How Long Do Opioids Stay In Your System?

August 1, 2024
Posted by Dr. Robert Sherrick

Opioid Withdrawal

Opioids are a class of medication used primarily to relieve pain. They have a variety of legitimate medical applications and are widely prescribed as a treatment in the United States. But there are also many different types of medications within the class of opioids that have varying degrees of side effects on a patient. These can include everything from oxycodone to morphine.

Unfortunately, opioids can be highly addicting. Many people in the US are currently suffering from Opioid Use Disorder (OUD) and have become dependent on opioids to function in their day-to-day lives.

No matter what the reasons are for taking opioids, there are many important reasons why a person would need to know how long a given opioid stays in their system, including many health and safety-related reasons. For example, both patients and doctors need to know how long the analgesic (pain-relieving) effect of an opioid typically lasts for a given dosage so they can adequately administer prescriptions and avoid overdoses. In some cases, people may be required to undergo drug testing for jobs where their employers require a negative result for opioids.

Unfortunately, answering this question is a little more complex than most people may anticipate. How long an opioid will remain active in your system depends on a variety of factors, such as:

  • Which drug is involved
  • How long you’ve been taking it
  • The definition of “stays in your system.”

It also can depend on what you eat or drink, what other drugs you are taking, how fast your body metabolizes the drug, and other features particular to your body. Many of these factors are determined mostly by your genetic profile.

To better understand how long opioids are likely to remain in your system or what effect they’re likely to have on you, it’s best to discuss your opioid usage with your doctor.

However, here are some answers to some of the most common use cases we see at Community Medical Services.

I am taking opioids for pain. How long do they last?

The length of time that an opioid provides pain relief depends on the drug involved. Most opioids, unless formulated to be longer acting, provide pain relief for several hours – most commonly 2-4 hours. Methadone and buprenorphine, which have a long half-life for preventing the signs and symptoms of opioid withdrawal (24 hours or longer), have a much shorter window of pain relief – usually 6-8 hours. The directions on your prescription bottle will have instructions on how to take it, which will depend on the duration of analgesia (pain relief). This is a good indicator of what to expect and what symptoms to watch out for.

How long after taking an opioid should I wait before driving?

All prescribed opioids come with the standard warning to avoid driving or operating heavy machinery while taking them. There’s a perfect reason for this. The side effects of opioids impact different people differently. Some people get drowsy and nod off, while others may get extra energy and insomnia. Some people may become severely sedated, while others may be essentially normal despite having opioids in their system to relieve pain. The warning against driving while using opioids is a general precaution because doctors and pharmaceutical makers have no idea how opioids will affect someone until they take them.

While it’s better to err on the side of caution and refrain from driving while using opioids, it’s ultimately up to the patient to assess their abilities and make sure they are capable of driving safely before getting behind the wheel.  Remember that you may be impaired when you are unaware of it. If you are not sure about your safety driving, ask another trusted person, and always have a designated driver if you are taking drugs or alcohol.

For people who are taking methadone or buprenorphine, once you are on a stable dose, you should be able to perform any regular activities, including driving, without restrictions. However, if you feel that your dose is making you drowsy or too strong, be sure to notify your treatment provider immediately so that your dose can be adjusted accordingly.

How long after taking opioids do you need to wait to pass a drug test?

For certain professions, it can be required to take drug tests that look for the presence of substances that impair function (like opioids) in urine samples. If you work in a position that requires drug testing but are also on opioids, you may need to wait before providing a urine sample. How long you need to wait depends on what sort of opioid you are taking. While these do not account for external factors such as which other medications you are taking concurrently or genetic factors, here are some rough time ranges for each common opioid:

  • For most short-acting opioids (morphine, oxycodone, hydrocodone, codeine, and heroin), your urine drug test should be negative within 24-72 hours.
  • For longer acting opioids (such as methadone or buprenorphine) it may take a week or more.
  • Fentanyl is a special case and may take several weeks

Keep in mind that these are very rough estimates. If you have an upcoming drug test and you are concerned traces of opioids may still be found in your system, it’s best to talk with your doctor. They will be more familiar with your specific medical circumstances, which may alter the timeframe.

There are numerous products available on the web that purport to “clear” your urine of any unwanted substances. However, be warned. Some are little more than ineffective scams meant to make a quick buck at your expense. The only 100% effective method to ensure you pass your drug test is to stop using any drugs that will be tested long enough before the test is given that it will be negative.

Additional concerns regarding fentanyl

Fentanyl has become the most used illicit opioid in the US, replacing heroin on the street in most locations. It also acts differently than most opioids, creating additional factors to consider when trying to determine how long its effects last or how long it’s detectable in a person’s urine. Fentanyl has a short time of action – from a few minutes to a few hours – before it wears off.  However, when taken regularly over long periods, it accumulates in fatty tissues and is slowly released. So, while the effects wear off quickly, there can still be a small amount remaining in your system. This amount is not usually enough to provide pain relief, cause drowsiness, or stave off withdrawal symptoms. Still, it can be detectable in the urine. Several weeks after stopping all fentanyl may be necessary for a urine test to be reliably negative. In some cases, CMS has seen patients need to wait a total of 2 months before they were able to pass a drug test after stopping all opioid usage.

What about injectable buprenorphine?

There are now two forms of long-acting injectable buprenorphine available for the treatment of Opioid Use Disorder: Sublocade and Brixadi. These are both designed to stay in the system for long periods to reduce cravings and begin to undo the dependence your body has developed on opioid usage.  Because of this, they may cause the urine tests to continue to be positive for buprenorphine long after the last injection. For Brixadi, this may be several months, while for Sublocade, the urine test may continue to be positive for 18 months or longer.

Get Opioid Addiction Help from Community Medical Services

Opioids are a potent pain reliever used throughout the medical industry to treat all sorts of conditions. But while they can be beneficial, they can also be highly addictive. If not used properly, they can also be very dangerous. If you are currently having issues with opioids, you are not alone. Millions of Americans struggle with OUD and feel trapped by their addiction. If this sounds like you, Community Medical Services is here to help.

The truth is, it doesn’t matter how you were first exposed to opioids or how long you’ve been taking them. We understand how devastating opioid addiction can be, and we’re ready to help you get your life back. Our highly experienced and compassionate treatment specialists offer the highest quality of Medication Assisted Treatment (MAT) combined with counseling to help you treat the root causes of your addiction.

Relief is always just a call or click away. Find a CMS opioid addiction treatment clinic near you, or give us a call at 855.203.6352 to speak to one of our OUD treatment specialists and begin your journey to recovery today.

About the Author​

Dr. Robert Sherrick was appointed as CMS’s first Chief Science Officer in 2023, transitioning from Chief Medical Officer, a role he served for years.

Prior to serving CMS he had experience working at an inpatient addiction treatment facility in Montana, Pathways Treatment Center, treating all forms of Substance Use Disorders and dual diagnosis patients. Dr. Sherrick has been providing Medication Assisted Treatment for Opioid Use Disorder since 2003, initially in an office setting using buprenorphine and subsequently with methadone in Opioid Treatment Programs.

He established a state-wide buprenorphine treatment program for VA Montana with an extensive focus on telemedicine. He is board certified in Addiction Medicine through the American Board of Preventative Medicine and is the Immediate Past President of the Northwest Chapter of the American Society of Addiction Medicine.

Dr. Sherrick received his MS and BS degrees in Electrical Engineering from the Massachusetts Institute of Technology, and his MD from George Washington University Medical Center.

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