How Long Do Opioids Stay in Your System?

Making it through opioid detox can be challenging and if you’re coming off a chronic drug problem, it can be downright excruciating. Opioid abuse disrupts the body’s normal processes, which becomes painfully obvious as the drug leaves your body. How long opioids stay in your system will vary depending on the degree of damage caused by drug use. The good news is many people have successfully completed detox and gone on to live clean and sober lives.

How Do Opioids Work?

Opioids encompass any and all drugs that interact with the body’s own opioid receptors. These include heroin and prescription pain pills, such as morphine and codeine. The pain-relieving effects of opioids stem from the drug’s ability to slow down the body’s chemical processes.

The body has its own opioid receptors, located throughout the brain, central nervous system, and gastrointestinal tract. Opioid receptors release neurotransmitter chemicals, including dopamine, serotonin, and norepinephrine. These chemicals act as messengers that relay information to different parts of the brain and body. They also produce feelings of pleasure, contentment, and well-being when they’re released.

Opioid receptors release these chemicals on an as-needed basis, based on the body’s needs. When you ingest heroin or pills, these receptors respond the same way as they do with the body’s own signals. This ability to activate receptors allows opioid drugs to do substantial harm.

While opioids will leave the body at some point, their effects can leave considerable damage behind. This means certain aftereffects may linger long after opioids have left your system. In this respect, how long opioids stay in your system and how long opioids impact your physical and mental well-being are two different time-frames.

Factors That Affect How Long Opioids Stay in Your System

After months or years of abuse, opioid effects have slowed down the body’s systems and negatively impacted your health. Since opioid receptors exist in areas that regulate several of the body’s functions (brain, central nervous system, gastrointestinal tract), health problems can take any number of forms depending on your physical makeup. When chronic drug abuse is an issue, severe health problems can be expected. All of this means your overall health upon starting detox will influence how long opioids stay in your system.

Other factors that affect your detox progress include:

  • How often you used opioids
  • Whether mental health problems are an issue
  • How severe your addiction is

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Opioid Withdrawal Stages

Withdrawal from opioids happens in stages where symptoms lessen in intensity along the way. Symptoms manifest as both physical and psychological. This array of symptoms stems from the widespread effects opioids have in the brain and body.

During the course of substance use disorder, you may have noticed how larger and larger doses are needed to get “high” over time. In effect, the brain and body develop an ongoing tolerance to opioids. Tolerance level increases occur when opioid receptors become less sensitive to the drug’s effects.

As opioids force the release of neurotransmitter chemicals, receptors in the brain and central nervous system automatically become less sensitive to their effects in order to maintain some semblance of chemical balance. After a while, this mechanism backfires, leaving receptors unable to produce dopamine and serotonin when they’re needed. For these reasons, the higher your tolerance levels are when starting detox, the more intense withdrawal symptoms will be.

Here are the three main stages of opioid withdrawal to watch for:

Stage 1 – Early Withdrawal

For short-acting opioids like heroin, withdrawal from opioids can start within six to 12 hours after your last dose. With long-acting opioids, such as Fentanyl and OxyContin, symptoms start to develop within 30 hours after stopping the drug. During this early stage of withdrawal, expect to experience intense symptoms as the brain and body start the process of restoring chemical equilibrium.

Early withdrawal symptoms can last for up to three days and typically take the form of:

  • Achy joints and muscles
  • Insomnia
  • Fever
  • Feeling anxious
  • Loss of appetite
  • Sweating

Stage 2 – Peak Period

On average, peak withdrawal begins around 72 hours after your last use. This stage brings on the most intense, uncomfortable symptoms. The overall discomfort that comes with opioid withdrawal accounts for why so many people hesitate to stop using. Knowing what you’re in for along the way can make help make the process more bearable.

Symptoms experienced during the peak period can last for up to five days and include:

  • Stomach cramps
  • Chills
  • Diarrhea
  • Persistent drug cravings
  • Nausea and vomiting
  • Depression

Stage 3 – Late Withdrawal

During the late withdrawal stage, the physical effects start to fade while emotional and psychological symptoms become more prominent. In effect, the body has mostly adjusted to a drug-free state. The brain structures that regulate thoughts and emotions still have a little ways to go.

This stage typically lasts for one to two weeks. Feelings of depression can become intense. Feelings of anxiety and restlessness also increase. Intense drug cravings and ongoing insomnia can also be expected. At this opioid withdrawal stage, the urge to use can feel overwhelming and may be hard to overcome on your own.

Post-Acute Withdrawal Syndrome

For individuals coming off chronic or severe opioid addiction, the repair processes in the brain and body require a bit more time before normal functions resume. This stage is known as post-acute withdrawal syndrome or PAWS. According to Semel Institute, an estimated 90 percent of people who successfully complete detox experience post-acute withdrawal syndrome so you can make it through detox no matter how severe the addiction problem.

During this time, the brain continues its “rewiring” process, restoring chemical pathways and normal brain functions. Symptoms to expect during PAWS include:

  • Frequent mood swings
  • Problems sleeping
  • Intense drug cravings
  • Depression

Coping With Opioid Withdrawal

While you can’t control how long opioids stay in your system, you can take steps to ease the process along. Trying to go cold-turkey on your own can lead to a successful outcome but also comes with a high risk for relapse. Increase your chances of breaking the hold of addiction on your life by getting the level of treatment support needed to make it through the detox period.

Rehab programs offer a wide range of specialized treatments that are designed to support the brain and body as it adjusts to a drug-free state. This includes medication therapies, such as Suboxone and methadone along with healthy eating, exercise, counseling, and ongoing emotional support. All of this is to say, when you’re struggling with an opioid abuse problem, you don’t have to go it alone.


Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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