respiratory depression with other CNS depressants. |
Benzodiazepine | Lorazepam | IM | ~90% | Moderate | Pain and tissue injury; absorption can be less predictable than oral administration. |
Benzodiazepine | Midazolam | Oral | ~30–50% | Moderate | Extensive first-pass metabolism; sedation and respiratory depression. |
Benzodiazepine | Midazolam | Intranasal | Formulation-dependent; substantial | Rapid | Nasal irritation; rapid CNS effects and respiratory depression. |
Benzodiazepine | Midazolam | IV | ~100% | Very rapid | Significant respiratory depression; medical monitoring is normally required. |
Stimulant | Cocaine | Oral | ~30–60% | Slow | Delayed peak can encourage redosing; cardiovascular toxicity remains possible. |
Stimulant | Cocaine | Intranasal | ~60–80% | Rapid–moderate | Nasal vasoconstriction, bleeding, mucosal damage and possible septal injury. |
Stimulant | Cocaine | Smoked/freebase | >90% in some studies | Very rapid | Rapid peak, strong reinforcement, pulmonary irritation and cardiovascular toxicity. |
Stimulant | Cocaine | IV | ~100% | Very rapid | Rapid cardiovascular/CNS toxicity; vein damage, abscesses, endocarditis and blood-borne infections. |
Stimulant | Amphetamine | Oral | ~70–90% | Moderate | Long duration; repeated dosing can cause insomnia, cardiovascular strain, hyperthermia and psychosis. |
Stimulant | Amphetamine | Intranasal | High / variable | Rapid | Nasal injury and faster concentration rise. |
Stimulant | Amphetamine | IV | ~100% | Very rapid | Abrupt cardiovascular/CNS effects plus injection-related infections and vascular injury. |
Stimulant | Methamphetamine | Oral | High | Moderate | Long duration; insomnia, agitation, hyperthermia, cardiovascular strain and psychosis. |
Stimulant | Methamphetamine | Intranasal | High / variable | Rapid | Nasal injury and faster CNS exposure. |
Stimulant | Methamphetamine | Smoked | High / variable | Very rapid | Rapid reinforcement, compulsive redosing, pulmonary irritation and cardiovascular toxicity. |
Stimulant | Methamphetamine | IV | ~100% | Very rapid | High acute-toxicity and injection-related risks. |
Entactogen | MDMA | Oral | ~65–80% | Moderate | Delayed peak can encourage redosing; hyperthermia, hyponatraemia and serotonin toxicity. |
Entactogen | MDMA | Intranasal | Not well established | Rapid | Nasal injury and potentially sharper concentration peak. |
Dissociative | Ketamine | IV | ~100% | Very rapid | Abrupt dissociation; respiratory/CNS complications; injection-related infection and vascular damage. |
Dissociative | Ketamine | IM | ~90–95% | Rapid | Tissue injury and prolonged dissociation. |
Dissociative | Ketamine | Intranasal | ~8–45% | Rapid | Nasal injury and highly variable absorption. |
Dissociative | Ketamine | Oral | ~17–29% | Slow | Delayed and variable effects can encourage premature redosing. |
Dissociative | DXM | Oral | ~10–20% parent drug | Slow–moderate | Extensive first-pass metabolism; large person-to-person variation; high exposures can cause dissociation, seizures and serotonin toxicity. |
Cannabinoid | Δ9-THC | Smoked | ~10–35% | Very rapid | Lung exposure to combustion products; rapid intoxication and impaired coordination. |
Cannabinoid | Δ9-THC | Vaporized | ~10–35%, highly variable | Very rapid | Rapid systemic exposure; device and product variability. |
Cannabinoid | Δ9-THC | Oral | ~4–12% | Slow | Delayed and variable onset; prolonged intoxication makes premature redosing a major risk. |
Cannabinoid | CBD | Inhaled | ~11–45% | Rapid | Respiratory exposure; rapid systemic delivery. |
Cannabinoid | CBD | Oral | ~6% | Slow | Variable absorption and extensive first-pass metabolism; drug interactions are important. |
Psychedelic | LSD | Oral/buccal | High; exact absolute F poorly established | Slow–moderate | Long duration; panic, impaired judgement and dangerous behaviour are the principal acute concerns. |
Psychedelic | Psilocybin | Oral | Not usefully expressed as a simple absolute F | Moderate | Nausea, panic/anxiety and impaired judgement; converted to active psilocin after absorption. |
