Heroin (diacetylmorphine) is a Schedule I controlled-substance in the United States and is considered the single most addictive drug in the world. Compared to other popular illicit drugs, heroin is associated with the highest likelihood of physical and psychological dependence. When injected intravenously, heroin avoids first-pass metabolism, meaning none of the drug is metabolized before circulating throughout your system.
This is primarily due to the fact that the injected heroin remains acetylated, causing the drug to remain fat soluble and as a result, rapidly cross the blood-brain barrier. Within the brain, heroin is deacetylated into various metabolites, and eventually morphine, which binds to mu-opioid receptors. The binding of morphine to mu receptors causes users to experience euphoria, as well as potent analgesic (pain relief) and anxiolytic effects.
Despite the pleasurable effects associated with a heroin “high,” long-term usage is associated with: depression, itching, inflammation, poor dental hygiene, memory loss, immune system abnormalities, and physical weakness. Furthermore, sharing of heroin needles for intravenous injection significantly ups a person’s risk for diseases like HIV/AIDS. Though over 100,000 people in the United States use heroin each year, many of these individuals have recognized the dangers associated with heroin, kicked their habit, and permanently cleared heroin from their system.
How long does heroin stay in your system?
Among those that have discontinued use and pushed through the grueling heroin withdrawal symptoms, many may still be curious as to whether the drug remains in their system. Upon ingestion of heroin, a person may remain “high” for a short-term (of minutes) or a long-term (hours); this depends on the modality of administration and dosage. Most consider heroin a relatively short-acting substance in that it has a short half-life (spanning between 3 and 8 minutes).
This means that following ingestion of heroin, approximately 50% of the drug has been cleared from the body in under 10 minutes. Mistakenly, many people assume that by the time their “high” ends, most of the heroin is already fully cleared from their system. Although when your heroin “high” ends, up to 50% of the drug will have been eliminated from your body, it will not have been fully cleared from the body (nor will its metabolites).
Assuming you took heroin with a half life of 8 minutes, some basic math would indicate that heroin (diacetylmorphine) should theoretically stay in your system for about 44 minutes. Although heroin is rapidly metabolized and eliminated from the body, its metabolites remain present for a longer duration. Following ingestion, heroin is deacetylated to 6-monoacetylmorphine (6-MAM), which is further metabolized into morphine.
The average half life of morphine is thought to be between 1.5 and 7 hours. As a result, the morphine (resulting from heroin ingestion) could stay in your system for 1.60 days before it is fully eliminated. It is also thought that among long-term/frequent heroin users, the drug may remain in a person’s system for much longer than detectable on a drug test.
This is due to the fact that some people ingest such a substantial amount of heroin, that the body cannot process it quickly enough. It metabolizes and excretes what it can, but if overexerted, lipophilic metabolites may be stored in fat cells – resulting in a prolonged clearance from the system.
Factors that may influence how long heroin stays in your system
It is important to realize that there is individual variation in regards to heroin’s half life, metabolism, and elimination. One individual may find that they’re able to clear heroin from their system within just 24 hours, yet another may realize that it takes at least 2 days for complete clearance. The variation in clearance times is often due to: personal factors (e.g. metabolism), modality of administration, dosage ingested, and frequency of usage.
Many individual factors influence how quickly certain drugs are metabolized and excreted from the body. These factors include things like: a person’s age, their BMI (height and weight), dietary intake, genetics, liver function, metabolism, and whether they are taking any other drugs (or supplements).
- Age: In general, younger people tend to be in better physical health and have higher metabolisms than older adults. Specifically, it is known that elderly (age 65+) aren’t able to metabolize most drugs at the same pace as younger individuals. Therefore, if you are a younger heroin user, you can expect that your body will likely clear the drug at a quicker rate than an older user.
- Body mass index: A person’s body mass index (BMI) may influence the speed by which your body is able to clear heroin. Specifically, individuals who ingest a greater amount of heroin in respect to their BMI may not be able to metabolize it as efficiently as individuals who ingest a lesser amount in respect to their BMI. In other words, the greater the amount of heroin you take in relationship to your body size may influence clearance.
- Diet / Hydration: It is thought that individuals who eat healthy foods and stay properly hydrated may metabolize heroin with greater efficiency. The degree to which proper hydration and healthy dietary intake may influence clearance of heroin is unknown. Dietary intake is known to affect metabolism, and as a result, this could indirectly influence speed of metabolism.
