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Medically-Supervised Drug And Alcohol Detox Programs

Dr. Anna Pickering

Medically reviewed by

Dr. Anna Pickering

April 2, 2019

Drug and alcohol detoxification, commonly called detox, is often the first part of a comprehensive treatment program for those in addiction recovery. Detox can be an uncomfortable and even dangerous process, so it’s best completed under medical supervision.

Detox is the process that allows your body to get rid of harmful toxins gained during substance abuse. For those dependent on a substance, they’ll likely undergo some taxing withdrawal symptoms.

That’s why medically-supervised drug and alcohol detox programs tend to be the best choice for people in need of detoxification. In these programs, you’ll receive the care you need to successfully complete detox so you can move on to the rest of your treatment program.

What Happens In Medically-Supervised Drug And Alcohol Detox Programs?

Before heading to drug or alcohol rehab, it’s important to understand a few facts. First, detox alone isn’t treatment. It’s simply a necessary step before treatment for some addicted or drug-dependent individuals.

Detox from some substances is simply uncomfortable while quitting use of others can cause withdrawal symptoms that can be severe to life-threatening. For example, detox from alcohol or benzodiazepines should never be attempted alone.

The detoxification process will vary from person to person. A typical detox period will last from seven to 10 days. However, some people may be in detox for as little as five days, or as long as a couple weeks. The length of time you’ll spend there depends on how your body handles the process.

During this time, you may experience withdrawal symptoms. Medication can be administered for some, and helps ease pain or discomfort, or may even help you taper off use of the drugs.

The entire time you’re in detox, you’ll be monitored for safe heart rate, breathing level, and other vital functions. Once you rid your body of the harsh chemicals from substance abuse, and overcome the worst part of withdrawal, you can enter the formal part of your treatment program and begin to heal.

The following are ways medically-supervised drug and alcohol detox programs can help you overcome addiction and dependence:

  • Reducing severity of withdrawal symptoms, such as cravings and urges
  • Easing pain or discomfort, sometimes with use of medication
  • Ensure safety and health during detoxification with round-the-clock medical care
  • Assess, identify, and treat other physical symptoms during detox, such as vitamin deficiencies

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Medically-Supervised Detox For Alcohol

Unaided withdrawal from alcohol can be life-threatening. Put simply, alcohol withdrawal symptoms can be painful, uncomfortable, and dangerous.

For those struggling with prolonged alcoholism (also called alcohol use disorder), they may undergo phases of withdrawal. The first phase may begin a few hours after the last drink, and include nausea, vomiting, sweating, and even abdominal pain. The second phase gets more severe, with increased blood pressure, body temperature, heart rate, and increasing confusion.

In the third and final phase of alcohol withdrawal, you may experience a condition called delirium tremens. While not everyone will experience delirium tremens, it is perhaps the most dangerous part of alcohol detoxification. People undergoing delirium tremens may experience high fever, hallucinations, extreme agitation, and seizures.

Despite the severity of these symptoms, with successfully completed detox and medical supervision, most tend to go away in roughly a week. While undergoing detox, you’ll be carefully assessed for all aspects of health to ensure the best chance at recovery success. A thorough clinical assessment is key for comprehensive healing.

If it’s discovered, for example, that you’re struggling with depression or anxiety, you and your clinician can find ways to treat these issues. Many people struggling with alcoholism have a deficiency in vitamin b1 (thiamine), and in detox this issue can be identified and properly addressed. To help with your comfort level, you may receive medication if you need it.

Finally, detox in a medically-supervised setting is extremely important for the safety aspect of it. If you’ve never had to detox from alcohol before, you may be unaware of the danger and risks of trying to complete this process on your own. Detox requires not only dedication and due diligence, but also medical care for when your body reaches its physical limits.

Medically-Supervised Detox For Benzodiazepines

Benzodiazepines are “among the most commonly prescribed depressant medications in the United States,” according to the Center For Substance Abuse Research (CESAR). The high prescription rate contributes to numbers of abuse, especially since the drugs are highly addictive.

