How Much Does Detox Cost?

Formal detox treatment is a critical first step of the recovery process. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines detox as “a set of interventions aimed at managing acute intoxication and withdrawal.”¹ Furthermore, detox allows the body to eliminate the toxins associated with alcohol or drug abuse.¹

Acute withdrawal can be both physically and emotionally distressing. Symptoms may range from uncomfortable to incredibly painful. For certain substances, like alcohol and benzodiazepines, certain withdrawal effects can also be life-threatening if left unmanaged.¹ Since a formal detox program provides an environment in which a treatment team can safely monitor withdrawal progress and manage any complications to arise, it’s often the most recommended course of action.

Detox can take place in a variety of settings depending on the person’s addiction severity and the substances they abused. There are many programs available, and each one will have different requirements and fees. While detox alone does not replace comprehensive addiction treatment, it is often the first step on the journey towards sustained recovery.

What Types of Programs Are Available?

There are several different types of detox programs available. A medical and psychosocial assessment from a doctor or addiction professional will help determine the appropriate level of care for each potential patient.

• Outpatient Detox: Considered the least-restrictive level of care, outpatient detox can occur within a physician’s office, freestanding treatment facility, day hospital program, or home health organization.^1,2 Outpatient detox typically ranges from a few days to a couple weeks. It may be recommended for patients with mild-to-moderate substance use disorders. Those attending outpatient detox typically live at home outside of treatment hours and are able to continue working, attending school, and participating in other daily activities.² 
• Non-Medical/Social Residential Detox: This level of care utilizes social and peer support for assisting patients with detox. These detoxes do not typically employ medical practices or prescribed medication to mitigate withdrawal symptoms.¹ 
• Medically Monitored Inpatient Detox: This level of care usually takes place at a detox center or as part of a substance abuse program. It provides 24/7 medical supervision and monitoring for its patients. Many patients receive medication to manage withdrawal symptoms and reduce cravings.¹ When given a choice between social or medical detox, patients struggling with an addiction to alcohol, sedatives, or opioids should consider medical facilities for the emphasis on safety, monitoring, and medical well-being.
• Executive Detox Centers: With services aimed at executives, celebrities, or people with high-powered careers, executive detox centers offer upscale amenities and flexible environments to its patients. These may include access to computers, phones, exercise equipment, gourmet meals, and private rooms.
• Luxury Detox Centers: Luxury detox programs often more closely resemble the environment of resorts and may offer exclusive amenities like spa treatments, massage therapy, personal trainers, golf, pools, and gourmet meals. Patients may receive holistic treatments such as yoga, acupuncture, and equine therapy. As these facilities typically cost more than other forms of inpatient or outpatient detox, they are typically marketed towards more affluent populations.

The price of detox depends on several factors including:^2,3

• Type of program chosen.
• Program location.
• Length of time receiving services.
• Insurance coverage and deductibles.

The Price of Withdrawal Treatment

There is no one singular cost of detox; different programs have different prices. While research lacks exact figures on the average price of detox, fees typically range anywhere between $600–$1,000 per day, for a minimum of a 7-day detox program.⁸ This means the total may range from about $4,000 to $7,000.⁸ With that said, these costs may be offset by government assistance or health insurance.

Inpatient detox is typically more expensive than outpatient detox due to the room and board costs and 24/7 monitoring.² Moreover, medical detox typically costs more than social detox models due to the utilization of medications. Executive and luxury facilities represent the most expensive detox options due to the exclusive perks and upscale amenities offered to its patients.

The amount of time spent in detox impacts the price, as longer programs will cost more than shorter ones. The duration of time spent in detox depends on numerous factors including:¹ 

• Type of substances used.
• Average amount of substance used.
• Concurrent use of other substances.
• Age.
• The individual’s physiology.
• Mental and physical health.
• Presence of co-occurring disorders.

Furthermore, each substance has different withdrawal timelines, which will impact the duration of detoxification. Consider the following commonly abused substances:

• Alcohol: The signs and symptoms of acute alcohol withdrawal can start 6–24 hours after the patient has their last drink. More severe symptoms, such as hallucinations, will occur within 12–24 hours after the last drink, and they can last up to a week.^1,3,4 The course of these symptoms tends to be quite varied, as some will progress through the symptoms quickly and without serious effects, and others will experience severe complications, such as grand mal seizures or delirium tremens. 
• Heroin and prescription opioids: Heroin withdrawal typically begins 8–12 hours after the last heroin dose, peaks within the first 1–2 days, and subsides within 3–5 days.^1,5 Prescription opioid withdrawal timelines vary depending on whether or not they are short-acting or long-acting. For shorter-acting, symptoms can emerge within 8–12 hours (similar to heroin). For longer-acting drugs, they may appear between 1–3 days.⁵ 
• Cocaine: Cocaine withdrawal typically starts with a “crash,” which occurs several hours to a couple days after the last dose. The acute withdrawal symptoms will last about 1–2 weeks and fade over time.^1,5,9 
• Benzodiazepines: Benzodiazepine withdrawal is influenced by the half-life of each drug. For shorter-acting substances, such as Xanax, withdrawal symptoms arrive within 10–12 hours. The symptoms may feel more intense initially, but gradually decrease. With longer-acting benzodiazepines, like Valium, it may take 1–3 days for symptoms to appear. Even though the symptoms may not be as intense, they tend to last longer, and may elongate the withdrawal process.^1,5. 
• Prescription stimulants: Stimulant withdrawal typically begins with an immediate “crash,” that can happen within 12–24 hours after the last use and last for up to 1 week.⁵ 
• Marijuana: Marijuana withdrawal symptoms can occur 1–3 days after last use, and the symptoms will peak within the first week and fade within 2 weeks.⁵

These timelines are a general guideline; everyone’s timeline will be affected by their own individual differences. On top of this, the detox duration will depend on whether the program implements medication into the process. For certain types of drug detox, medications are extremely beneficial, because they can alleviate unpleasant and potentially fatal withdrawal symptoms, reduce drug cravings, and minimize the risk of medical complications. With that said, patients may need to be gradually tapered from the treatment medication itself, which could in turn extend their detox length.