- Genetics: While some studies have hypothesized that variations of cytochrome P450 2D6 may alter rate of heroin (and opioid) metabolism, it is unclear as to whether these polymorphisms influence clearance speed. Based on genes for CYP2D6, most people are characterized in one of the following: ultra-rapid metabolizers (UMs), extensive metabolizers (EMs), intermediate metabolizers (IMs), and poor metabolizers (PMs). A poor metabolizer may retain heroin for a longer duration than an ultra-rapid metabolizer.
- Liver/kidney function: A healthy, properly functioning liver is responsible for the metabolism and processing of most drugs – including heroin. If your liver isn’t working well, you may retain the drug (and its metabolites) for a longer duration than someone with a perfectly healthy liver. In part, diminished liver functioning is a major reason why elderly individuals cannot clear heroin as quickly as younger individuals.
- Metabolism: A person’s baseline metabolism may influence how quickly heroin is broken down. Someone with a slower baseline metabolism may take longer to fully “break down” the drug compared to someone with a fast baseline metabolism. It should be noted that since CYP2D6 (a liver enzyme) is responsible for most of the drug metabolism, genetic variations in that particular gene are more likely to influence clearance speed compared to body metabolism.
- Other drugs / supplements: It could be thought that certain drugs (or supplements) may serve to induce or expedite metabolism of heroin, while others may prolong its metabolism. For this reason, it is important to be aware of how the drugs (or supplements) you are taking interact with heroin (as well as its metabolism). Furthermore, certain supplements are known to facilitate detoxification, thereby expediting the clearance.
The dosage of heroin that a person ingests may dictate how long it stays in their body prior to elimination. Assuming two twins smoke heroin of equal type and potency, yet one ingests a greater dosage, the one who ingested the greater dosage may be unable to clear it from his/her system as quickly as the other twin. Although your body will be able to efficiently metabolize heroin up to a certain dosage, if this dosage is exceeded, metabolism will slow.
This is due to the fact that your body can only process a set amount of heroin at once. If you exceed its baseline threshold for metabolizing heroin, the drug will overwhelm your system and likely get stored in fat tissues. Although the drug stored in fat tissues likely won’t cause you to fail a drug test, it will mean that heroin has not yet been fully eliminated from your body – it will still linger.
Those who use a lower dose (assuming all other factors are the same), may clear heroin from their system at a quicker or more efficient pace. Similarly, those that ingest higher amounts of heroin may overwhelm their bodies and have trouble eliminating it quickly. Keep in mind that dosage should be considered in respect to modality of ingestion; doses vary based on how the drug is taken.
Note: Among those who inject, inhale, or smoke heroin, the number of metabolites produced is linearly related to heroin dosing.
Frequency of usage
How frequently a person uses heroin typically dictates their tolerance, which directly influences the future dosages that they’ll administer. A frequent/long-term heroin user that has been using multiple times per day for a year will obviously have a higher tolerance than a first or second time user. In fact, the frequent/long-term user may be ingesting doses that the first time user wouldn’t be able to tolerate.
It is thought that since tolerance (and ultimately dosage) is related to frequency of usage, the more frequent users tend to overwhelm their body’s ability to rid itself of heroin. This happens when they frequently administer high doses of heroin. Although their body is still able to metabolize the drug, the efficiency of metabolism may have decreased and some of the drug will have likely accumulated within body fat.
Infrequent/short-term users of heroin will likely have ingested smaller doses, and haven’t become highly tolerant to the drug’s effects. Among infrequent users, the body is still able to efficiently clear itself of heroin and it is unlikely that much of the heroin will be retained within body fat. The bottom line is that the less often you use heroin, the less likely you are to have become tolerant, the greater the likelihood that you’re taking a lower dose, and the less likely your body will have been to store the drug in fat tissues.
Heroin purity (“grade”)
It is thought that the greater the purity of the heroin a person ingests, the longer it stays in their system. Higher purity heroin delivers a greater overall effect than lower purity formats. Heroin is classified by purity in four number grades including: No. 4 (purest), No. 3 (pure), No. 2 (less pure), No. 1 (least pure).
The higher the purity, the less the total “dosage” necessary to derive a significant effect. Number 4 heroin is the drug in white powder (salt) format, which is commonly used for injections. Number 3 heroin is typically utilized for smoking and is in base (“brown sugar”) format. Both Number 2 and Number 1 heroin are considered unprocessed, lesser pure forms of the drug.
When considering the purity of heroin in regards to system clearance, it is also necessary to factor in dosing. Someone who ingests a small dosage of No. 4 (highest purity) heroin may find that it stays in their system for longer than a person who ingests large dosage of No. 1 (least pure) heroin.