Some of the most commonly abused benzodiazepine prescriptions in the United States include Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam), Restoril (temazepam) and Valium (diazepam).

Detox from benzodiazepines (benzos) should be taken as seriously as detox from alcohol, as both can cause life-threatening withdrawal symptoms. People who have developed tolerance, or no longer feel the effects of benzos and take higher, more frequent doses are at increased risk for severe symptoms.

Withdrawal symptoms for benzos can affect both mind and body, and can range in severity from moderate to extreme.

Mental/psychological symptoms:

  • Confusion
  • Depression
  • Hallucinations
  • Headaches
  • Irritability
  • Memory loss
  • Panic attacks
  • Psychosis

Physical symptoms:

  • Body aches
  • Digestive issues
  • Extreme abdominal cramps
  • Feelings of numbness or tingling
  • Dizziness
  • Increased blood pressure/heart rate
  • Insomnia/sleep troubles
  • Muscle pain
  • Nausea, diarrhea, or vomiting
  • Vision impairment
  • Sensitivity to light and sound
  • Seizures
  • Speech troubles
  • Sweating
  • Tremors
  • Vertigo/balance issues

Because benzodiazepines are most commonly prescribed to treat anxiety and insomnia, when people quit use of them they may experience these conditions again. This is called the “rebound effect,” and with close medical monitoring, it can be managed.

Death from benzodiazepine withdrawal is rare, but has happened. Benzodiazepines are especially dangerous when mixed with other drugs of abuse, like alcohol or opioids, and this is a common way to abuse benzos. That’s why it’s always a good idea to undergo detox from benzos in a safe, medically-supervised environment.

Stopping use of benzodiazepines may seem daunting. Yet in addiction recovery, you can overcome your dependence on the drugs, conquer addiction, learn ways to manage behaviors that foster addiction, and address and treat co-occurring disorders (such as mental health conditions like anxiety or insomnia).

Medically-Supervised Detox For Heroin

More than half a million people in the United States had a substance use disorder involving heroin in 2015, according to the American Society Of Addiction Medicine (ASAM). Heroin withdrawal symptoms are not dangerous in nature, and range from moderate to extremely uncomfortable.

Heroin withdrawal symptoms can include:

  • Aggression
  • Anxiety or depression
  • Cold flashes and/or fever
  • Diarrhea and vomiting or stomach cramps
  • Extreme cravings
  • Increased heart rate or blood pressure
  • Insomnia
  • Lack of concentration
  • Leg tremors
  • Mood swings
  • Muscle and bone pain
  • Pupil dilation
  • Restlessness and irritability
  • Runny nose
  • Tearing
  • Uncontrollable yawning

Symptoms can begin as early as a few hours after the last use, tend to peak between one and three days after last use, and may abate within a week.

However, heroin is highly addictive, and withdrawal symptoms can last for months or even years, depending on duration of abuse. While heroin withdrawal may not cause seizures or other dangerous effects, the long-term effects can become a detriment to your life and your health.

The National Institute On Drug Abuse (NIDA) explains, “repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed.”

Part of these changes include aligning your brain with the powerful cravings that keep you going back to heroin again and again. Because of this, you may find it difficult to detox from heroin on your own. In medically-supervised detox programs, you’ll find the support, structure, and medical care you need to quit heroin and manage addiction.

Medically-Supervised Detox For Opioids

Drug overdoses are now the leading cause of death in Americans under 50, with prescription drugs leading this epidemic, as reported by CBS News. The ASAM states, “in 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills.”

Unfortunately, opioids are some of the most addictive, and most potent and powerful, drugs on the market and on the streets. Some opioids, like a popular new drug called Gray Death, can be fatal with just one dose. Others are harmful even to the touch.

Some commonly abused opioids in the United States include Rolatuss (codeine), Actiq (fentanyl), Vicodin (hydrocodone), Dilaudid (hydromorphone), Demerol (meperidine), Dolophine (methadone), Duramorph (morphine), OxyContin (oxycodone), Opana (oxymorphone), heroin, and various synthetic opioid combinations, such as Gray Death.

