People with severe alcohol or drug addiction rely on substances to function normally. These individuals need to go through medical detox before they are ready for addiction treatment.

Medical detox gets people to the point where they feel physically well enough to work on the underlying causes of their addiction. The next phases of their addiction treatment program will be more effective once withdrawal symptoms are under control.

What is Medical Detox?

Using alcohol or drugs for many months or years alters the brain’s natural chemistry. Once a person’s brain learns to adapt to the steady incoming supply of substances, it relies on them to function normally. When someone who is addicted to drugs or alcohol suddenly stops using them, they experience unpleasant physical and mental reactions. These reactions are called withdrawal symptoms.

What is medical detox

Detoxification is the process of removing all drugs and alcohol from a person’s system and managing their withdrawal symptoms when they first arrive at treatment. Medical detox uses medications to manage the impact and severity of their body’s response to the lack of substances. This makes detox a safer, smoother, and more comfortable process.

Definition of Medical Detox

Medical detox incorporates the use of medications to provide relief from drug and alcohol withdrawal symptoms during detoxification. Withdrawal symptoms range from mild to severe depending on a few different factors:

  • Type or types of substances used
  • Amount of substances used
  • How long the person used for
  • Age
  • Overall physical health

The more severe the withdrawal symptoms, the greater the need for medical detox. Some reactions are dangerous or life-threatening when left untreated or handled alone. Medical detox takes place in a specialized facility under the supervision of medical professionals trained to handle the detox process.

People are more likely to fail at their attempts to get and stay clean and sober if they try to detox alone. Medical detox provides a safe environment that makes the process as simple and comfortable as possible. Once all traces of drugs and alcohol are removed from a person’s body, they’re ready to move on to the next step of addiction treatment.

Which Substances Require Medical Detox?

Not everyone requires the assistance of medical detox. Drugs like marijuana do not cause the same intense withdrawal symptoms that harder, more addictive substances do. There are numerous kinds of drugs that cause severe and dangerous withdrawal symptoms. The most common examples of substances that require medical detox include:

Medical Detox vs. Rehab

Medical detox and rehab are not the same things. They are two separate parts of a comprehensive addiction treatment plan. Medical detox handles the first few days of recovery when the chances of relapse are highest. It provides an environment geared towards separating an individual from their substances of choice as safely as possible.

Rehab is the portion of treatment that focuses on teaching newly clean and sober individuals more about their condition. It involves counseling, group therapy, educational sessions, activities, and more. Each addiction rehab facility has its own selection of approaches they use to work with their clients.

Not everyone who needs rehab needs to go to medical detox, but everyone who goes to medical detox should go to rehab. Safe separation from alcohol and drugs is only the first part of recovery. There is far more to learning to live life clean and sober than only staying away from drugs and alcohol.

An effective addiction treatment plan transitions clients directly from medical detox into rehab. This could be a partial hospitalization program, inpatient treatment, or an intensive outpatient program. Transitioning into the care of addiction rehab leads to a higher likelihood of not turning back to alcohol and drugs.

Stephen H. Denzer, M.D., FACP – Addictionalist at Hawaii Island Recovery
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How Medical Detox Works

Medical detox is a safe environment where people with severe drug and alcohol addiction can separate from all substances. It’s usually the first part of a comprehensive addiction treatment plan. People with serious drug and alcohol problems can’t treat their addiction while still dealing with the effects of substances.

How Medical Detox Works

Someone who drank or used for months or years before trying to get clean and sober will need to go to medical detox. It clears all drugs and alcohol from an individual’s system so the next steps of their treatment plan are effective. Without a proper detox, addiction treatment approaches aren’t going to help.

When Is Medical Detox Necessary?

There is no one-size-fits-all addiction treatment program. Not everyone seeking help for their drug or alcohol problem needs the same approach to treatment. Some people benefit from an intensive outpatient program while others need a full, comprehensive program. Many require medical detox when they’re getting sober but in some cases, medical detox isn’t necessary.

