When drugs are ingested, smoked, or injected, they travel through the body, and over time,

convert into drug metabolites, which are subsequently excreted from the body. The highest
concentrations of these drugs and metabolites is in the urine, but they are also present in
measurable quantities in blood, saliva, sweat, tears, hair and even finger and toenails.
Improved instrumentation has allowed laboratories to measure drugs in these “alternative”
matrices.
Window of detection
For most drugs, the detection time after use, using urine as the specimen, is approximately 2-
4 days. (Note: An exception is marijuana, where in some cases, chronic marijuana smokers
can be detected up to 2-3 weeks after last use).
For oral fluid, the detection window is generally shorter, although for some drugs it can
approach 2 days, overlapping the urine window. The advantage of this is that very recent
drug use can be detected by employing saliva as the test specimen. Since saliva is thought to
reflect blood levels at a given time point, the presence of a parent drug (for example, cocaine)
can be interpreted as an indication of being “under the influence” of cocaine at that specific
time. It is generally not possible to interpret a urine test result as being “under the influence”
of a drug, and this critical information would be lost using urine as the test specimen.
Applications specifically based on the ability of saliva to show a person to be “under the
influence” of a drug include:
Probation and Parole settings, where using illegal drugs is a violation of parole
“Reasonable suspicion”, “For cause” or “Post accident” testing, when there is an incident or a
suspicious activity in the workplace, which may be due to drug or alcohol use
Methadone maintenance and pain management centers, requiring a rapid answer as to
whether the individual recently ingested the prescription drug
CODEINA
A medication’s half-life is the time it takes for the body to metabolize and exctrete half of
one dose. Drugs with short half-lives are often taken multiple times daily, as with codeine.
After codeine enters the bloodstream, it is broken down in the liver to its metabolites. These
metabolites include codeine-6-glucuronide, norcodeine and morphine and are also active in
the body.
Codeine’s half-life is about three hours. However, many of codeine’s metabolites have longer
half-lives and can continue to provide cough and pain relief, even after codeine is
metabolized (for about six hours).
In addition, there are reports of false positives on enzyme-linked immunoassay (EIA) drug
screens which report positives for a class of medication (opiates) rather than specific drugs
(codeine). Other medications that can cause a false positive for opiates on this type of test
include:
Verapamil: a prescription medicine used to treat high blood pressure
Diphenhydramine: the active ingredient in Benadryl used OTC for allergies or to help sleep
Doxylamine: an OTC antihistamine often used for allergies or medications to help sleep
Dextromethorphan: an OTC medication used to treat cough
Testing for codeine in saliva can be challenging because this testing depends on several
factors, including the sensitivity of equipment used, the dose of codeine taken and variability
between people. However, it has been reported that codeine is detected in saliva for
approximately seven hours.
After taking Tylenol with codeine, codeine (and its metabolites) have a longer half-life and
would remain in the system for about a day, whereas Tylenol would only stay in the body for
nearly half that time. However, because the liver metabolizes both components of this
medication, taking this combination would profoundly impact the metabolism of each if there
were any underlying liver damage, and they could cause liver damage in the case of excessive
use or overdose.
Several naturally occurring opiate alkaloids—such as morphine, codeine, and thebaine—
serve as the chemical building blocks of many semi-synthetic opioid drugs, including heroin,
oxycodone, and hydrocodone.
Many opiates are essential in the medical community for their sedative and painkilling
properties, though heroin is a morphine derivative that’s exclusively recreational and highly
illegal. All of these drugs have a high addiction potential, and even those that are given out
legally via prescription are often abused and can be found on black markets. According to the
United Nations Office on Drugs and Crime 2012 World Drug Report, 26.4-36 million people
across the globe abuse opiates.
How Long Does Codeine Stay in Your System?
Lastly, codeine is one of the fastest of all opiates to leave the system. It can be found in the
blood for just 24 hours, and in urine for 24-48 hours. Saliva tests have a wider range, being
effective for 1-4 days after the last dose. As with the rest, it can be found in a person’s hair
for up to 90 days.
These are all averages. However, due to the fact that opiates will build up in fatty tissues after
excessive use, these averages may extend beyond the outer limit if the individual is a heavy,
long-term user.
Other Notable Drugs & The Body
How Long Does Fentanyl Stay in Your System?
Blood: Up to 12 Hours
Saliva: 1-4 Days
Urine: 8-24 Hours
Hair: Up to 90 Days
How Long Do Poppy Seeds Stay in Your System?
People always wonder if eating a poppy seed muffin or bagel before a drug test will end in a
false positive. The answer to that is, yes it can. However, testing guidelines have improved
and it’s less likely to be flagged for opiate use after eating poppy seed-containing foods. In
the past, poppy seeds have been known to cause testers to fail for up to 16 hours after
consumption. Since poppy seeds contain low levels of opiates, many tests now have a higher
threshold to avoid false positives.
