Detox is the body’s first step toward balance, but it can also be physically demanding. Some people develop only mild symptoms, while others face intense withdrawal that becomes dangerous within hours. Medical detox provides round-the-clock care so participants can rest, stay stable, and receive medication when needed.
Seizures, hallucinations, chest pain, or thoughts of self-harm are all warning signs that require immediate medical attention. People with heavy dependence, co-occurring mental health conditions, or those who are pregnant should not attempt to detox at home. In a supervised setting, care teams monitor vital signs, manage discomfort, and intervene quickly if complications arise.
Inpatient detox is especially recommended for people with a long history of substance use, those at risk of severe withdrawal from alcohol or benzodiazepines, or anyone with complex medical or psychiatric needs. With the right care, detox offers many benefits for a safe and supported beginning to recovery.
How long does detox take?
The length of detox depends on the substance used and each person’s health, but most people experience withdrawal for 3–10 days.
- Alcohol: 3–7 days
- Opioids: 4–10 days (longer for methadone or fentanyl)
- Benzodiazepines: Several weeks to months
- Stimulants: 1–3 weeks
Medical detox helps manage these timelines safely through supervision, medication, and support.
Detox vs. withdrawal: What’s the difference?
Withdrawal refers to the body’s reaction when substance use stops. It can cause a wide range of symptoms, from anxiety and restlessness to tremors and nausea.
Detox is the medical process of stabilizing someone through withdrawal. It focuses on safety, symptom management, and preparing participants for continued treatment. At New Bridge Foundation® in Berkeley, detox is part of a full continuum of care that includes residential rehab and a flexible intensive outpatient program (IOP). These programs help participants build coping skills, strengthen recovery strategies, and stay connected after detox ends.
Call New Bridge Foundation® today at 866.772.8491 or reach out online to check medical detox availability and verify your insurance benefits.
Alcohol detox timeline
Onset, peak, duration
Alcohol withdrawal usually starts 6–12 hours after the last drink. Symptoms reach their peak between 24–72 hours and generally resolve within 3–7 days.
- Stage 1 (6–12 hours): Tremors, anxiety, nausea, restlessness.
- Stage 2 (12–48 hours): Elevated heart rate, sweating, confusion, mild hallucinations.
- Stage 3 (48–96+ hours): Delirium tremens, seizures, severe disorientation.
Symptoms and risks
Withdrawal from alcohol can stress every system in the body. Rapid pulse, dehydration, and agitation are common. In severe cases, seizures and delirium tremens can occur. Without medical care, these symptoms can be life-threatening.
Monitoring and medications
At New Bridge Foundation®, clinicians use the CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol) to track symptoms and guide care. Benzodiazepines are typically used to prevent complications and support stabilization. The ASAM Clinical Guidelines recommend medical supervision for alcohol withdrawal to prevent severe complications, including delirium tremens.
After detox
Once medically stable, participants are encouraged to move into residential rehab or IOP within a few days. Continuing care after detox helps prevent relapse and strengthens the foundation for long-term recovery. Learn more about alcohol withdrawal from the NIAAA Core Resource on Alcohol Use Disorder.
Opioid withdrawal timeline
Short-acting opioids (heroin, oxycodone)
Withdrawal starts 8–24 hours after the last dose, peaks at 48–72 hours, and typically lasts 4–10 days. While not life-threatening, symptoms can be intense and emotionally draining.
Long-acting opioids (methadone, ER formulations) and fentanyl notes
For long-acting opioids, symptoms begin later—24–48 hours after last use—and can last 10–20 days. Fentanyl withdrawal can be more severe and drawn out because the drug lingers in fatty tissue, leading to prolonged discomfort. The NIDA opioid resource explains that fentanyl’s potency and persistence make medical detox especially important for safety and comfort.
Symptoms and care
Common symptoms include muscle and joint pain, chills, gastrointestinal distress, and insomnia. Emotional symptoms like anxiety and depression are also frequent.
Medications and induction
Withdrawal is managed using COWS-guided (Clinical Opiate Withdrawal Scale) buprenorphine induction, which helps ease symptoms and reduce cravings. Supportive medications such as clonidine, lofexidine, and antiemetics can also be used for comfort.