People become physically and psychologically dependent on drugs or alcohol when they drink or use them for a long time. Their body develops a tolerance to the substances they use as time passes. For example, someone who drinks a 6-pack every night will eventually need to drink a 12-pack to reach the same point. They need to drink or use more to achieve the effects they want.

Medical detox is necessary for people with a physical dependence on their substance of choice. Their body becomes used to the incoming substances. When those substances run out, they experience physical and psychological reactions. These reactions, or withdrawal symptoms, range from minor to serious.

Medical detox separates people with a physical dependence from their substances of choice. It manages withdrawal symptoms and monitors overall health and wellbeing to ensure the person’s safety. But if someone isn’t physically dependent on substances, they won’t go through withdrawal symptoms and there is no need for detox.

What Happens During Medical Detox?

When a person first arrives at medical detox they undergo an assessment and evaluation. The facility gathers information about their alcohol and drug use to determine the best approach for their needs. Then the facility develops an individualized treatment plan based on what they learn about the person’s medical and addiction history.

As any substances leftover in the person’s system start to wear off, they will enter the withdrawal period. They start experiencing the physical and psychological symptoms associated with withdrawal from their substance of choice. Withdrawal symptoms include a wide range of reactions like:

  • Tremors or shaking
  • Sweating
  • Fever or chills
  • Runny nose
  • Nausea or vomiting
  • Diarrhea
  • Abdominal cramps
  • Muscle and bone aches
  • Headaches
  • Exhaustion
  • Nightmares
  • Insomnia
  • Anxiety
  • Depression
  • Irritability or anger
  • Paranoia
  • Agitation
  • Difficulties concentrating
  • Extreme mood swings
  • Cravings

Medical detox exists to minimize the impacts of these withdrawal symptoms. Someone with severe alcohol or drug problem will also experience severe withdrawals. Their stay in detox aims to eliminate as much discomfort and make their symptoms as tolerable as possible.

Some facilities use a medication-assisted treatment approach during detox. This means they use different kinds of medications to relieve some symptoms associated with the withdrawal process. These medications can reduce anxiety and depression, enable the person to sleep, reduce substance cravings, and more.

What Is Medical Detox Like?

Medical detox is a straightforward introduction to addiction treatment. The first few days of sobriety are the most uncomfortable. The facility focuses on keeping individuals safe and sober through the discomfort of these difficult days. They offer support around the clock to ensure the best outcome possible for each person.

Detox doesn’t include traditional addiction treatment approaches like counseling or group therapy. These parts of treatment won’t be as effective when a person is going through withdrawal symptoms. They need all substances cleared from their system before these portions of the treatment process will be effective.

How Long Is Medical Detox?

The length of time spent in detox depends on how long the withdrawal period lasts. Medical detox lasts as long as a person’s withdrawal symptoms last. The length of time it takes to fully detox from all substances depends on a few different factors:

The types of drugs or alcohol used

Whether the person mixed different substances
How long they drank or used drugs for
Their age and gender
Their medical history and overall health
The existence of co-occurring physical or mental health conditions

Most detoxes last between 5 and 10 days depending on the factors listed above. Additionally, some substances have longer withdrawal periods than others. For example, alcohol withdrawals begin between 6 to 24 hours after the last drink. They peak around 72 hours then decrease until about a week after their last drink.

On the other hand, opioid and opiate withdrawals begin much sooner and often last longer. Withdrawal symptoms begin within hours after the person last used and peak toward the end of the first week. Symptoms then decrease throughout the second week in most cases but some heavy users have symptoms that last longer.

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Medical Detox for Alcohol

Alcoholism is a chronic, progressive disorder characterized by compulsive alcohol use. Most people with alcoholism drink so much that they become physically dependent on it. Their brain chemistry adjusts to continue function while exposed to alcohol almost constantly.

Medical Detox for Alcohol

When these people stop drinking suddenly they go into alcohol withdrawal. Alcohol withdrawal happens because of the adjustments their body and brain made to handle ongoing alcohol exposure. This causes overstimulation which results in physical and psychological reactions called alcohol withdrawal symptoms.