Modality of ingestion
Heroin can be ingested in a variety of formats including: intravenous (IV) injections, smoking, oral ingestion, and insufflation (snorting). It is known that the modality of ingestion will influence how quickly heroin (and its metabolites) appear within the body, the duration of effect (i.e. “high”), absorption, and metabolism. Furthermore, it is suspected that certain routes of administration may be associated with quicker clearance times than others.
Intravenous injection: Many users inject heroin intravenously to attain a more potent “high” that exceeds other modalities of administration. When injected, heroin retains 100% bioavailability, and enters the bloodstream within just 10 to 20 seconds. The duration of the “high” from injections lasts between 4 and 5 hours.
In addition, injected heroin is generally of higher purity than heroin smoked or snorted and is rapidly absorbed. Intravenous users tend to retain heroin and its metabolites for a longer duration compared to other routes of administration. Additionally, intravenous injection produces the quickest and most intense elevation of metabolites 6-monoacetylmorphine and morphine (MOR).
As a result, these metabolites can be detected within just one minute after IV administration, and are detected for a longer period than among users who smoke. Frequent intravenous heroin users are most likely to end up with unchanged (non-metabolized) heroin in urine. It should be hypothesized that intravenous users are most likely to fail a heroin drug test and will take longer to clear it from their systems.
Smoking: When a person smokes heroin, it is inhaled and absorbed by the lungs. Smoking yields a “high” within 10 seconds and the high can last between 3 and 5 hours. The bioavailability of heroin is less when smoked (52%) compared to injected.
A high-grade product is typically used for smoking, and it is rapidly absorbed via the alveolar-capillary within the lungs. The fact that it is absorbed by the lungs prevents first-pass metabolism by the liver. This means that heroin and its metabolites remain for a longer duration within the body compared to those who resort to oral ingestion.
Among heroin smokers, peak concentrations of heroin are attained within just 1 to 2 minutes, and 6-acetylmorphine (active metabolite) concentrations can be detected in the blood within one minute after smoking.
Snorting (Insufflation): Snorting heroin delivers the drug to the bloodstream via intranasal tissues, giving users a high within 2 minutes for a total duration of 3 to 5 hours. Snorted heroin is usually less pure than that used for injections or smoking, and as a result of lower purity, it may be less detectable within the body. Absorption of snorted heroin occurs via mucous membranes and the drug avoids first-pass metabolism; resulting in greater levels of circulating metabolites.
Some individuals that snort heroin will end up with a second peak in morphine metabolites due to the fact that some of the drug ends up getting swallowed and is later absorbed by the GI tract. Insufflation (snorting) of heroin yields approximately 2 to 6 times lower the number of heroin metabolites compared to an intravenous injection.
Oral ingestion: Some heroin users take the drug orally as a preferred modality of administration. The bioavailability of oral ingestion is regarded as being relatively low at around 35% and it takes longer for the effects to kick in. Lower quality forms of heroin are often taken orally, and absorption may be less efficient.
In addition, metabolites aren’t as easily detected when taken orally because heroin undergoes first-pass metabolism in the liver. The likelihood of heroin or its primary metabolite 6-monoacetylmorphine being detected in plasma following oral ingestion is considerably lower than injected, smoked, or inhaled heroin.
How is Heroin Metabolized & Excreted?
Following its ingestion, heroin is rapidly hydrolyzed into 6-monoacetylmorphine, and eventually into morphine. Glucuronides are then conjugated into the 3- and 6- positions of morphine to form the metabolites: morphine-3-glucuronide and morphine-6-glucuronide. Upon formation of these glucuronides, they are excreted primarily via the urine – and to a lesser extent through bile.
Assuming a person injected heroin intravenously, nearly 70% of the drug’s metabolites would appear in urine, mostly in the form of conjugated morphine (over 50%). Various other metabolites that appear in urine post-heroin ingestion include: normorphine, codeine, morphine-3-6-diglucuronide, and morphine-3-ethersulphate. The majority of morphine undergoes glucuronidation in the liver, but other organs such as the kidney, intestines, and brain have a minor role in the process.
In general, the half life of heroin ranges between 1.3 minutes and 7.8 minutes. The drug is estimated to be cleared from the body at a rate of 189-1939 liters per hour. Since blood flow to the liver is (on average) an estimated 80 liters per hour, and that to the kidneys is an estimated 60 liters per hour, heroin must be metabolized mostly by peripheral tissue and within circulation – otherwise it wouldn’t be eliminated as rapidly as it is.
