How Long Do Opioids Stay in your System?

Dr. Saurabh Bhardwaj

Dr. Bhardwaj, Medical Director is a Board-Certified Addiction Psychiatrist (ABPN) and currently the Medical Director of Defining Wellness Center in Brandon MS. He is also an Associate Professor of Psychiatry and Medical Director of Center for Innovation & Discovery in Addictions (CIDA) at the University of Mississippi Medical Center. He has been in Mississippi since 2018, building Addiction services for the state's only medical center and joined Defining Wellness Center in 2022 to provide specialized dual diagnostic services. He is a recipient of Ruth Fox scholarship from AAAP and trailblazer teaching award from UMMC. He is also a Fellow of the American Society of Addiction Medicine.

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A number of factors determine the amount of time that opioids stay in your system. They include the user’s history of opioid use, medical history, gender, weight, and amount of opioids consumed. Additionally, general guidelines apply.

What Are Opioids?

Opioids or opiates are a class of drugs that are derived from the opium poppy plant. Opioid drugs are composed of various naturally occurring opiate alkaloids such as codeine, morphine, and thebaine. The drugs include oxycodone, heroin, and hydrocodone.

Medical opioids are used due to their pain-killing and sedative properties. Heroin is derived from morphine and is mainly used for recreational purposes. It is illegal and has a high addiction potential similar to all the drugs in this class, even prescription ones legally given in hospitals.

These drugs can be found on the black market and are often abused. Over 36 million people across the world abuse opiates, according to the 2021 drug report from the United Nations Office on Drugs and Crime. The words opiates and opioids are often used interchangeably, although they have different meanings.

Opiates are natural substances derived from the opium poppy plant seeds. Examples include codeine and morphine. On the other hand, opioids are semi-synthetic or synthetic, meaning that they are not 100% natural but artificially made through chemical processes. Common examples of synthetic and semi-synthetic opioids include:

Prescription opiates are often used in hospitals to help manage moderately severe pain from operation recovery, cancer, or other chronic pain. They are effective painkillers, and this led to a rise in opioids prescriptions. However, they are also very addictive and, if used unchecked, could lead to a severe dependency.

Opioids and opiates have different chemical makeup, although they produce similar effects. They are available in the form of pills, patches, lozenges, nasal sprays, or liquid form for IV use. Various testing methods can be used to detect opioids in the body. They include tests of blood, urine, saliva, and hair.

Drug Testing Methods for Opioids

Drug tests are crucial tools used by doctors, caregivers, and therapists to hold accountable clients in recovery from addiction. Someone may fail to use opioids when they know they are scheduled to have a drug test. However, drugs tests are not always accurate, and they can produce misleading results, especially if the person doing the test doesn’t know how long someone has been using opioids. Urine and hair follicle tests can detect opiates in the system for more extended periods than saliva or blood tests.

Urine Testing

Urine tests are commonly used. A person is required to provide a urine sample in a clear and clean container for analysis. The byproducts of metabolism usually pass through the kidneys and then through the urine for disposal. Each opioid has a specific byproduct, and a urine test can match the byproducts in the urine to the drug.

Hair Follicle Testing

Hair testing also relies on metabolic byproducts released by the body after consuming drugs. After metabolism, the byproduct can flow through the bloodstream in the scalp and deposit on growing hairs. This means that the hair can store some of the byproducts for months after an individual uses an opioid. Hair testing is less common, as most drug tests look for ongoing or recent drug abuse.

Saliva Testing

Saliva testing is less invasive and thus often preferred. However, it has a concise window for testing compared to urine testing. The presence of opioids may not be detected accurately unless the drugs are consumed within several hours of testing.

Blood Testing

Blood testing offers a comprehensive way to see a person’s recent drug use. It can show the levels of drugs in the blood as a percentage at the time of the test. Blood testing is the only method that can guarantee a result during the test. All the other methods depend on specialized test facilities for verification of the results. However, blood testing is invasive and expensive, and this deters most people from using it.

Perspiration Testing

This new method is not commonly used to test for drugs. It tests sweat from the body, and it usually takes a long time, usually two weeks. Perspiration testing is typically used to monitor an individual for a prolonged time rather than instantly.

Some drug tests may not indicate clearly which type of opioid someone has used. The individual has to provide this information.

Older people or those who do not exercise regularly and have more body fat will metabolize opioids more slowly; thus, tests can detect opioids in their system longer. Additionally, an individual who uses opioids often in high doses will test positively for opioids longer than one who uses lower doses occasionally.

The method of opioid testing affects the detectability of some opioids. For example, hydrocodone only presents itself in a saliva sample after 12 hours. Morphine takes up to eight hours to show up in a blood test, while codeine takes 12 hours. Methadone is different from other opioids since it manifests itself in a urine test for six to 12 days after use and for 10 days in a saliva test.

Factors That Influence How Long Opioids Stay in Your System

Opioids have short half-lives, and they exit the body quickly, but their effects can last for longer periods. The amount of time each opioid can be detected in the body depends on various factors, such as the ingestion method. Prescription opioids are usually provided in the form of pills.