Withdrawal symptoms range from mild to severe depending on how serious their drinking problem was. Sometimes withdrawal symptoms are so intense that they require medical attention. This is where detox comes in.

Medical detox for alcohol helps people through the alcohol withdrawal process. It is a supervised environment that aims to safely separate people from alcohol. Additionally, some facilities use medications to relieve the discomfort caused by withdrawal symptoms. This form of treatment is called medication-assisted treatment.

How Medical Detox From Alcohol Works

Detox is usually the first step for people with a severe drinking problem entering alcohol abuse treatment. People often arrive at treatment under the influence to at least some extent. They’re moved to the medical detox portion of the facility to wait for the alcohol to wear off and the withdrawals to start.

Once withdrawals start, medical detox staff take over. Most medical detox facilities provide 24-hour supervision to ensure the person detoxes safely. Facilities look for signs of worsening symptoms while alcohol leaves the person’s system. They oversee the detox process from the moment withdrawals begin until symptoms taper off.

Medical detox that incorporates medication-assisted treatment uses different medications during the process. They provide relief from some withdrawal symptoms like anxiety, restlessness, insomnia, nausea, and more. Medication-assisted treatment also aims to limit cravings during these times when cravings can be most intense.

Once all alcohol clears from a person’s system and their withdrawal symptoms lessen, they’re finished with detox. They’ll move to the next phase of their treatment plan, usually inpatient rehab, PHP, or IOP.

How Long Does Medical Detox From Alcohol Take?

People seeking treatment for alcohol abuse have different experiences. Some drank for only a few months while others drank for decades. Medical detox lasts as long as it takes for a person’s withdrawal symptoms to leave. The length of time medical detox from alcohol takes depends on a few factors including:

  • Age
  • Gender
  • Overall physical health
  • How long the person drank for
  • The type of alcohol they consumed
  • How much they consumed when they drank

People who drank for years but only had a few drinks at a time likely won’t have extreme withdrawal symptoms. On the other hand, some drink for only a few months but drink constantly and heavily. These individuals will experience much more intense withdrawal symptoms.

Withdrawal symptoms can start as soon as 6 hours after the last drink. Symptoms usually include anxiety, restlessness, and tremors. People with severe drinking problems are at risk of having withdrawal-induced seizures at this point.

Most withdrawal symptoms set in within the first 24 hours after the last drink. Tremors worsen; nausea or vomiting begin; levels of anxiety and restlessness are higher. Some people experience auditory or visual hallucinations at this time.

Symptoms continue through the first 48 hours, including tremors, stomach discomfort, and headaches. Withdrawal symptoms in people with mild alcohol dependence often peak at this point and start to decline afterward. Most alcohol withdrawal symptoms are through by the fourth or fifth day.

Is Medical Detox From Alcohol Safe?

Medical detox from alcohol keeps clients safer than if they tried detoxing on their own. This is especially true for people with severe alcohol dependence. These individuals experience the most extreme withdrawal symptoms including hallucinations, seizures, and even delirium tremens (DTs).

People who have these symptoms require medical attention. Seizures and DTs can be life-threatening if the person doesn’t receive treatment. Placing a person in medical detox ensures they’re in a safe environment. They can receive the immediate help they need if their withdrawal symptoms reach this extreme point.

Is Medical Detox From Alcohol Painful?

Alcohol withdrawal symptoms can be painful. Headaches and nausea are two of the most common withdrawal symptoms. Some people also experience body aches. Most symptoms cause at least some physical discomfort while alcohol leaves their body.

Medical detox exists to make sure the detox process is as painless as possible. Facilities that use medication-assisted treatment relieve the uncomfortable or painful symptoms with the help of medications. Attending medical detox ensures that you’re as safe and comfortable as you can be while detoxing.

