I just found this excelent guide from the user
WeirdOneTwoThree on reddit. A couple of things they suggest are to use only 1ml of liquid so it absorbs faster and insert the syringe about 1.5" because that is where the greatest absorption happens. A very detailed guide maybe I can post the whole thing here:
If you find this information offensive in any way, simply stop reading now, sorry but I’m not going to make this less detailed for your benefit. Per rectal administration uses the anal canal and rectum as a route of administration for drugs which are most usually prepared in an aqueous solution and absorbed by the blood vessels. The drug then rapidly flows into the circulatory system which distributes it to all the body's organs and systems. When we compare all the generally used methods of drug administration, this is clearly the most effective and least harmful method that is so easily available as there is absolutely no harm whatsoever, except perhaps from the drug of choice (DoC) itself. Drugs administered Per Rectal have a faster action than via the oral and at least as fast as the nasal route and a higher bioavailability – that is, the amount of effective drug that is available is greater as it has not been influenced by upper gastrointestinal tract digestive processes. Rectal absorption results in more of the drug reaching the systemic circulation with less alteration on route. In choosing this method, we are bypassing around two thirds of the first-pass metabolism and the liver as the rectum's venous drainage is two thirds systemic (middle and inferior rectal vein) and one third hepatic portal system (superior rectal vein). It also provides many of the same benefits of nasal insufflation (also known as snorting or sniffing) in a slightly more efficient manner without the damage. The only routes of administration that will use less of your DoC involve the use of a hypodermic needle, if you haven’t yet gone there do you really want to?
Unfortunately this method of administration is often met with a great deal of resistance by many who often have a very strong aversion to the practice due to cultural diversity and individual sensitivities or even the intimacy of this area as it requires the momentary insertion of a small oral syringe into their anal canal. With very few exceptions, this method is second only to IV administration in efficiency and effectiveness and it is also certainly much safer. To spite many advantages this is perhaps the most underutilized method of administering drugs. After using this method for well over a year I was curious to know what percentage of people were also using it: Upon a review of several studies that collected statistics for routes of administration in illicit drug use I was surprised and disappointed to find that the researchers had overlooked it entirely, not even mentioning this as a possible route of administration. It is quite commonly used in nursing home and even pediatric situations with a wide variety of drugs so I truly lack any explanation for why it is so unpopular given the speed and efficiency at which it will deliver your DoC almost directly into the bloodstream and the often very clever resourcefulness of most drug users.
I have tried to make this guide as factual as possible with nothing in it based on opinions or assumptions. If you notice anything you disagree with or have evidence to the contrary I would appreciate knowing about it.
"When the facts change, I change my mind. What do you do, sir?" - Often attributed to John Maynard Keynes,1st Baron Keynes of Tilton, but just as often disputed.
The primary purpose of this guide is in the interest of harm reduction. Per Rectal should almost always be considered as a direct replacement for, or absolutely “no harm alternative’ to, nasal insufflation and is therefore almost always preferable. Some people enjoy the sensation of snorting their DoC so much they will never consider a no harm alternative that lacks this sensation but repeated snorting of drugs causes cumulative irritation of the external nares (nostrils), nasal passages and sinus structures that can lead to a number of adverse events, such as perforation of the nasal septum, irritation of the nasal mucosa, sinusitis, nose bleeds, loss of sense of smell, problems swallowing, hoarseness, infection in the lungs and blockages of respiratory tracts and nasal airways. All of these very undesirable outcomes can be completely avoided if you can overcome any illogical aversions you may have and find your way to be able to use this method instead, you will also save at least 10% of your DoC or be that much more intoxicated or high.
The secondary purpose of this guide is education as much of the published information on the Internet is simply incorrect or misleading. Some guides I have seen recommend to insert the syringe all the way or as far as you can, the average length of such a syringe being 7 or 8 cm, or to squirt the solution as far in as possible, oh my, do not do these things this way! While I make no warranty that the information here is correct in every last little detail, most of the very detailed or specific information was gathered from material presented in nursing textbooks and magazine articles and has been tested in actual practice over the course of several years and found to be very accurate.
When compared to nasal insufflation, the bio-availability (the proportion of the drug that enters circulation) is always superior, generally by at least 10%, if not sometimes much more. If nasal insufflation was frequently used previously, the effectiveness may be much more of an improvement as the nasal passages are likely already heavily damaged and unable to absorb the drug as well as they would otherwise due to crust or eschar tissue (scabs) and scar tissue from previous abuse so in this case extra care must be taken to avoid an overdose as the difference could be effectively much more than 10%.
