How Long Does Codeine Stay in Your System?

Codeine being poured into a spoon

Products that contain the opioid codeine are commonly prescribed for both pain and cough. If you have been prescribed codeine, you may wonder how long the drug lasts in your system. A variety of factors influence the amount of time codeine remains in your body, and understanding them is key to knowing how long you can expect codeine to stay in your system.

What Is Codeine Used For?

Codeine is used for mild to moderate pain and cough. The drug is a natural derivative of the opium poppy, like morphine. This makes codeine an opiate, or a natural opioid, as opposed to most other opioids like oxycodone and fentanyl, which are synthetic. It is available alone or in combination with other products and is a drug that can be abused for its euphoric or pain-relieving effects.

Promethazine-codeine Cough Syrup

Codeine comes as a combination product with the antihistamine promethazine. The product, also known as Promethazine VC with Codeine, is a liquid prescribed for cough and cold symptoms. It is a Schedule V controlled substance.

Tylenol 3 with Codeine

Acetaminophen and codeine come as a combination product formerly sold under the brand name Tylenol 3 with Codeine. Some people still refer to it by that name. It is currently available as a generic drug and is prescribed for mild to moderate pain. The product is a Schedule III controlled substance.

Lean (Purple Drank)

Starting several decades ago, mixing codeine, soda and pieces of hard candy became a popular mixture among illicit drug users in Texas. The mixture, also known as purple drank, has no medical benefit and is considered drug misuse.

Purple drank may contain several ingredients, including:

  • Codeine
  • Promethazine, an antihistamine
  • Dextromethorphan, a cough medication
  • Light-colored sodas like Sprite
  • Ice
  • Hard, fruit-flavored candies

How Long Does Codeine Take to Work?

Codeine is usually taken either as an oral tablet or as an oral liquid in combination with other agents. It absorbs into the body within 15 to 30 minutes, reaching its peak pain-relieving effect within two hours and peak cough-relieving effect within one to four hours.

In the United States, codeine is only available as a quick-acting product. It wears off quickly and is usually dosed every four hours for this reason. It is important to note, however, that other countries like Canada have long-acting forms of codeine as well as the quick-acting forms. If you have gotten codeine outside the United States, it might last longer.

Half-Life of Codeine

A drug’s half-life is the amount of time it takes the body to metabolize and remove half of a dose. Generally, it takes around five half-lives to remove a drug from your system completely.

The half-life of codeine depends on what is being tested — for example, blood versus urine. Further, because codeine has multiple breakdown products, including morphine, those half-lives should also be taken into account. In the blood, codeine’s half-life ranges from 1.4 to 3.5 hours. In saliva, the half-life ranges from 1 to 3.8 hours.

How Long Does Codeine Last?

Codeine’s effects last different lengths of time depending on what the drug is being taken for. When used for pain, codeine’s effects last for four to six hours. When used for cough, codeine can last for four hours.

Will Codeine Show up on a Drug Test?

Codeine will show up in drug tests for different amounts of time depending on whether urine, blood, saliva or hair is being tested. Once codeine is swallowed and enters the bloodstream, the liver starts to break down the drug. Codeine has multiple breakdown products, including morphine and morphine-6-glucuronide, or M6G. When codeine has finally been processed by the liver, both the drug and its breakdown products are detectable in drug tests.

How Long Does Codeine Stay in Urine?

Codeine and its breakdown products like morphine show up in urine tests for up to three days after use.

How Long Does Codeine Stay in Your Blood?

Codeine can be found in your blood for almost four hours after the last dose.

How Long Does Codeine Stay in Your Saliva?

When taken by mouth, codeine shows up in saliva drug tests about an hour after use. When injected, the drug can be found in saliva even more quickly, in as little as half an hour. Codeine continues to be present in the saliva for up to two days after use.

How Long Does Codeine Stay in Your Hair?

Codeine starts to show up in the hair about three weeks after being used. The drug continues to stay in the hair for about ten weeks after the last use. One study showed that to prove no current codeine use, about three centimeters of hair should test negative six months after the last use.

False Positives for Codeine

Some substances can cause false positives for codeine when urine is being tested. These include:

  • Poppy seeds
  • The antibiotics rifampin, rifampicin and quinolones like ciprofloxacin
  • Naloxone
  • Suboxone and Subutex
  • Heroin, which may contain small amounts of codeine as an impurity

Factors Affecting How Long Codeine Stays in Your System

Several factors can impact the length of time codeine stays in your body, such as:

  • Amount used: The more codeine you have taken, the longer it may take for your liver to process and get rid of the drug.
  • Frequency of use: If you use codeine frequently, it can reach a steady level in your blood in as little as 48 hours. Therefore, it may take your liver longer to get rid of the built-up codeine in your system.
  • Country of origin: If you are using long-acting codeine from outside the United States, it may take longer to leave your body than short-acting codeine from the United States.
  • Age: Older people may take longer to clear codeine from their systems than younger people, especially if they have kidney problems.
  • Overall health: Someone in better overall health may be able to get codeine out of their body faster than someone in poor health.

Codeine Withdrawal

Common signs of codeine withdrawal are similar to those of other opioids and include:

  • Muscle aches
  • Insomnia
  • Runny eyes and nose
  • Sweating
  • Yawning
  • Wide pupils
  • Abdominal cramping
  • Diarrhea
  • Goosebumps
  • Nausea and vomiting
  • Agitation
  • Anxiety

Withdrawal symptoms typically start within 12 hours of the last codeine dose and peak within one to two days, waning after three to five days.

Opiate Addiction

Because codeine is a controlled substance like other opioids, it carries a risk of abuse, addiction and dependence. This is especially true because codeine-containing products are among the most-prescribed opioids in the United States, accounting for more than 3.5 million prescriptions a year as of 2019.

Because codeine is so widely available, risks for codeine addiction have been specifically studied and may vary slightly from other opioids. Risk factors for codeine addiction include:

  • Daily codeine use over the last three months
  • Needing higher codeine doses to achieve the same effects as before
  • Problems maintaining responsibilities due to codeine use
  • Seeking advice on the internet to handle codeine use
  • A current or past struggle with alcohol or drugs

Opiate Addiction Treatment

Opiate addiction can be hard to overcome on your own. Opiates like heroin, codeine, morphine and opium may be natural substances, but treating an opiate addiction is similar to treating addictions to other opioids.

The Recovery Village Ridgefield can help you every step of the way as you overcome codeine addiction. At our picturesque facility nestled in the Cascade Mountains, we offer a total of 64 beds with around-the-clock medical care. Treatment can include detox to help get you off codeine, followed by rehab to help keep you off codeine for good. We also have a variety of amenities, including exercise gyms and music therapy to help you heal your body as well as your mind.

If you or a loved one struggle with codeine or codeine-containing products, help is here. Our caring experts at The Recovery Village Ridgefield are here to help you quit codeine for good. Contact us today to learn more.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.