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Medical Detox For Drugs

Like alcohol addiction, drug addiction also rewires a person’s brain chemistry. Their body and brain adapt over time to function while under the influence of drugs. They become used to the steady stream of incoming substances. When they suddenly quit using all substances, they go into withdrawal.

Medical Detox for Drugs

Drugs cause both physical and psychological withdrawal symptoms. The specific symptoms a person experiences, as well as the severity of symptoms, depends on the types of drugs used. Some symptoms cause only mild discomfort while others are life-threatening if left untreated. How does medical detox for drugs work?

How Medical Detox From Drugs Works

Medical detox from drugs works by safely separating a person from all illicit substances. It’s often the first step of addiction treatment especially for those with severe substance dependence problems. Before any approaches to addiction treatment can be effective, a person must be completely clean and sober.

Additionally, newly sober people are at the greatest risk of relapse during the withdrawal period. They’re used to using drugs to relieve the discomfort of their withdrawal symptoms. Medical detox from drugs works to keep them away from substances during these difficult first few days.

People often come into treatment while still under the influence. They’ll be high for their first few hours in treatment but eventually, the effects start wearing off. Drug detox begins when they start sobering up and the withdrawal symptoms kick in.

Medical drug detox provides supervision 24 hours per day until the person is completely clean of all substances. Until then, though, qualified detox technicians observe each client and make sure they’re as safe and comfortable as possible.

The sole focus of detox is to get someone through the withdrawal period safely. Once they’re clean from substances and their symptoms are under control, they transition into the next phase of their treatment program.

Which Drugs Require Medical Detox

Not all drugs require medical detox. Some substances, like marijuana, don’t cause intense withdrawal symptoms that need medical attention. Drugs like prescription painkillers, heroin, and benzodiazepines all cause intense reactions during the detox period. Others require medical detox when the person has a severe enough abuse problem.

Prescription Painkillers (Opioids)

Prescription painkillers cause both physical dependence and eventual addiction. Painkillers are a complicated drug because many people don’t realize how easily they can develop an addiction. These drugs interact with the body’s opioid receptors and can cause painful, life-threatening symptoms if not treated immediately.


Heroin is one of the most dangerous drugs available. Also in the opioid class, heroin causes intense physical and psychological reactions when a person quits using it. Heroin withdrawal feels intense regardless of how long the person used the drug. It’s a powerful substance that causes severe withdrawal symptoms as soon as a few hours after the last use.


Benzodiazepines are prescription medications used to treat anxiety disorders and sleep conditions. They affect the central nervous system and slow down brain and body function to relieve excessive worry and nervousness. Benzodiazepines cause intense withdrawal symptoms including panic attacks, difficulties sleeping, and possible risk of psychosis.


Not all methamphetamine users require medical detox. Those with a severe methamphetamine addiction may need the additional assistance of detox, though. The drug doesn’t cause as many physical withdrawal symptoms as opioids or benzodiazepines but does cause intense psychological reactions. Supervision during the withdrawal period can keep these clients safe.

How Long Does Medical Detox From Drugs Take

The length of time medical detox from drugs takes depends on a few different factors. Detox usually takes between a few days and a few weeks. Those with severe drug addiction will take longer to detox than those with a mild substance use problem. Other factors that affect the length of drug detox include:

  • Whether one or multiple substances were used
  • Type of substance or substances used
  • How long the person used drugs
  • The frequency with which they used drugs
  • The quantity of drugs the person used
  • Whether they tried quitting before
  • Possible underlying mental or physical illnesses
  • Overall health
  • Age
  • Gender

Opioid withdrawal symptoms can begin as soon as a few hours after the last use. Faster acting opioids like heroin can lead to quicker onset of symptoms. Acute opioid withdrawal symptoms last between 7 and 10 days but more mild symptoms can persist for 6 months or longer.

Benzodiazepine withdrawal symptoms start within the first 12 to 24 hours after the last use. Severe withdrawal symptoms last about a week and residual symptoms can persist from 10 up to 14 days.