To facilitate rapid elimination of heroin from plasma, it is thought that serum esterases (hydrolase enzymes) trigger “hydrolysis” within bodily fluid. In nearly every case, 100% of ingested heroin is converted into metabolites prior to its excretion by the kidneys. Only in extreme cases (among long-term/frequent intravenous users) would a small-percentage (fraction of a percent) remain unchanged (non metabolized) within excreted urine.
The concentrations of the metabolite 6-monoacetylmorphine peak within a span of 0.7 to 2.7 minutes following intravenous injection of heroin. It is estimated that the half life of 6-monoacetylmorphine is somewhat longer than that of heroin; ranging between 5 and 52 minutes. Post-intravenous injection, 6-monoacetylmorphine is detectable for a period of 1 to 3 hours within plasma and for a period of 1 to 5 hours within the urine.
Only 1-2% of the heroin dose (inhaled or injected) will appear as 6-monoacetylmorphine in urine samples. Other metabolites of heroin to understand include: morphine and morphine-glucuronides, which appear within 3 to 8 minutes following heroin ingestion. The half life of morphine can range between 1.5 and 7 hours, whereas the morphine glucuronides (M3G and MG6) range from 2 to 6.5 hour half-lives; they are not influenced by route of administration.
It is hypothesized that the longer half lives of morphine (MOR) and glucuronides (M3G and MG6) are a result of enterohepatic recirculation. In other words, these metabolites are processed through the liver and biliary tract to be excreted and travel through the digestive tract. However, in the digestive tract M3G/MG6 are hydrolyzed by glucuronidase enzymes into morphine and are reabsorbed into the bloodstream, getting recirculated before elimination.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/16433897
- Source: http://www.ncbi.nlm.nih.gov/pubmed/18666382
- Source: http://www.ncbi.nlm.nih.gov/pubmed/8930175
- Source: http://www.ncbi.nlm.nih.gov/pubmed/1255475
Types of Heroin Drug Tests
There are several types of drug tests that may be administered to determine whether someone has been using heroin (or another opioid). Due to the fact that heroin is rapidly metabolized and has an extremely short half-life, most drug tests will not be able to detect it. Most heroin drug tests will assess for the presence of heroin’s (diacetylmorphine) metabolites including: 6-monacetylmorphine, morphine (MOR), M3G, and M6G.
Urine tests: The most common testing method to detect the presence of heroin (and its metabolites) is via a urine sample. Following the collection of a urine sample, it is analyzed for the presence of diacetylmorphine, as well as various metabolites. It is highly unlikely that any user will have non-metabolized diacetylmorphine in their urine, making it difficult to pinpoint heroin ingestion.
In some heavy/frequent intravenous heroin users, a small percentage (a fraction of a percent) is detected in urine samples. Urine samples are most likely to detect heroin ingestion based on the presence of heroin metabolites including: 6-monoacetylmorphine, morphine (MOR), M6G, and M3G. Urine tests are able to detect the presence of heroin within a window of 2 to 5 hours post-ingestion.
Opioid metabolites may be detectable within urine samples of heroin users for as long as 1-3 days post-ingestion. That said, these metabolites cannot reveal with conviction that an individual has ingested heroin. Unless you are a chronic/heavy heroin user, it is unlikely that the drug (or metabolites) will be detectable in a urine sample collected 3+ days post-ingestion.
Blood tests: Sometimes individuals will be subject to blood tests to determine whether they have heroin (or any of its metabolites) in their system. Since heroin is known to leave the bloodstream within a period of 2 hours, it would be highly difficult for a blood-test to reveal the presence of diacetylmorphine (or even 6-monoacetylmorphine) unless an individual had literally just ingested heroin prior to the test. A blood test may only be administered if a law enforcement agent suspects that an individual may be high on heroin.
While some metabolites of heroin may be recycled throughout the bloodstream for a longer duration than heroin, blood tests are not usually as accurate as other tests. Furthermore, blood tests are considered invasive, difficult to administer, and there’s always a possibility of laboratory errors (or mix-ups) – which could skew the results.
Hair tests: An accurate way to determine whether someone has used heroin within a longer-term span of several months is via a hair test. During a hair test, an individual is instructed to provide a hair sample (at least 3 cm to 6 cm). These samples are then collected and analyzed to determine whether the individual has been using heroin (or any other drugs).
