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How Long Does Fentanyl Stay in Your System? (Timeline)

  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Modified:
  • Reading Time: 14 minutes
  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Last Update:
  • Reading Time: 14 minutes

Understanding how long fentanyl stays in your system is important for both medical patients and those concerned about misuse, as it affects detection times, side effects, and overall health.

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Drug overdoses are a big problem. They are now one of the main reasons Americans aged 18 to 45 die. Fentanyl has recently become a big concern in the United States and other places. This is due to its risk of overdose, addiction, and substance abuse.

The CDC reported that in 2022, more than 110,000 people in the United States died from drug overdoses. Of these deaths, 70% were connected to fentanyl and other synthetic opioids. Due to ongoing concerns about fentanyl, other opioids, alcohol, and other substances, communities need access to reliable information. This will help them make informed choices.

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Medical Uses & Risks

What is Fentanyl?

The substance is a synthetic opioid. This means it is a type of medicine made to work with the same brain receptors as natural opioids from poppy plants. Fentanyl has a long chemical name: N-(1-(2-phenethyl)-4-piperidinyl-N-phenyl-propanamide. It is often used to treat severe chronic pain and has been a standard treatment for many years.

However, its simple production in clandestine laboratories has resulted in widespread availability in the underground marketplace. Fentanyl is easy to get, making it a common drug for misuse. This use can be very risky for people who take it without a prescription.

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Medical & Illicit Uses

How is Fentanyl Used?

Fentanyl can be given in a variety of ways, including skin patches, oral lozenges, and injections. It is routinely administered intravenously during procedures in hospitals.

However, the growth of illegally made fentanyl is quite concerning. It is often mixed with other medications, and many users may be unaware they are taking it. This unawareness can have disastrous, even fatal consequences.

Medicinal Use

If you plan to take fentanyl for medical reasons, your doctor knows it comes in different forms and doses, including:

  • Transdermal patches (like APO-fentanyl®, Durogesic® and many other generic versions).
  • Lollipops or Lozenges (like Actiq®).
  • Intravenous injections (like B. BRAUN FENTANYL® and Sublimaze®).
Illicit Use

Some individuals abuse fentanyl by removing it from patches and injecting it. This is extremely hazardous because it is difficult to determine how much they will get.

The drug can also be “diverted.” This means it might not be used as directed when bought from a healthcare professional. This can happen in several ways:

  • Healthcare personnel may obtain drugs without appropriate prescriptions from a fellow healthcare professional.
  • Some people may take their prescription fentanyl recreationally.
  • Others may take medicine that has been prescribed to another person.

Fentanyl is sometimes mixed with illegal or prescribed medicines to enhance its potency. Illegally produced illicit fentanyl can appear as:

  • A standalone product.
  • A cheap additive to boost the potency of drugs like heroin.
  • Counterfeit pills, such as fake oxycodone®.

These reasons all add to growing concern over fentanyl, which affects both healthcare professionals and the general population.

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Key Factors Influencing Detection Time

How Long Does Fentanyl Stay in Your System?

Several variables can affect how long fentanyl remains in the body.

Factors that Affect Fentanyl Detection Time

  • Dosage and Frequency of Use: Taking higher doses or using more frequently can lead to longer detection times.
  • Metabolism: We all have different metabolic capacities for various substances. While some people can clear drugs like fentanyl from their system quickly, for others, the drug can hang around longer.
  • Age and Health: If you are over 60 or have certain health issues, fentanyl may stay in your body longer. This is especially true for problems with your liver or kidneys. Your body might not process it as well.
  • Method of Use: The way fentanyl is administered also plays a role. For example:

Transdermal Patches: Fentanyl patches slowly transfer the medicine into your system through the skin. This implies that the amount of fentanyl in the bloodstream remains constant, and the effects linger for many hours. The medicine builds in body fat, so it may take a few days to leave your system after you stop taking it.

Lozenges and Lollipops: These forms act quickly because fentanyl is absorbed through the mucous membrane in the mouth. While the results are seen quickly (within minutes), they do not last as long as transdermal patches.