The potential for this route of administration to deliver an overdose is just as high as with any other method although it does facilitate easily being able to dose smaller amounts and more frequently when testing a substance of unknown strength or potency for the first time (more on that later).
A few necessary words of warning: If you deliver a dose to the anal canal and obviously by extension to the rectum, we know that at least two thirds of the drug will now be absorbed bypassing the first-pass metabolism and the liver, the exact amount being dependant on the amount of drug that stays in your anal canal, the amount that moves on to the rectum and even the layout of your retcum. If you have been routinely snorting your DoC you should strongly consider using just 50% of that amount with this method until you understand just how efficient it is in your particular case and with your DoC (results known to vary greatly with drug choice). You can always dose more in a little while (15 - 20 minutes) but you can’t very easily dose less and you certainly can’t take it back -- once you dose you are dosed and your DoC is going to do to you what it will, perhaps using a much more effective method so beware and be safe.
I can think of nothing worse than someone taking this document which is written in the interest of harm reduction and using the efficiencies outlined here to administer an unintentional overdose. If you have never used this method the result is going to be unpredictable. It may exceed your expectations by a significant margin so please be careful and be safe, 50% of the usual intranasal dose is strongly suggested until you truly understand what you are dealing with. Depending on the drug, some have been shown to have 100% more systemic availability compared to other routes of administration like orally. There are simply too many factors to take into consideration when trying to determine the outcome in advance. You are therefore using yourself as a lab rat at your own risk, so please be careful.
NOTE: You have have trouble with some of the optimizations that are used here (standing but not experiencing any leakage, administration in the anal canal as opposed to the more standard practice of in the rectum, etc.) You are still very much encouraged to give the more conventional Per Rectal method of administration a chance without these optimizations (it is still superior) as opposed to starting or continuing to use the very damaging practice of nasal insufflation.
Over the years I have heard many misconceptions about this method. Some of the more common false assumptions and objections are: You have to remain in a particular position for an extended period of time, it is not possible to use this method at the office or at work, it requires too much preparation (e.g. defication or an emema), it would be painful or harmful. Then there is perhaps the strangest and most baseless (best one) of all: only gay people do that or even would do that. Simply absolutely none of this is in any sense true.
Often people who usually employ nasal insufflation or another route of administration will eventually try this method and report that they were quite underwhelmed with the results. It’s not uncommon for them to go there out of desperation (willing to try what they weren't willing to try previously), their nasal passages having been so irritated and blocked from prior abuse that they are no longer useful to dose their DoC. Everyone is different and obviously your results are likely to be somewhat different from someone else’s but I believe it is very often administered incorrectly in one manner or another and this often results in a less than optimal experience. In many cases they may have been diligently following one of the many guides that are full of inaccurate or incorrect information. Such guides are pretty light on the real facts. If you are currently sniffing or snorting your drugs (as so very many are) then please give this method a fair chance, your nose may thank you.
The Downside - If this is all so great, what are the disadvantages
Clearly the most obvious one is you need privacy. While some other routes of drug administration might be socially acceptable to do in the company of others it’s pretty unlikely you would be comfortable with anyone other than the most intimate lover who also uses drugs with you to be watching you dose your drugs in this manner. If you need to defecate before absorption is complete then you will lose the unabsorbed remainder of your dose. Many of the advantages can also be thought of as disadvantages (e.g. that it does work so well, quick and convenient). While this isn’t the same leap someone makes moving to IV administration it is still increasing the intensity of your drug habit by giving you such rapid and foolproof access to rapidly get your drug into the bloodstream. It is also very quick and easy, therefore easy to administer too often which is obviously also equal to too much.
I tried it before and it didn’t work as well as you say it does
Perhaps the most common error that people make is not correctly realizing where the area of the most efficient absorption is and the drug is often incorrectly delivered far beyond this area into the rectum. Another common error is to use too much aqueous solution and/or too large an oral syringe (which causes discomfort when inserted), only a very limited amount can be present in this area of high absorption, a 1ml oral syringe is ideal, therefore it is always best to create a solution of 1 ml or very slightly less. A normal or standard size 1ml oral syringe will be 7 to 8 cm in length but very narrow, if a small amount of lubrication is applied to the tip of the syringe you should really feel next to nothing. Far more than 1 ml can be administered this way (overflow will simply be held in the rectum and even absorbed slower from there while waiting to trickle back to the anal canal where it can be absorbed more rapidly) but you want to keep it down to 1 ml per dose (if you can) to shorten the amount of time it takes be to absorbed. I have found when a weaker solution is mixed and you now have you DoC dissolved in too much water it easy to administer 5 or 6 ml (as multiple 1 ml doses) and still have no leakage (or you can carefully add more drug to bring up the strength to 1 ml = 1 dose) but always do the math.