A drawback associated with hair testing is that they will not reveal whether someone has used heroin within the past few days. However, if someone uses heroin today and they’re tested in 2 months with a hair follicle analysis, it should reveal whether they’ve used heroin. This is due to the fact that heroin stays in the hair for a longer period than it does within the bloodstream; the more heroin a person used, the more likely it is to be revealed within a hair sample.
Some labs may be able to detect the presence of heroin within the hair after the passage of just 7 days (following ingestion). Most laboratories will be able to determine (with accuracy) whether someone has used heroin within the past 3 months (90 days). Factors that could influence hair test outcomes include: length of the hair sample, amount of heroin ingested, as well as proficiency of the specific lab.
Saliva tests: It is uncommon for a saliva drug test to be issued to determine whether someone has used heroin. Saliva tests are generally easier to conduct and relatively non-invasive – all that’s required is a swab of a person’s cheek (to gather a saliva sample). This saliva sample is then analyzed in a laboratory for the presence of heroin (and other opioid metabolites).
Saliva tests are thought to be most accurate when the saliva sample is collected 1 hour post-ingestion. In other words, the heroin does not instantaneously show up in saliva samples – it takes at least an hour. In some cases the tests will detect the presence of heroin for an average of 21 hours post-ingestion.
Although saliva tests are less invasive and provide a longer window of detection compared to blood tests, they are not as effective as urine tests. Furthermore, there is significant individual variability in detection times in saliva testing. Some heroin users may pass a saliva test within just 5 hours post-ingestion, while others may retain metabolites in their saliva for up to 48 hours.
- Source: https://www.nlm.nih.gov/medlineplus/ency/article/003578.htm
- Source: http://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1965-01-01_1_page006.html
Tips to Clear Heroin from your System
If you have stopped using heroin and want to clear the drug from your system as quickly as possible, there are some steps you can take that may expedite the process. Keep in mind that none of these clearance tips are meant to manipulate the results of a drug test. Rather, they are meant to help your system recover and return to normative, healthy, homeostatic functioning without influence of an exogenous substance.
- Stop using immediately: The most obvious tip for those who wish to clear heroin from their system as quickly as possible is to stop using. Many people assume that taking a small dose after they’ve stopped won’t be detectable on a drug test. The truth is that the more frequently you use heroin and the longer you continue to ingest it, the longer it will take to clear from your system. With each subsequent use, you risk the drug accumulating in various fat tissues throughout your body – taking longer for clearance.
- Drink plenty of water: If you want to rid your system of exogenous substances, metabolites, and toxins – it is important to stay hydrated. Avoid unhealthy beverages that add toxins to your body and impair homeostatic functioning (e.g. sodas, sugary drinks, etc.) and drink water. Though you won’t want to drink too much water, ensuring that you are drinking enough as to maintain sufficient hydration will help you efficiently clear heroin from your system.
- Light exercise: If you are in heroin withdrawal, you won’t want to start running sprints or lifting weights like a madman. The discontinuation process is pretty taxing on your nervous system, and heavy exercise could impair your recovery. However, adding some light exercise (e.g. slow jogging / regular walking) could expedite recovery. Getting exercise helps your body maintain optimal blood flow, circulation, and metabolism – all of which will aid in clearance of heroin. Exercise also helps you burn fat, thereby eliminating heroin that may have accumulated in fat cells.
- Take the right supplements: Taking certain supplements may help your body metabolize heroin quicker than usual and prevent it from lingering longer than necessary in the body. Some supplements are known to promote optimal liver and kidney functioning, while others may speed up metabolism. By taking the right supplements, you’ll ensure that your body clears heroin as fast as possible.
- Healthy diet: If you are eating junk food, it may ramp up the toxic burden within your body. Unhealthy foods often contain artificial sweeteners, colorings, and antinutrients that put a strain on your physiological functioning. By eliminating junk food and ramping up healthy food intake, you’ll provide your body with sufficient antioxidants and nutrients that it needs to clear drugs like heroin as quickly as possible.
Have you been drug tested for heroin?
If you’ve been drug tested for heroin, feel free to share a comment below. Mention whether you passed the testing, the type of test that was administered, as well as whether any opioid metabolites were detected. To help others get a better understanding of your scenario, discuss the time span between the last time you used heroin and your drug test.
Note whether you were a chronic/frequent user, the modality of ingestion, and if you were tolerant to high doses. How long do you believe that heroin stays in your system? Do you know anyone that has failed a heroin drug test after having stopped for 3 days? If you know of any methods for expediting the clearance of heroin from your system, feel free to share them as well.