Opioids are a class of drugs primarily used for pain-relief, but also abused for recreational purposes. They’re also one of the most frequently abused drugs in the United States, with presidential action taken to identify the opioid crisis as a national emergency. The 2018 National Survey on Drug Use and Health suggests that 10.3 million Americans abused opioids in 2018, most of which (9.9 million) were abusing prescription pain pills. That’s critical, considering opioids are the number-one cause of drug-related death, with drugs like fentanyl, heroin, codeine, and hydrocodone contributing to over 70,000 deaths in 2017, or over 130 each day.
This increasing publication of the opioid epidemic, increasing crackdown on substance abusers, and increasing awareness of pain-pill abuse has led many doctors and employers to utilize more frequent drug testing. While anyone with a valid prescription for opioids shouldn’t have to worry about a test, you or a loved one may have used opioids outside a prescription, in excess of a prescription, or after your prescription ended. If so, you’re likely wondering how long opioids stay in your system, and if they will come up in a drug test at work, at your doctor’s, or for any other purpose.
The answer is that it’s complicated. Opioids are a complex drug-type, there are many different types of opioids, and effects vary considerably depending on the individual, quantity taken, their metabolism, and other factors. The following article will help you determine how long different types of opioids might stay in your system.
What is Opioid Elimination Half-Life
Half-life is the first and most important consideration when looking at whether a drug will remain in your system. This number directly measures the period of time between when a drug enters the system and when it is metabolized to half-volume.
While there are standard ranges for most types of drugs, these ranges vary depending on the individual and their drug use. For example, if someone were to take one dose of the drug, it would metabolize to half at a set time, and then continue to metabolize at the same rate. If someone were to take a second dose at any point, the drug would stack on top of existing opioids in the blood, meaning that the time to reach half-life would be longer.
How Long is Elimination Half-Life for Opioids?
Opioids vary considerably, with elimination half-lives ranging from just a few minutes to several days. To give you a better idea of how this works, we’ll look at average half-life periods for common opioid pain pills and street opioids, and then look at the total elimination period for a single drug.
- Diamorphine – 34 minutes
- Codeine – 2-3 hours
- Fentanyl – 10 minutes- 4 hours
- Methadone – 8-59 hours
- Hydrocodone – 3-4 hours
- Oxycodone – 2.4.5 hours
This half-life allows lab technicians to not-only see whether or not you’ve used a drug, but also to see how long ago you used it, in what quantities, and possibly how many doses you took.
Elimination half-life is also an ongoing process, that continues until the drug is metabolized. So, if someone were to take a single 12.00 mg dose of diamorphine (heroin), a simplified look at the elimination half-life period is the following calculation: Half-life x 7 (½ > ¼ > 1/8 > 1/16 > 1/32 > 1/64 > 1/128) = duration.
- 34 minutes to ½
- 68 minutes to ¼ s
- 102 minutes to 1/8
- 138 minutes to 1/16
- 172 minutes to 1/32
- 206 minutes to 1/64
- 240 minutes to 1/120
This total period results in about 4.5 hours of active effect in the body and about 6 hours of detectability in the bloodstream.
Half-life isn’t a precise science if you don’t have a lab. Instead, you can use it as a benchmark of how long a drug is likely to be detectable in your body. For example, using the same calculation written out above, you could estimate the following ranges for how long opioids stay in the system:
- Heroin – 1-7 hours
- Codeine – 14-21 hours
- Hydrocodone – 21-28 hours
- Oxycodone – 14-30 hours
- Fentanyl – Average of 28 hours
- Methadone – 56-400+ hours
Can you rely on these figures as exact? No. However, you can use them as a benchmark.
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What Affects How Long Opioids Stay in Your System?
Why do some opioids stick around for days and others for hours? What’s the difference? In most cases, factors including metabolism, ingestion, and strength are the largest factors. For example, opioids injected into the bloodstream will typically last the longer. Heroin taken by mouth typically remains for just a few minutes.
Equianalgesic Table – The equianalgesic table compares drug strength to a 10mg dose of heroin to ascertain its comparative strength. Importantly, the equianalgesic table does not account for drug accumulation, where doses become stronger with consecutive dosage as active metabolites continue to accumulate in the body.
- Diamorphine (Heroin) – 2.5 mg
- Codeine – 67-100 mg
- Fentanyl – 0.1 mg
- Methadone – 3.33 mg
- Hydrocodone – 10 mg
- Oxycodone – 6.67 mg
In short, hydrocodone is the same strength as a dose of morphine, where fentanyl is over 100 times the strength. This affects how long the drug stays in the system, as well as its potential for overdose.
Metabolism – Individual metabolism affects half-life, because it changes how quickly the body uses the drug.
Body Mass – Fat and muscle makeup dramatically affect drug metabolism. Very muscular or very large persons (with more muscle) will metabolize drugs more quickly. Persons with more body fat will take longer, because opioids are lipophilic and deposit in fat. So, a person with a large amount of body fat will retain opioids for considerably longer, increasing the chances of drugs showing up in a drug test and increasing the chances of overdose.
Age – Metabolism slows down with age.
Health – Organ health, especially the liver and kidneys, will affect metabolism. Longer-term users with damaged kidneys will have drugs in their system for considerably longer.
Accumulation – Drugs accumulate over time, so a person regularly taking drugs may retain traces of them for significantly longer than the previous half-life, simply because the body has to metabolize considerably more of the drug than the final dose.
These factors can be difficult to predict without an individual metabolism test. However, most people can rely on the general ballpark method used by half-life.
Duration of Action
Duration of Action is the final consideration for determining how long opioids remain in the system, and one of the most important for anyone taking a drug test. This is especially important for slow-release opioids like Oxycodone, which might slow release over a period of 48 hours or longer.
In most cases, duration of action means that opioids can be detected in the following tests:
- Saliva – 0-7 days (average of 4)
- Urine – 2-4 Days (average of 3)
- Blood – 12 hours to 4 days (average of 2 days)
- Hair – 90+ Days (average of 90 days)
For this reason, most drug tests will include a urine sample, cheek swab, or hair sample rather than a blood test. Trace remains of drugs may also remain in the body for days or even weeks after usage. These trace remains include how the drug was metabolized into hair and fingernails, side-effects in the body such as chemical production that is not an opioid, and other changes.
Most standard drug tests (saliva or urine) will detect drugs up to 4-7 days after your final dose. Hair drug tests can detect opioids more than 3 months after the final dose. Most drug tests are not false positives, but you can request a re-test (which will be a hair sample) if you feel that your drug test result is wrong. If you or a loved one is using and facing a drug test, the best option is to be honest. Most employers have drug programs in place, insurance covers opioid rehab under the Affordable Care Act, and you are entitled to time off work to seek out rehab. Most importantly, going to rehab will offer you or your loved one the tools to recover from addiction, build the tools to live and be happy without drugs, and to get your life back.
If you have any questions concerning addiction treatment for yourself or a loved one, contact us at Truvida Recovery. Call 877-228-1102 to speak in confidence with an experienced treatment advisor now.