The effects of oral ingestion take longer to begin since the drug has to pass through the digestive system first. Opioids like heroin are mostly smoked, injected, or snorted, which are faster methods to feel the effects and create an intense high while leaving the body sooner. Other factors include:

  • Body mass and weight
  • Health of the liver and kidney
  • Quality of the drug
  • Amount of water in the body
  • Body fat content
  • Age
  • Metabolism rate
  • Ethnicity
  • Presence of other drugs in the system
  • Pre-existing medical conditions affecting drug elimination
  • How often and how heavy opiate use is

Opioid Metabolism

Food and drugs are metabolized in the body with the help of enzymes and several organs. The metabolism process involves breaking down a substance, transmitting it to various body organs, and then expelling it as waste. When a person ingests opioids orally, they first undergo metabolism in the stomach and liver and enter the bloodstream.

Injecting opioids directly into the bloodstream bypasses the first phase of metabolism. Opioids usually pass through the kidneys and liver at least once before leaving the system in the urine. The byproducts of opioids are metabolites after metabolism. Some metabolites of opioids are other forms of opioids. For example, the byproduct of heroin is morphine, while hydrocodone and morphine yield hydromorphone, and oxycodone yield oxymorphone.

Metabolism rate is one of the clearest indicators of how long an opioid will remain in the body. The opioid and metabolites remain in the body during the process of metabolism. Opioids can still be detected in a person’s blood, urine, hair, and saliva even after metabolism.

The half-life of opioids usually depends partially on a person’s metabolism. People with a faster metabolism will have a shorter metabolism rate, meaning the drug will leave the body sooner.

Opioids can have a long or a short half-life regardless of other metabolic factors. Short half-life opioids include oxycodone and hydrocodone. A half dose of these drugs usually leaves the body between three to five hours. Long half-life opioids include methadone, which can leave the body in 24 to 36 hours. During the opioid epidemic, fentanyl was the leading cause of fatal overdoses, with a half-life of four hours. In order to completely leave your body, an opioid requires several half-lives.

How Long Do Opioids Stay in Your System?

The length of time opioids stay in your system depends on the type of drug used. Opioids have similar effects, although most of them metabolize at different speeds by the body and therefore exit the body at different rates.

Semi-synthetic and synthetic opioids such as fentanyl are up to 100 times more potent than natural opiates like morphine. The detection period varies for different opioids due to how they are processed through the body and their difference in chemical makeup.

Heroin

Heroin has a short life, as it is a fast-acting drug. Blood tests can detect the presence of heroin for about six hours after the last use, while a saliva test can detect it after five hours. The most commonly used test method for heroin is a urine test, which can detect the drug up to seven days after the last use. Hair testing can detect heroin up to 90 days after use.

Factors that influence how long heroin stays in your body include individual variations such as age, diet, genetics, liver and kidney function, and body mass index. Other factors include heroin purity, frequency of use, and mode of ingestion. Tips for clearing heroin from your system include:

  • Stopping use immediately
  • Light exercise
  • Drinking plenty of water
  • Eating a healthy diet
  • Taking the right supplements
  • Hydrocodone

Hydrocodone leaves the body quicker than heroin, with saliva tests only detecting use for the first 12 to 36 hours. Hair tests detect it up to 90 days after the last use, while urine tests are effective for two to four days.

Codeine

Codeine is one of the quickest opiates to leave the body since it can be detected in the blood for just 24 hours. It can be found in urine for 24-48 hours, while saliva tests offer a wider range of one to four days after last use. Hair testing can find codeine for 10 weeks or longer.

Morphine

Morphine’s effects last longer since it takes longer to work than opioids like heroin. Blood tests can effectively detect morphine for the first 12 hours after use, while urine tests can detect for up to three days. Saliva tests can find traces of morphine for four days, and the hair test can find them for 90 days.

Oxycodone (Oxycontin)

Oxycodone can be detected in the urine within one to three hours after using it and remains detectable for the next one to four days. A saliva test can detect the drug for up to 48 hours after a person takes it. Hair tests can detect it for up to 90 days.

The liver initially metabolizes oxycodone and produces metabolites such as noroxymorphone and noroxycodone. These byproducts and oxycodone are excreted through the kidneys. The drug has a half-life of three to five hours, meaning it takes that time to eliminate half of the dose of the drug from the bloodstream.

Fentanyl

Fentanyl takes up to 12 hours to be detected in a blood test and one to four days in a saliva test. A urine test can detect it after eight to 24 hours, and just like the other opioids, the hair test can find it after 90 days.

Methadone

Blood tests are very effective in detecting methadone, taking 30 minutes up to three days. Saliva tests take 30 minutes up to two days, while urine tests can detect the drug after one hour and up to two weeks. A hair test can detect the drug after a few days and up to 90 days.

Opioids are highly addictive and can lead to life-threatening overdoses. Saturating your body with opioids can have long-term health risks. The good news is that help is available for people struggling with opioid addiction. The process of recovery is not simple, but it is possible with the proper support and treatment.

Treatment options include individual counseling, medical detox services, group therapy, medication-assisted treatment, and holistic and alternative therapies.

If you know a friend or loves one struggling with opioid abuse, please get in touch with a dedicated treatment provider to get help and learn more options for opioid rehab.

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