If you are serious about embracing this approach I suggest you practice it first with a 1ml syringe and some chilled water (you don’t want your precious DoC dribbling all over the floor). The chilled water will allow you to actually feel exactly where the drug solution would be going and you will then be accustomed to doing this in the absence of spills before you risk it with your expensive drug solution.
The anal canal is completely extraperitoneal. The length of the anal canal is about 4 cm (range, 3-5 cm), with two thirds of this being above the pectinate line (also known as the dentate line) and one third below the pectinate line.
The area with the most absorption is located in the anal canal, starting approximately 1.5 - 2.8 cm before the exit and continuing on in for another 1 or 2 cm. That’s where the real magic can happen. There are rarely any solids there unless they are on the move so most often there is usually no real need to worry about that. As an opiate user you most likely suffer from constipation as most do and this is certainly nothing to be embarrassed about. If you can have a bowel movement at all then you always very much should. As soon as you feel you can, do so to avoid being even more seriously constipated than otherwise necessary. It isn’t required to do this and most often it doesn’t make any appreciable difference but it can’t hurt if you can do it (ok, so that can hurt but “Per Rectal” administration of your DoC should never hurt or even be uncomfortable). Within the anal canal are two areas to control the opening of the anus – the internal and external sphincters (see diagram). The internal sphincter functions involuntarily, whereas the external sphincter is under your control. Is very important you are sufficiently relaxed to enable both insertion of the syringe and retention of the drug.
That special area and how to find it (the real secret no one seems to know)
This special area with the most rapid absorption is from within the anal canal via its highly vascular mucous membrane that is divided into folds or pillars, known as anal columns above the Pectinate line in the anal canal (see diagram of rectum). Drugs can and will also be absorbed via the walls of the rectum
but not at anywhere near the rate afforded by the anal columns. I think this is probably why most people that try this technique are not impressed and find it quite underwhelming, they unknowing deliver the dose into the rectum where absorption is much less effective and efficient. It is necessary to insert the syringe the correct amount (
approximately one half way for a standard size 1 ml syringe, which is normally 7 to 8 cm in length) so the business end is correctly positioned and then slowly (no less than 3 seconds from start to finish) deliver the dose directly into the anal canal onto these anal columns, so you have to push the plunger slowly such that the drug mixture dribbles right where it should go and then it can be quite overwhelming with the dose of a strong, fast acting drug felt almost immediately. With most people and standard size 1ml oral syringes the syringe will inserted approximate one half way (or just a little less) and that will be more than precise enough. Precise positioning isn’t entirely critical as the anal canal is not open or dilated (like shown in the diagram) except when necessary to eject fecal matter. The drug mixture is going to sloppily flow around a bit in the usually very small area that is your anal canal and nothing you can do about that, the real secret is to get as much of it in the anal canal on the columns as you can by using no less and no more than 1 ml per dose.
If you came here to find the secret, here is really is: the ideal scenario is that you deliver the dose right on the anal columns where maximum absorption can happen and your anal canal is filled (as much as it can be by just 1 ml of solution) with a closed external sphincter (because you are so relaxed) such that no leaking can or will occur. You will find much better results when the majority is absorbed through the anal canal walls. Nothing goes to waste as any overflow will go into your rectum and eventually be absorbed there as well (just not as quickly).
A second secret: the absorption through vascular mucous membranes can only happen so quickly and by limiting the amount that must be absorbed to 1 ml, we limit (and reduce) the amount of time it takes to absorb it.
I find standing is best, that’s right, it really isn’t necessary to lay in some special position for a certain length of time, in fact it is really best if you don’t. If you prefer to lay down as most guides suggest I would suggest you do not. Standing or sitting after administration is best. The nursing guides suggest laying down but they have an abundance of medication that comes from a pharmacy with an virtually inexhaustible supply and if anything they want the drug to be absorbed more slowly. I have found references in medical literature that mention delivery to the anal canal should be avoided when using an aqueous drug solution as absorption will likely be much more rapid than desirable. Those that seek to abuse drugs always want them administered as rapidly as possible, not more slowly.