Psychedelic | DMT | Inhaled/vaporized | Rapid absorption; absolute F not established | Extremely rapid | Abrupt onset can produce severe panic/dissociation and loss of coordination; burns possible with improvised equipment. |
Psychedelic | DMT | Oral + MAOI | Highly formulation-dependent | Slow | MAO inhibition dramatically changes DMT pharmacology; potentially dangerous drug interactions. |
Depressant | GHB | Oral | High; universal F not established | Rapid | Very narrow margin between intoxication and unconsciousness; respiratory depression, aspiration and coma. |
Depressant | GBL | Oral | Rapidly converted to GHB | Very rapid | Particularly easy to overdose because onset and potency differ from GHB; profound CNS depression. |
Barbiturate | Phenobarbital | Oral | ~90–100% | Slow | Long half-life and accumulation; respiratory depression and dangerous withdrawal. |
Barbiturate | Phenobarbital | IV | ~100% | Very rapid | Severe CNS/respiratory depression; normally requires medical monitoring. |
Z-drug | Zolpidem | Oral | ~70% | Moderate | Amnesia, falls and complex sleep behaviours; greatly increased danger with alcohol/opioids. |
Z-drug | Zolpidem | Sublingual | Formulation-dependent | Faster | Faster absorption can increase impairment; use only as formulated. |
Gabapentinoid | Gabapentin | Oral | ~60% at lower doses; decreases at higher doses | Slow–moderate | Saturable absorption; sedation and respiratory depression, particularly with opioids. |
Gabapentinoid | Pregabalin | Oral | >90% | Moderate | Dizziness, sedation and impaired coordination; respiratory depression with opioids/CNS depressants. |
Nicotine | Nicotine | Smoked tobacco | Variable; rapid systemic delivery | Very rapid | Combustion produces major pulmonary/toxicant exposure; rapid delivery reinforces dependence. |
Nicotine | Nicotine | Vaped | Highly device/product-dependent | Rapid | Variable nicotine concentration; respiratory exposure and dependence. |
Nicotine | Nicotine | Oral/transmucosal | Variable | Moderate | Nausea, vomiting and nicotine poisoning at excessive exposure. |
Nicotine | Nicotine | Transdermal | Slow/sustained | Slow | Prolonged exposure; skin irritation; considerably slower CNS delivery. |
Alcohol | Ethanol | Oral | ~80–100% absorbed | Moderate | Acute poisoning, aspiration, accidents and respiratory depression; especially dangerous with opioids/benzodiazepines. |
Inhalant | Nitrous oxide | Inhaled | Rapid pulmonary uptake; absolute F not normally reported | Very rapid | Hypoxia, unconsciousness and falls; chronic heavy exposure can cause functional B12 deficiency and neurological injury. |
Inhalant | Butane/propane | Inhaled | Rapid pulmonary absorption | Very rapid | Potential fatal arrhythmias, hypoxia and CNS depression; fire/explosion and cold-injury risks. |
Synthetic cannabinoid | Synthetic cannabinoid agonists | Smoked/vaporized | Compound-specific / not established | Very rapid | Highly variable potency; severe agitation, psychosis, seizures, hyperthermia and cardiovascular toxicity. |
Synthetic cathinone | Mephedrone | Oral | Limited human data | Moderate | Repeated dosing can lead to cardiovascular strain, agitation and hyperthermia. |
Synthetic cathinone | Mephedrone | Intranasal | Limited human data | Rapid | Nasal injury and faster concentration rise; cardiovascular toxicity. |
Synthetic cathinone | 3-MMC | Oral | Not established | Moderate | Variable illicit composition; cardiovascular and hyperthermic toxicity. |
Synthetic cathinone | 3-MMC | Intranasal | Not established | Rapid | Nasal damage and potentially sharper concentration peaks. |
Anticholinergic | Diphenhydramine | Oral | ~40–70% | Moderate | High exposures can cause delirium, seizures, hyperthermia, arrhythmias and coma. |
Anticholinergic | Atropine/scopolamine-type drugs | Oral / medical parenteral | Drug/formulation-specific | Variable | Anticholinergic delirium, tachycardia, hyperthermia, urinary retention and seizures at toxic exposure. |