Intravenous Injections: This approach delivers fentanyl straight into your system, allowing you to experience its effects immediately. However, it will also be out of your system within a few hours.

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Physical Signs & Behavioral Signs

What are the Signs of Fentanyl Use?

It’s difficult to witness someone in your family dealing with the dire repercussions of drug misuse. It is reasonable to be curious about the telltale signs so that you may intervene and aid them as needed. If you’re concerned about someone you know taking fentanyl, here are some signs to look for:

Physical Signs:

  • Poor Hygiene: A lack of concern for personal cleanliness or grooming routines.
  • Weight Reduction: A considerable decrease in body weight.
  • Persistent Fatigue: Prolonged spells of unusual weariness or lethargy may signal a major problem with drugs like fentanyl.
  • Dermatological Issues: Evidence such as injection marks, lesions, or skin infections.
  • Pallor or Ashen Skin: Changes in skin tone.
  • Drowsiness refers to a lack of energy or chronic drowsiness.
  • Respiratory Difficulties: Slow or shallow breathing might indicate fentanyl or opioid use. It is critical to watch any irregular or decreased breathing and contact an opioid addiction specialist.
  • Profuse Sweating: Excessive sweat that occurs even without physical exertion.
  • Tremors (involuntary shaking or muscular spasms).
  • Symptoms of gastrointestinal distress include nausea and vomiting.

Behavioral Signs:

  • Isolation: If a person starts to distance themselves from friends and activities they used to love, it could mean they have a drug problem. You might notice they prefer to be alone and no longer enjoy sports or social events.
  • Mood Changes: Look out for irritability or quick mood swings. People using drugs often struggle to manage their anger, leading to noticeable emotional outbursts.
  • Ignoring Responsibilities: If they have trouble keeping up with work, personal care, money matters, or household chores, it might suggest they are dealing with drug issues, possibly fentanyl.
  • Strained Relationships: Drug use can make it hard to keep social connections. This can hurt friendships and family relationships. It may lead to more arguments with loved ones. These conflicts could show deeper problems in their life.

What are the Side Effects of Fentanyl?

While fentanyl can provide significant pain relief, it is not devoid of risks. Older adults are more likely than younger people to have negative side effects. This is especially true for the drug’s effects on breathing.

If you have other health problems, the side effects of fentanyl can be much worse. A person’s age and health condition are usually taken into consideration by medical experts before prescribing fentanyl.

Short-Term Side Effects

If you have a prescription for fentanyl or are starting to misuse it, you should know these short-term effects:

  • Nausea.
  • Confusion.
  • Slowed breathing.
  • Constipation.
  • Drowsiness.
  • Vomiting.

Long-Term Side Effects

After using fentanyl for a long time, the brain and central nervous system adapt to the drug. They do this to function “properly.” If your body cannot function unless you take the drug, you have become addicted to fentanyl.

If you develop severe withdrawal symptoms when you try to stop using the drug, then you may have developed dependence. The longer you use the medicine, the less sensitive it becomes. As a result, you are compelled to take increasing dosage sizes of the drug to experience the same effects as before. When you reach this point, you’ve developed what specialists call tolerance.

When you are hooked and have built a tolerance to fentanyl, it is hard to gain pleasure from anything other than the drug. Thus, fentanyl-seeking takes over your life, and the consequences can be devastating in many facets of your life. Fentanyl usage has long-term psychological and physical effects that you should be aware of, including:

Dependence and tolerance: If you keep using fentanyl, you will need larger doses to feel the same high. This can quickly cause withdrawal symptoms if you lower the dose or try to stop using it.

Addiction: Given the euphoric effects of fentanyl, people with addictions frequently engage in obsessive fentanyl-seeking behavior

Organ damage: The heart, liver, and kidneys are particularly vulnerable to the harmful effects of fentanyl. Additionally, respiratory depression is a common side effect of using fentanyl. It can lower the body’s oxygen supply. It has the potential to harm a variety of other organs.

Mental illnesses: If you have been using this drug for a long time, you may have a higher risk of anxiety and depression. Fentanyl can change your brain chemistry. It disrupts the normal balance of brain neurotransmitters. This can lead to long-term mental health issues.

