How Long Does Heroin Stay in Your System?

Heroin is an opiate drug made from morphine. It is not legally available by prescription in the United States, although it is available on a limited basis in Canada, Netherlands, and the United Kingdom to treat heroin addiction. Using heroin brings a high risk of overdose and dangerous interactions with other drugs and prescribed medications. Knowing how long it could be active in your system can help you understand the risks and variables.

Heroin is classified as a Schedule I drug, meaning that it's a drug with no currently accepted medical use and a high potential for misuse. Because heroin is so fast-acting and has such a short half-life, it can sometimes be difficult to detect in standard drug screenings. The effects of the drug last for about 30 minutes, but the metabolites produced as the drug is broken down are detectable on standard drug screening tests for around one to four days.

Heroin sold on the street is manufactured illegally and differs widely in strength, purity, and what other substances it is mixed with. People who take heroin recreationally use it in many different ways, each of which can affect how soon and how long its effects are felt. Heroin can be smoked, injected, or snorted.

The effects of heroin are felt swiftly. Depending on the dose, a wave of intense euphoria lasts 45 seconds to a few minutes, with the other effects peaking for one to two hours and most effects wearing off in three to five hours, although sedation can last longer.

Common effects are a surge of euphoria followed by a drowsy twilight state alternating between wake and sleep. Physical effects include constricted pupils, feelings of nausea, flushed skin, and dry mouth, and a feeling of having heavy hands and feet.

Heroin has an extremely rapid half-life of two to six minutes and is metabolized to 6-acetyl morphine and morphine. The half-life of morphine is one and a half to seven hours and the half-life of 6-acetyl morphine is just six to 25 minutes. It takes four to five half-lives for a drug to be effectively eliminated from the system.

Heroin and 6-acetyl morphine enter the brain more readily than morphine. In the brain and nervous system, these substances act on receptors involved with euphoria, pain suppression, depressing breathing, reducing gastrointestinal activity, drowsiness, dysphoria, delusions, and hallucinations.

Urine tests are the most frequently used type of drug screening because they are less costly and easy to administer. Heroin can be detected on a standard urine test for between one to four days after the last use. 

Research has also shown that the 6-AM assay test, originally developed as a urine test, is sensitive enough to detect heroin metabolites in blood. Such tests may be useful for following traffic accidents or overdoses to distinguish between recent heroin use and the therapeutic intake of opioids for pain relief.

The National Highway Traffic Safety Administration reported that high levels of the heroin metabolite 6-acetyl morphine can be detected in saliva samples. Such tests may be a better indicator of heroin use than urine screens in some situations. However, such tests must be administered fairly quickly after the last use in order to be effective.

Heroin can be detected by hair follicle tests for up to 90 days after use. People who have been using heroin for longer periods of time may have much longer hair detection windows, however.

Eating foods containing poppy seeds such as muffins or bagels can lead to a false-positive result for opiates on a drug test. Poppy seeds contain trace amounts of morphine and codeine. While most of this is removed during processing, the tiny amount of opiate residue left is enough to trigger a false-positive result on many drug tests. 

Consuming poppy seeds may lead to a positive test result within two hours of consumption and are detectable in urine for as long as 60 hours, depending on the amount ingested. 

Certain medications, including quinolones, rifampin, and diphenhydramine, can also trigger false-positive results for opiates on enzyme-mediated immunoassays (EIAs). Because these tests have good sensitivity and lower costs, they are often used in employment and medical drug screenings. Such tests are, however, more prone to false positives, requiring confirmation testing.

Like most drugs, the main way heroin is eliminated from the body is via the kidneys in urine, but it can also be excreted via sweat, tears, saliva, and feces.

How long heroin will show up on a standard drug test depends on several factors such as weight, body mass, and personal metabolism. Overall health, including liver and kidney function, can also play a role in how quickly heroin is processed and cleared from the body.

The main factor in how long heroin is detectable in a drug test is the amount of the drug taken. Heroin will stay in the body only one or two days with light use, but with heavy, chronic use, it can remain detectable in a urine test for almost a week.

Because heroin is illegal, there is little consistency in the purity of the substance. Some doses may be purer and stronger, which will increase the amount of time the drug takes to be eliminated from the body. Interactions with other substances can also affect how quickly heroin is metabolized.

Heroin is metabolized quickly and is not detectable by most standard drug tests after about three days. The only way to get heroin out of your system is to stop using the drug and allow your body time to metabolize and eliminate it. 

Stopping heroin cold turkey can often lead to severe withdrawal effects, however, so talk to your doctor about your treatment options. Staying healthy by getting regular exercise and drinking plenty of fluids may help you metabolize the substance more quickly.

While heroin is in a person's system, they are at risk of interactions with other drugs and substances as well as overdose. Street heroin varies in purity from 26% to 47%, and it is often combined with other substances like ketamine, cocaine, diphenhydramine, alprazolam, and MDMA (ecstasy).

One of the main reasons to be aware of how long heroin remains in the system is the risk of overdose. If you take more heroin because the effects of the last dose have worn off, but the drug is still in your system, it could cause an accidental overdose.

Symptoms of a heroin overdose include:

• Shallow, slow or difficulty breathing
• Dry mouth
• Extremely small pupils (pinpoint pupils)
• Discolored tongue
• Low blood pressure
• Weak pulse
• Bluish-colored nails and lips
• Constipation
• Spasms of the stomach and intestines
• Coma
• Delirium
• Disorientation
• Drowsiness
• Uncontrolled muscle movements

The above symptoms are related to an overdose of heroin alone, but heroin sold on the street is often mixed with other substances or drugs that can cause their own set of symptoms. Street heroin cut with the powerful painkiller fentanyl, for example, has caused a noticeable increase in overdose. 

Heroin is highly addictive and both physical and psychological dependence on the drug can occur quickly. If you want to quit using heroin, there are things that you can do to get through the withdrawal process and succeed in your recovery.

Heroin withdrawal can feel much like a bad case of the flu. Symptoms can begin six to 12 hours after the last dose and last for five to 12 days. Common symptoms of heroin withdrawal include:

• Nausea
• Vomiting
• Cold sweats
• Body aches
• Diarrhea
• Runny nose
• Tremors
• Insomnia
• Fatigue
• Anxiety
• Drug cravings
• Agitation

There are a number of different recovery options including inpatient and outpatient residential treatment. Medications are also available that can help people with the withdrawal process. Such medications include methadone, Buprenorphine, Naloxone, and Naltrexone. Psychological treatments such as cognitive-behavioral therapy and contingency management have also been shown to be effective in treating heroin addiction.