How Long Does Codeine Remain in the System?
The estimated detection times for codeine are as follows:
For most, people codeine can be detected in their urine for up to 48 hours after their last use
of the drug. However, it may be detectable for up to 1 week in chronic users.5,6
It can be detected in saliva for 21 hours after last use.6
It can be detected for up to 10 weeks in hair follicle tests.7
Oral fluid testing is less commonly used but oral samples represent a convenient, promising
matrix for many settings. Unlike urine samples, oral samples are not easily tampered with,
and can be collected with minimal invasion of privacy [15,16]. Oral secretions contain either
the original drug compound or its metabolite for approximately 24-48 hours after last use
[9,15,16]. Importantly, use of breath sprays, mouthwash or other oral rinses containing
alcohol does not affect drug testing result as long as they are not used within 30 minutes of
sample collection [17]. To collect an oral sample, a swab is placed adjacent to the lower gums
against the inner cheek and left in place for several minutes before being inserted into a vial
for transportation to the laboratory [9]. Point-of-care oral testing is also available in some
settings [18].

Luna decembrie ne-a adus încă o întalnire profesională valoroasă pentru acest an, în
comunitatea farmaciştilor braşoveni. Ne-am reunit interesul ştiinţific pentru a discuta efectele
pe care medicamentele eliberate din farmacie le pot avea asupra conducătorilor auto.
Alina Grecu, farmacist specialist în farmacie clinică, ne-a reamintit că există
suficiente publicaţii ştiinţifice (inclusiv cele oferite de producătorii de medicamente în RCP-
ul produselor) care subliniază că utilizarea anumitor medicamente trebuie atent evaluată în
contextul şofatului sau manipulării de utilaje. Acestea ar fi antihistaminicele H1
(difenhidramina şi levocetirizina), relaxantele centrale ale muşchilor scheletici (baclofen şi
tolperison – care au o rată mai mare de afectare a şofatului în special la asociere cu AINS-uri)
si bineînţeles, medicaţia psihoactivă (cea inclusă în Tab II şi Tab III conform Legii
339/2005).
Subiectul discuţiilor a continuat cu informaţiile disponibile legate de durata de
remanenţă în lichidele biologice a substanţelor medicamentoase psihoactive şi administrate
strict la indicaţia medicului, prezentate tot de farm. Alina Grecu. Studiile clinice arată că
benzodiazepinele, inclusiv cele administrate ca doză unică, pot fi prezente în salivă până la
48h din momentul ingerării. În mod similar, tramadolul şi codeina sunt prezente în salivă
până la 48h de la administrare, iar fenobarbitalul până la 52h. Există informaţii publicate
despre interferenţa anumitor substanţe medicamentoase, inclusiv din categoria OTC-urilor, cu
rezultatul testarii rapide pentru consumul de substante cu risc. Acest fapt, este posibil şi diferă
de la un tip de tester la altul, însă probabilitatea scade semnificativ pe măsura dezvoltării unor
matriţe cu sensibilitate şi specificitate crescută la substanţele cu risc.
Alături de noi au fost domnul comisar şef Cosmin Giosanu şi agent şef principal
Ciprian Ciobanu, din cadrul IPJ Braşov - Serviciul Rutier. Aceştia ne-au transformat
experinţa într-una şi mai valoroasă deoarece farmaciştii prezenţi au avut parte de o prezentare
a cadrului legislativ de testare a consumului de substanţe de risc la conducătorii auto, ocazie
care le-a dat şansa farmaciştilor să adreseze întrebări direct reprezentanţilor Poliţiei Rutiere.
Punctul culminant al întâlnirii a fost reprezentat de testarea propriu-zisă cu DrugTest a doi
voluntari. Ambele rezultate au fost negative, cu toate că unul dintre farmacişti şi-a adminstrat
intenţionat un produs OTC ce conţine 30 mg pseudoefedrină cu aproximativ 60 de minute
înainte de testare.
În final, întâlnirea a adus în atenţia farmaciştilor o serie de teste rapide ce pot fi
disponibile în farmacii, cu utilizari de testare diversă, inclusiv la substantele cu risc sau
markeri cardiaci, aduse în România de K-MARA Healthcare Corporation Romania şi
prezentate de doamna Carmen Szazs.
Vă mulţumim tuturor pentru prezenţă şi experienţele valoroase pe care le-am
împărtăşit în cadrul acestei întâlniri. Aşteptăm cu nerăbdare surprizele profesionale ale
Colegiului Farmaciştilor Braşov din anul 2024!