You don't want to be "squirting" it in too quickly
I think this is probably why most people that try this technique are not impressed and find it quite underwhelming, they unknowing deliver the dose into the rectum where absorption is much less effective and efficient. It is necessary to insert the syringe the correct amount so the business end is correctly positioned near the anal columns and then slowly (no less than 3 seconds from start to finish, you can go slower if you like but there is really no need to) deliver the dose directly to these anal columns, so you have to push the plunger slowly such that the drug mixture dribbles right where it should go and then it can be quite overwhelming with the dose of a strong, fast acting drug felt almost immediately. With practice one can be seated, stand up, dose and sit back down in under 10 seconds (assuming you don’t have to mess around with the belt on your trousers, shorts or pants, the elastic waist band on track pants is almost too convenient).
If you lay down on your side, the aqueous solution is going to drain into the recum from gravity. Standing works just fine in practice (and much better in situations where you can’t lay down like a public washroom stall).
The equipment
Kit consists of a 15ml bottle of aqueous solution (Fentanyl hydrochloride 130mcg/ml), 10ml bottle of massage oil and two oral syringes. Total cost, $5, $1 for the case at Dollarama and about $4 worth of fentanyl, provides 15 doses or a much as a weeks’ supply.
Not rocket science
Fill a 1 ml oral syringe with 1 ml of your aqueous drug solution (or simply cool distilled water if practicing), 1 ml of liquid should be the entire dose. Add a small amount of personal lubricant to the end of the syringe (lubrication is more important than you may initially think, if you have to do without it more than a couple of times after enjoying that luxury you will really come to realize this), while standing insert slowly approximately one half the length (3 - 4 cm) of your syringe, press the plunger down slowly and then remove as slowly or quickly as you care to. It is very important you are properly relaxed so there should be no leakage and that is all there is to it. Maximum plasma concentration should occur within 10 to 15 minutes but usually any noticeable effect will be felt pretty quickly or almost immediately (depending on your DoC). Yes I promise, if you have done it correctly with the right technique you may well feel the effect beginning in literally a few seconds.
The differences from most of the previous guides are pretty obvious. Most dramatically I am not suggesting that you lay down but rather stand and later (when finished) be seated in a chair. This puts the anal canal in the proper position (sloping downwards) so that the drug solution will even run back into the anal canal due to gravity but it requires you to be relaxed enough doing this so that the sphincter will remain closed and prevent any leaks. Doing this just the right way can take a little
practice and patience. Practice with distilled water is suggested to perfect and learn your technique and also to be relaxed when doing this which is extremely important to prevent any leakage. We are also recognizing that absorption of the aqueous drug solution takes time and by using less volume it takes less time for it to be completely absorbed. More will be absorbed by the anal columns and less by the rectum walls. And finally it is suggested to dispense the aqueous drug solution directly on the area which is most able to absorb it faster and remain upright such that there is a continuous supply of solution to this area until it is completely absorbed. If you envision the diagram as the anal canal usually is (not dilated like in the diagram) then you should also be able to see how we have created perhaps the most optimal delivery to the anal columns by using the lower part of the rectum as a reservoir to continuously supply the drug to the area that can absorb it most quickly.
Here is an interesting question I once received after explaining this route of administration to someone. Question: I withdrew the syringe and now it is brown in color, I think it is covered in fecal paste. Answer: I have heard that fecal matter is sometimes present there so perhaps that could happen. Turns out that opioid users are often constipated or in various states of constipation. Since I started using opioids more regularly and unfortunately all the time at times due to dependance I find I require a lot less bathroom tissue, that area is much cleaner and this situation is much less likely. Solids tend to be much more solid and this doesn’t seem to be very often a problem but whenever something like that has occured it does not affect my dosing so it is still not a problem. Obviously you need to wipe your syringe off with some bathroom tissue or something equally disposable and then wash it if you plan to reuse it. Perhaps I am desensitized to this issue having spent so much time in the Dominican Republic where any plumbing outside of an international resort chain can’t carry bathroom tissue so you have to store it in a bin and dispose of it by means other than flushing it.
Next we going to discuss using this new found easy and rapid access to your circulatory system for safely dosing small amounts of a substance of unknown strength or potency to safely determine the strength and/or potency.