Health risks of long-term fentanyl use: Chronic fentanyl use can have serious and lasting effects on both the mind and the body. Aside from the side effects already described, below are some additional crucial long-term health risks of taking fentanyl:

Hormonal imbalances: Fentanyl abuse can disrupt regular hormonal action in the body. Prolonged use can result in hormonal abnormalities, including estrogen, testosterone, and cortisol. These anomalies can lead to a myriad of issues, including:

  • Sexual dysfunction.
  • Reproductive issues.
  • Mood swings.
  • Alterations in the way the body reacts to stressors.

Weakened immune system: Fentanyl usage can impair the immune system, leaving users more prone to illnesses and infections. Chronic usage can hamper the immune response, raising the risk of breathing-related bacterial infections and other opportunistic diseases.

Overdose: Spotting an overdose of opioids like fentanyl could save a life. According to the Centers for Disease Control, the following are the indicators you should watch for:

  • Discoloration of the skin (mainly around the lips and nails).
  • Cold and/or sweaty skin.
  • Gurgling or choking noises.
  • Drowsiness or unresponsiveness.
  • Tiny, constricted “pinpoint” pupils.
  • Flaccid body.
  • Slow, weak, or absent breathing.

Cognitive impairment: The use of fentanyl can impair mental and cognitive functions. Long-term use may cause memory problems, focus challenges, reduced attention span, and poor decision-making ability. Cognitive deficiencies can significantly influence daily functioning, productivity, and quality of life.

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Metabolism & Elimination

How is Fentanyl Metabolized and Eliminated from the Body?

The length of time fentanyl stays in your bloodstream depends on how your body absorbs it.

Fentanyl mainly undergoes processing in the liver. Here’s a straightforward look at how it works:  

  • Absorption: Once the drug—via a patch, injection, or other methods—enters your bloodstream and makes its way to the liver.  
  • Liver Processing: The liver has many enzymes for different metabolic processes. For fentanyl, the specific enzyme that works on it is called CYP3A4. It breaks down fentanyl. The CYP3A4 is part of a bigger group known as cytochrome P450.  
  • Main Byproduct: The primary by-product formed is norfentanyl.

Elimination of Fentanyl

Major metabolites of fentanyl formed in the liver include mainly norfentanyl and a few other substances. The kidneys then remove any of these chemicals, including norfentanyl, from the blood. These byproducts are primarily excreted through urine; however, a small fraction may also be found in feces.

How is Fentanyl Detected in the Body?

Fentanyl can be detected in the body for varying periods, depending on the test used. Let’s examine a few of the most often-used detection techniques in fentanyl testing.

Drug Tests for Fentanyl

The standard drug tests include:

  • Urine Tests.
  • Blood Tests.
  • Saliva Tests.
  • Hair Tests.

Always choose prevention over treatment. You may wish to confirm the existence of this substance in the medications you are taking, even before taking them.

Fentanyl testing strips (FTS) are a low-cost tool that can help prevent overdoses. When used with other methods, they are even more effective. FTS are small paper strips that can detect fentanyl in different substances. These include cocaine, meth, heroin, and more.

FTS gives drug users and the public important information about fentanyl, especially in illegal supplies. This helps them take steps to reduce the risk of overdose. Please look for groups in your hometown or state that supply FTS, carry them with you, and utilize them!

Fentanyl test strips (FTS) are a valuable tool for harm reduction; however, they are not infallible. For example, they cannot tell the difference between the drug and its similar versions. This means they might miss some, like alfentanil or carfentanil. They may also be less trustworthy if there is a high concentration of substances like methamphetamine, MDMA, or diphenhydramine.

Furthermore, these strips do not show the quantity of fentanyl in a sample; instead, they indicate whether or not it is there. So, while they are beneficial, there are certain limitations.

Detection Windows for Fentanyl

The time it takes for a medicine to test positive in the body is related to its half-life. This half-life refers to the time it takes for the active ingredients in your body to fall to half of their original concentration. This depends on how the body digests and removes the chemical. Half-lives can vary from a few hours to several days or weeks.