Inpatient Medical Detox

Medical detoxification can be completed in both inpatient and outpatient settings. Inpatient detox services are a residential form of treatment where patients stay in the facility overnight. Outpatient detox allows patients to attend sessions during the daytime or evening hours and still live at home.

Some people seeking detoxification qualify for an outpatient program. These individuals don’t have an alcohol or drug problem that’s severe enough to warrant treatment in an inpatient medical facility. Their withdrawal symptoms are mild enough to manage on an outpatient basis.

The biggest drawback to outpatient detox is the higher risk of relapse. Patients are under supervision for only a few sessions per week and return home outside of those hours. They can also choose to skip their detox appointments which disrupt the process.

Inpatient medical detox is a far safer and more consistent option. Patients are under 24-hour medical supervision during their entire withdrawal process. This is a crucial component for people with severe alcohol and substance use disorders. Those at risk of serious reactions, such as seizures or delirium tremens, need to attend inpatient treatment.

Inpatient medical detox also removes the temptation to relapse. It removes patients from their everyday environment and places them in the middle of a recovery-focused facility. This decreases the chance of relapse and increases the likelihood of adhering to the program.

Medical Detox Facilities

Whether you attend an inpatient or outpatient medical detox facility depends on the person’s needs. Outpatient detox facilities do not offer 24-hour care. They’re similar to a day clinic where patients stop in briefly for their medication then continue with their day. These programs offer more flexibility to those who can’t commit to a full-time program.

Inpatient detox takes place in a supervised residential environment. Some inpatient detox programs are in a hospital setting that services patients with substance and alcohol use disorders.

There are also specialty treatment facilities that provide inpatient detox services as part of a comprehensive treatment program. They offer onsite detoxification overseen by medical practitioners and other clinicians. Once detox is complete patients transition into the next phase of treatment at the same site.

Medical Detox in Hawaii

Deciding where to attend treatment is another important decision. Some people can go to a treatment facility in their hometown with little to no trouble. They’ve decided to get clean and sober and feel comfortable enough doing so in their normal environment. They don’t feel the need to separate from possible temptations during their early recovery.

Medical Detox in Hawaii

Others prefer to attend a treatment facility further from their daily life. Early sobriety is already challenging enough without the added difficulty of staying away from substances in the same place the problem developed.

Going to treatment out of state is a great way to make sure recovery is the primary focus while in treatment. There is less temptation to leave detox early before the withdrawal symptoms subside. Detox facilities provide structure and support around the clock to keep patients safe and on course.

Attending a facility out of state in a beautiful location like Hawaii is another excellent way to go to treatment. Medical detox in Hawaii places patients in the center of a breathtaking, tranquil environment. They’re surrounded by a beautiful landscape in a place where people come to
relax and unwind. Rehab in Hawaii is unlike rehab anywhere else in the country.

How Much Does Medical Detox Cost?

The cost of medical detox is what keeps many people from seeking the help they need. Not all programs are the same price; some are more affordable than others. There are multiple options for treatment. Determining how much medical detox costs depends on a few factors:

  • Type of program
  • Length of treatment
  • Facility location
  • Available amenities
  • Whether any ongoing treatment is needed
  • Insurance coverage

The more intensive the medical detox the more it costs. Longer treatment programs also cost more. Medical detox is a vital part of the recovery process, though, so finding a way to attend treatment is often necessary.

Is Medical Detox Covered By Insurance?

Thankfully many programs for medical detox are covered by insurance. The Affordable Care Act requires private insurance plans to offer at least some coverage for substance and alcohol abuse treatment. The exact details of coverage depends on specific plans, policy coverage, and history of recovery attempts.

Some insurance companies require members to attend a facility that’s within their network. The best way to determine which drug rehab programs fall under insurance coverage is to reach out to an insurance company directly. They can provide a list of facilities and programs that are covered by a specific plan or level of coverage.

Do You Need Detox?

If you or a loved one need help, call Hawaii Island Recovery toll-free right now.