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Heroin Detection: How Long Does Heroin Stay in the System?

Abuse of heroin comes with potentially severe medical and social consequences.1 The easily accessible, low-cost illicit drug is highly addictive, and among the leading causes of deadly opioid-related overdoses in the U.S. As its toll continues to climb, heroin testing has become a valuable tool for identifying individuals who abuse the drug and may need treatment to stop.2

heroin home drug, urine & blood test - heroin detection time in the body

Heroin Detection Time

Heroin detection time or window of detection for heroin is the range of time that heroin can be detected in a biological sample or matrix, that is:3 

  • Time to detection (how long it takes for heroin to be absorbed and distributed to the sample material).
  • Time to clearance (how long it takes for heroin to be metabolized/eliminated/excreted). 

Different tests are used to detect heroin and possibly the presence of other illegal or prescription drugs in the system:3

  • Hair follicle test
  • Urine test
  • Blood test 
  • Saliva test

Window of detection depends on the matrix used, as different matrices retain heroin for different lengths of time.3

In addition to maximum detection time, other criteria taken into consideration when choosing a test include:3

  • Time to detection.
  • Time to obtain results.
  • Ease of collection.
  • Invasiveness/unpleasantness of collection.
  • Availability of the sample.
  • Susceptibility to tampering.

How Long Does Heroin Stay in Your System?

In general, the longest windows of detection occur in hair, followed by sweat, urine, oral fluid or saliva, and blood.3

The relationship between concentration of heroin and matrix depends on:3

  • How the body processes heroin and the matrix being analyzed.
  • The consumer’s underlying health functioning and other individual factors.
  • The pattern (acute or chronic use), dose and route of drug administration. 

These factors influence the absorption, distribution, and elimination of the drug and ultimately determine detection time.3

For instance, when heroin is used infrequently such as among individuals who may solely use the drug on the weekends, testing for heroin use should be done within one day as the body may not retain heroin and its metabolites longer than a day. For frequent use, it should be done within one to two days. This short detection time makes it exceedingly difficult to identify recreational opioid use by a random testing protocol.4

How Is Heroin Processed in the Body?

Heroin metabolism refers to the process of biotransformation by which heroin is broken down so that it can be eliminated by the body.5

Several factors can extend detection time:6

  • Heroin has a short half-life, which is why persons who abuse the drug may take the drug several times per day to maintain the effect. These individuals may develop tolerance to the drug over time. As a result, they continue to increase their intake of heroin to get the desired effect until they must take the drug just to feel normal and avoid withdrawal syndrome.
  • The presence of contaminants in the illicit drug can have an effect on how it is processed in the person’ body.

How Does the Body React to Abrupt Reduction of Heroin Intake?

If a person has already developed physical dependence and the body became adapted to the presence of heroin, withdrawal syndrome can occur rapidly, especially if the intake of the drug is reduced abruptly.1 Withdrawal signs and symptoms vary in severity, time of onset, and duration, depending on the percentage of heroin and other agents used, the duration of use, the daily dose, and the interval between doses.7 Heroin withdrawal typically begins 8 to 12 hours after the last heroin dose and subsides within a period of 3 to 5 days.7

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Frequently Asked Questions

How Is Heroin Detected Through Drug Tests?

Traditional drug tests are standard practice in determining heroin abuse. The initial test for heroin in a primary care setting is the screening test. If found to be positive, the screening test is followed by a confirmatory test.8 

When testing a person for heroin use, accurate metabolite identification is crucial for the purpose of obtaining precise test findings:6

  • Metabolites frequently have significantly longer half-lives than their parent drug, which means they are more likely to be detected.
  • Identifying accurate metabolite concentrations can be essential in the determination of the actual drug used.

Biochemical laboratory tests can be used to detect the presence or absence of alcohol or another substance of abuse, including heroin.7 These tests may be able to determine the level of present use or quantify cumulative use over the past few weeks.7

How to Get Heroin Out of the System?

The half-life of a drug is defined as the time taken for 50% of the drug to be removed from the body by the person’s metabolism or excretion. After heroin is consumed, it is broken down or metabolised by the body into other chemicals which can be detected through tests after excretion.8

Heroin drug test detection times can be affected by:8

  • Quantity of drug administered, frequency of use, route of administration.
  • Parent drug and metabolite chemical properties and half-life.
  • Physiological factors (individual metabolism rates and excretion routes, health, diet, weight, gender, fluid intake, etc.).
  • Sensitivity and specificity of the test.
  • The biological specimen tested.
  • Selected cutoff concentration.

Generally speaking, a urine sample will contain the highest concentration of parent drug and its primary metabolites within 6 hours of administration.8 However, route of administration may affect detection time:8

  • When heroin is smoked or injected, absorption occurs almost instantly and excretion of the drug in urine begins almost immediately. 
  • Absorption is slower in case of oral or nasal administration of heroin, which may delay excretion for several hours. 

As drug elimination usually occurs at an exponential rate, a single dose of heroin will be eliminated almost completely within 48 hours. Heroin may also be accumulated in the body as a result of frequent, multiple dosing over extended periods of time, which can lead to significantly extended detection times.8

Why Do Individuals in Detox Require Medications?

Abrupt heroin withdrawal is a set of severe signs and symptoms which a person experiences as the body rids itself of heroin without medications. This is what happens when they attempt to quit the drug cold turkey. While generally not life-threatening, abrupt withdrawal causes great distress to the person’s body and mind and may prompt relapse. A preferred alternative to this is a supervised, medication-assisted detoxification which is a set of interventions aimed at managing acute intoxication and ensuring safe withdrawal.7

How Long Does Heroin Stay in Blood?