When inpatient makes sense
Inpatient detox is often recommended when someone is using multiple substances, is pregnant, or has complex medical or psychiatric needs.
Benzodiazepine withdrawal timeline
Short vs. long-acting agents
Withdrawal begins 1–3 days after the last dose and peaks within 7–14 days, though symptoms from long-acting agents can persist for weeks to months.
Risks and tapering
Stopping benzodiazepines abruptly can lead to seizures, panic attacks, or severe anxiety. Medical teams typically use a cross-taper approach—gradually reducing the dose under supervision—to keep participants safe and comfortable.
Monitoring and setting
Because of seizure risk, most people benefit from inpatient or closely supervised detox. The ASAM Clinical Guidelines and APA practice recommendations both advise tapering under clinical care to minimize withdrawal risks.
Stimulant withdrawal timeline (methamphetamine and cocaine)
Phases
Withdrawal unfolds in three broad phases:
- Crash (24–72 hours): Fatigue, increased sleep, low mood.
- Withdrawal (1–2 weeks): Irritability, anxiety, strong cravings.
- Extinction (weeks to months): Gradual improvement but lingering anhedonia and cravings.
Symptoms and risks
Depression, insomnia, and loss of motivation are common. Some people experience suicidal thoughts, especially in the early crash phase, making monitoring essential.
Care approach
There are no specific detox medications for stimulants, so care focuses on supportive measures—rest, hydration, balanced nutrition, and sleep hygiene. Ongoing mood monitoring and contingency management (reward-based behavioral support) are key parts of recovery.
Post-acute withdrawal syndrome (PAWS)
Even after acute detox ends, some symptoms can linger. This is called post-acute withdrawal syndrome (PAWS).
- Alcohol and opioids: Mild symptoms may persist for several weeks.
- Benzodiazepines: Fluctuating anxiety and sleep issues can last for months or longer.
- Stimulants: Mood swings and fatigue may continue for several weeks.
Counseling, medication support, and consistent follow-up can manage PAWS and reduce relapse risk.
At-home detox risks and when to call 911
Detoxing without medical supervision can be dangerous. Severe vomiting, chest pain, confusion, hallucinations, or seizures require emergency care. Call 911 immediately if these occur.
For anyone considering detox at home, it’s safer to first contact a professional detox program or use the SAMHSA treatment locator for local options.
What happens after detox
The hours and days following detox are crucial. Once participants are stable, they typically move into residential rehab. These programs continue medication management, introduce counseling, and involve family support to strengthen recovery.
At New Bridge Foundation®, participants transition directly into ongoing care to maintain momentum. This seamless handoff helps prevent relapse and builds lasting stability.
A connected path forward
Detox is the starting point of recovery. At New Bridge Foundation®, participants move directly into structured counseling and long-term support that strengthens both body and mind.
Voted one of America’s “Best Addiction Treatment Centers” by Newsweek six years in a row, New Bridge Foundation® provides compassionate, evidence-based care that helps people start fresh and stay supported every step of the way.
If someone you love is ready to begin healing, call New Bridge Foundation® today to take the first step toward recovery.
FAQs
It depends on the substance. Alcohol detox usually lasts 3–7 days, opioids 4–10 days, benzodiazepines several weeks, and stimulants about 1–3 weeks.
Symptoms usually peak between days two and three for most substances, though longer-acting drugs can peak later.
Yes. Detox clears the body of substances and prepares participants for counseling and continued treatment. Then, you can move on to long-term or short-term residential rehab.
Most people take time off to complete detox safely. Afterward, flexible options like IOP can support recovery while returning to work or school.
Yes. Severe alcohol withdrawal can cause seizures or delirium tremens, which require immediate medical attention.
These methods carry risks and are not recommended by most medical professionals. Gradual, supervised detox is safer and more effective.
Buprenorphine (Suboxone) is typically started once mild withdrawal symptoms appear, guided by a COWS assessment.
PAWS can last weeks to months depending on the substance and individual factors. Ongoing therapy and medication support help manage it.
Only mild cases with medical clearance might be suitable for at-home detox. Most people are safer in a monitored program.
Relapse can be dangerous because tolerance drops quickly. Medical staff can help stabilize participants and adjust the care plan safely.