Opioid withdrawal symptoms will vary from person to person, but may include:

  • Agitation or anxiety
  • Fever and/or chills
  • Hot and/or cold flashes
  • Increase in blood pressure and/or heart rate
  • Loss of appetite
  • Nausea, vomiting, and stomach cramps
  • Pupil dilation
  • Restlessness, insomnia, or sleep troubles
  • Runny nose and watery eyes
  • Sweating, yawning
  • Tremors, muscle and bone pain, body ache

Duration of opioid withdrawal may be affected by several factors, including duration of abuse, opioid of abuse, and frequency and severity of abuse.

Like heroin (also an opioid), the danger of continuing to abuse opioids is that tolerance can keep you taking the drug and increases your risk of overdose. Before reaching this point, your best chance at stopping use of opioids and overcoming addiction is entering a medically-supervised detox program.

You may require medication during detox from opioids due to the highly addictive properties within the drugs. Buprenorphine treatment (Suboxone, Subutex, Zubsolv) has proven to help those in opioid addiction recovery taper off use of the drugs while remaining comfortable enough to succeed in treatment.

Suboxone is a partial agonist opioid medication. It works by producing effects that are similar to the opioid of abuse, but far less intense. This helps those in detox to remain comfortable, while giving the brain enough of the drug to keep body functions such as heart rate and breathing at safe levels. Opioids often slow breathing and heart rates, and with increased abuse, overdose risk mounts quickly.

Opioid withdrawal is not in itself always dangerous, but several complications can arise during detox from opioids. Aspiration, which can cause asphyxiation, extreme dehydration due to vomiting and diarrhea, and suicidal thoughts fostered by the depression or anxiety that can accompany withdrawal are just a few of these complications.

Enrolling in a medically-supervised opioid detox program will help you lessen risk of overdose or health complications and increase your chances of addiction recovery success.

Psychological Addiction Vs. Physical Dependence

How do you know if you will need medically-supervised detox? Understanding the difference between psychological addiction and physical dependence is a good start.

There is no set standard for who will need medically-supervised detox and who won’t. Many people who have formed a physical dependence on a substance, and have abused that substance for some time, will need detox.

Physical dependence, or dependence, is a physical manifestation of your body’s reliance on a substance. Alcohol, barbiturates, benzodiazepines, heroin, and opioids may all cause a physical dependence that may require medically-supervised detox.

Psychological addiction, or simply addiction, is your mind’s reliance on a substance. Dependence occurs because your body undergoes physical changes in response to a drug that make you dependent on it. Addiction occurs because your brain undergoes chemical changes during substance abuse, or during addictive activities, that keep you going back to the addictive behavior.

Both dependence and addiction can have physical consequences. For dependence, those symptoms are known as withdrawal. For addiction, these symptoms are not withdrawal, but occur when your body begins producing physical consequences because you aren’t giving it what it craves. Examples of these symptoms include headache and sleep troubles.

Perhaps the most confusing part about the difference between addiction and dependence is that they can occur together and separately, but you won’t necessarily have both if you have one. If you’ve formed a dependence to a highly addictive drug, like heroin, it’s likely you’ll develop addiction to it simply because the dependence will keep you abusing it long enough for addiction to occur. You can develop addiction to drugs which don’t cause dependence, or even to addictive activities, like gambling.

While you may not need medically-supervised detox for drugs that foster only addiction, like cocaine or ecstasy, you may still need help to overcome a mental addiction to the drugs. In the end, the most important outcome is that you have help to overcome your addiction or dependence issues. Each can lead to a myriad of health consequences when left unchecked.

Find Medically-Supervised Detox That’s Right For You

If you or someone you know is struggling with addiction, dependence, or both, medically-supervised detox may be exactly what you need. At, we can direct you to resources, help you find a rehab center that best fit your needs, and design a custom, individualized treatment program that works for you.

CBS News - Overdoses Now Leading Cause Of Death In Americans Under 50

National Institutes Of Health - Opioids And Chronic Pain

Psychology Today- - Medically Supervised Alcohol Detox Aids Alcoholism Recovery -

U.S. National Library Of Medicine - Alcohol Withdrawal

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