The factors we discussed earlier affect how long fentanyl remains in your body. These factors include the dose you take, how often you use it, your metabolic rate, body weight, age, and overall health. In general, the detection windows for this drug are based on various testing methodologies and are as follows:

Urine Tests:  Urine testing is the most frequently used method for testing the presence of opioids like fentanyl. This drug has a half-life of 3 to 7 hours. This means it is metabolized at a certain speed in the body. However, it can be found in urine tests for 1 to 3 days after use.

This long detection window happens because the drug and its metabolites take time to leave the body. About 75% is removed through urine, and around 9% is excreted in feces. Many half-lives happen before the medication is gone. So, the pee test shows when the drug is leaving the body, not when it is active.

Blood Tests: The drug can be detected in blood for 12 to 48 hours after the previous dose. Fentanyl is quickly processed and removed from the system; therefore, the detection window is shorter.

Saliva Tests This testing approach can detect fentanyl for 1 to 4 days after consumption. Saliva tests are less intrusive and increasingly common, although the detection time varies according to individual consumption patterns.

Hair Follicle Tests: Fentanyl can be found in hair for up to 90 days after its last use. Hair tests give a detailed history of drug use. However, it usually takes a week or more for the drug to show up in hair.

Remember that these time frames are estimates and can differ widely among individuals. Fentanyl works quickly and strongly, so it is broken down fast. However, traces of the drug and its byproducts can still be found for a while after use.

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How to Get Fentanyl Out of Your System?

If you or someone you know is having trouble with fentanyl addiction, there is help available. It’s important to reach out for support.

If things have gotten to this point, reaching out for professional support is crucial.

You can contact Rolling Hills Recovery Center to get assistance in getting fentanyl out of your system. RHRC provides popular therapies for fentanyl addiction. These treatments can help you overcome addiction with expert support.

Fentanyl Addiction Treatment at Rolling Hills Recovery Center

Medications

Several approved drugs can be used to treat fentanyl use disorder, reducing cravings and preventing relapse. Naltrexone, buprenorphine, and methadone are all approved by the FDA (Food and Drug Administration) for opioid use disorders. Medically assisted detox involves using FDA-approved drugs under supervision. This helps people gradually reduce and overcome fentanyl dependency in a detox program.

Behavioral Therapies

Behavioral counseling plays a significant role in treating opioid use disorder. Behavioral therapy equips you with the skills needed to manage triggers and avoid relapse. Common approaches for fentanyl and other opioid use disorders include:

  • Cognitive behavioral therapy (CBT).
  • Contingency management (CM) that utilizes rewards to reinforce positive behavior.
  • Dialectical behavioral therapy (DBT).
  • Motivational interviewing (MI).
  • Experiential therapy.
  • Group therapy.

Inpatient and Outpatient Programs

Inpatient therapy means living at a rehab center. Here, you get 24/7 medical and mental health support. It’s a focused environment that offers constant care.

On the other hand, outpatient treatment lets you live at home while you go to therapy and support groups regularly. This care option offers more flexibility. You can include therapy in your daily routine while still getting the help you need.

Aftercare Planning

Getting complete medical care with aftercare treatment programs is essential during treatment. Aftercare plays a significant role because it helps you develop strategies to maintain your recovery after treatment. Preparing for this is vital to your journey, as it can reduce the risk of relapse, impacting your success in the future.

If you or someone you know is having trouble with fentanyl addiction, please reach out for help. You can call Rolling Hills Recovery Center right away.

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Written By:

Geoffrey Andaria

Geoffrey Andaria mental health writer at rolling hills recovery center
Rolling Hills Recovery Center

Mental Health Writer

About Author:

Geoffrey Andaria is an experienced mental health content writer and editor. With a B.A. in English and Journalism, Geoffrey is highly educated in freelance articles and research. Having taken courses on social work, Geoffrey is adamant about providing valuable and educational information to individuals affected by mental health and the disease of addiction.

Medically Reviewed By:

Dr. Carl Williams Ph.D., LCADC

Carl Williams, medical content reviewer at rolling hills recovery center
Rolling Hills Recovery Center

Expert Contributor

About Reviewer:

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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