Due to the rapid metabolism and elimination of heroin and its metabolites, the window period for detecting and quantifying the illicit drug in a person’s body is short, sometimes as short as 1 to 2 days. Other limitations of blood tests are that they are invasive and samples can only be collected by trained staff.2

In contrast, heroin use can be detected in a hair sample even months after the drug was

consumed.9

How Long Can Heroin Be Detected Through Saliva?

Drug screening through saliva has advantages over blood and urine:3

  • The sample is relatively easy to obtain.
  • Collection is rapid and non-invasive.
  • This method is more tamper-resistant.

However, as mentioned above, the detection period is relatively short:3

  • Saliva concentrations of heroin decline rapidly after intravenous administration, and detection time can be as short as 60 minutes. 
  • Heroin concentrations in saliva after smoking decline more slowly and detection times range from 4 to 24 h.
  • Heroin’s primary metabolite 6-MAM can be detected for only 0.5–8 hours in oral fluid as opposed to the detection time of 1–3 days in urine for the same cutoff concentration.

How Long Does Heroin Show Up in Urine?

Heroin rapidly metabolizes to 6-acetylmorphine and morphine.3 It takes approximately 2 hours after use for heroin to be detected in urine, and the window of detection is typically 1–3 days, although this depends on factors such as fluid intake and urinary pH.3

Heroin and other organic opioids derived from opium can be detected by urine tests. Synthetic opioids, on the other hand, cannot. Illicit drugs such as heroin may contain various adulterants and other mixing agents, including synthetic opioids.7

The key issue associated with urine heroin tests is that they are easily adulterated.2

How Long Does Heroin Stay in Your Hair?

Hair testing for heroin use has several advantages over other forms of sampling and analysis:9 

  • Blood and urine testing can be problematic due to the short half-life and short detection times of heroin and 6-MAM, heroin’s primary metabolite, in these fluids.
  • At the same time, morphine and codeine, heroin’s secondary metabolites, are more persistent, which can make it difficult to distinguish heroin use from use of other opioids. Additionally, some of these secondary metabolites can also come from licit sources.
  • On the other hand, 6-MAM is the major marker of heroin use which can be traced through a hair sample even months after the person took the drug.

However, the routine use of hair testing is not appropriate for most addiction treatment settings, partly due to its high cost, especially if repeated tests are needed, and urine testing remains the most commonly used matrix.3

How to Test for Heroin at Home?

Home use tests for drug abuse indicate the presence in urine of heroin and/or other prescription or illicit drugs. These are qualitative tests which can be done at home and may detect the presence of heroin in the urine, but cannot determine the amount of the drug.10

Neither positive nor negative tests results are 100% accurate:10 

  • If the quick at-home test for heroin done immediately after collecting a sample of urine suggests that heroin may be present, the sample should be sent to a laboratory for additional testing. 
  • Factors such as timing can lead to negative test results. The drug will not appear in the urine immediately after taking it, nor will it stay in the urine indefinitely. 
  • Another factor which can affect test accuracy is incorrect storage or using the test passed the expiration date. 
  • It will roughly take 2-6 hours for heroin to appear in the urine, and the test will remain positive for only 1-3 days after taking the drug.

Why Is a Heroin Test Important for Treatment Evaluation?

During an evaluation prior to detoxification, the person is tested for the presence of heroin in the bloodstream and the concentration of the drug is measured. In the cases of suspected polydrug abuse, the evaluation may also include measuring blood alcohol level and urine drug screening.7

Since this evaluation serves as the basis for the initial heroin addiction treatment plan to be initiated following the withdrawal period, it also includes screening for co-occurring mental and physical conditions and a comprehensive assessment of the patient’s medical and psychological conditions and social situation, such as in the case of veterans with heroin addiction.7

What Is Typical Testing Frequency for Individuals in Recovery?

In a treatment setting, testing frequency is tailored to the individual and adjusted as needed.8 Positive test results of recovering individuals can serve as indication that their addiction treatment needs to be adjusted to better serve each individual patients’ needs. Negative drug tests are often used as reward points in treatment approaches such as contingency management to encourage recovering individuals to stay in treatment.1

Sources

  1. National Institute on Drug Abuse. (2020). Research Report Series: Heroin.
  2. American Association for Clinical Chemistry. (2018). Breakthrough Test Detects Heroin and Cocaine From a Fingerprint.
  3. American Society of Addiction Medicine. (2017). Appropriate Use of Drug Testing in Clinical Addiction Medicine.
  4. Office of Scientific and Technical Information. (2007). Drug Detection Study.
  5. Howard S. Smith. (2009). Opioid Metabolism
  6. Robert C. Oelhaf; Mohammadreza Azadfard. (2020). Heroin Toxicity.
  7. Substance Abuse and Mental Health Services Administration. (2012). TIP 45: Detoxification and Substance Abuse Treatment.
  8. Substance Abuse and Mental Health Services Administration. (2012). TAP 32: Clinical Drug Testing in Primary Care.
  9. Mark L. Miller, Brian Donnelly, and Roger M. Martz. (1997). The Forensic Application of Testing Hair for Drugs of Abuse.
  10. Food & Drug Administration. (2018). Drugs of Abuse Home Use Test

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