Detox Medications

Because drug detox can be so distressing and uncomfortable, medication can ease these symptoms and reduce cravings. Medications are approved for the management of withdrawal from opioids and alcohol, although supportive medications, such as antidepressants, may be used for other substances or to treat co-occurring psychiatric conditions, if applicable.

Methadone: Methadone is a long-acting opioid agonist that displaces opioids of abuse, like heroin, at the receptor sites in the brain, and essentially reverses withdrawal symptoms.¹ Methadone may be part of an individual’s detox process, and it may also be used in the longer-term as a form of medication-assisted treatment (MAT), as it can reduce opioid cravings and help avoid relapse as part of maintenance therapy. While prices of methadone vary and published information remains scant for estimating averages, one study by the Drug Alcohol Dependence journal found that methadone maintenance cost approximately $1,764 annually.⁶

Buprenorphine (Suboxone): Buprenorphine is a partial opioid agonist that has been approved for detoxification purposes. In order to avoid diversion and abuse, a combination medication, known as Suboxone, is also used to treat opioid dependence. The formula contains buprenorphine and naloxone, which is an opioid antagonist. Like methadone, Suboxone can also be used for MAT. Unlike methadone, which must be dispensed at a specific treatment facility, buprenorphine can be dispensed at a physician’s office.¹ Research has found that buprenorphine can cost up to 10 times more than methadone, and many physicians even reported that costs were a major challenge for providing this form of treatment.⁶

Benzodiazepines: For alcohol withdrawal, patients are likely to receive benzodiazepines, which can lower the risk of severe withdrawal developments such as seizures and agitation. According to SAMHSA, benzodiazepines remain the medication class of choice for treating alcohol withdrawal.¹ Common benzodiazepines used include Librium, Valium, Ativan, and Serax.¹

Relapse prevention medications: Relapse prevention agents, such as naltrexone and acamprosate, may also be used during late alcohol withdrawal treatment, although they are not suitable for acute detox purposes. These medications can help reduce the probability of drinking during later stages of detox treatment and help to improve patient retention. Generic naltrexone costs an average of $132 per month and acamprosate costs about $125 per month.¹⁰

It is important to discuss your medication payment options with your insurance company and/or detox center.

Using Your Insurance to Pay

If you have health insurance, your plan should cover some or all of your detox services. The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires that insurance companies cover behavioral health services, such as substance abuse treatment, to the same extent that they do medical services. The Affordable Care Act (ACA) expanded upon the MHPAEA, enabling plans offered on the Health Insurance Marketplace to cover addiction treatment services as well.¹¹ This policy has made detox and addiction treatment services more readily accessible and affordable to those who need it.

You should always call your insurance company to determine the limits and eligibilities offered by your individual plan. Some detox treatment centers will accept Medicare or Medicaid plans.⁷ When searching for a detox program, you’ll want to do your research and ask the various programs what insurance plans they accept.

If you don’t have health insurance, you can purchase a plan on the Health Insurance Marketplace, where there are affordable plans that cover pre-existing conditions, such as a substance use disorder. This means that you can still purchase an insurance plan after realizing you may need professional addiction help.

Alternative Ways to Finance Detox

If you don’t have insurance, there are other ways to pay for your detox treatment.

• Sliding scale: Many programs will offer a sliding scale fee, which means they adjust the costs according to your income level.
• Payment plan: Some detox programs may allow you to pay for your treatment in affordable installments.
• Credit card: Credit cards that offer higher limits can allow you to pay for detox or treatment now, even if you don’t have the money on hand. Just be cautious of high interest rates and set a budget to pay back your debt accordingly.
• Healthcare credit card: Specialized credit cards focus on assisting people specifically with managing the cost of healthcare, even for those who may have a poor credit history. These do tend to have higher interest rates than ordinary credit cards, so it’s essential to prioritize paying these bills as quickly as possible.
• Specialized healthcare loans: Some financial institutions, such as Prosper Healthcare Lending and My Treatment Center, offer loans that cover healthcare costs.
• Personal loans: You can take out a personal loan to cover your detox costs and pay it back over time. Shop around for the lowest interest rate.
• Crowdfunding: Crowdfunding websites, such as GoFundMe and IndieGoGo, make it easy for friends, family, and kind strangers to contribute to your treatment fund.
• Other accounts: You may be able to tap into your savings account, retirement funds, or home equity in order to afford detox treatment.

Although exploring detox options and entering treatment may feel overwhelming, nothing is more important than your sobriety. Recovery is possible. Don’t let anything stand in the way of getting the proper care and help you deserve.

Sources

1. Substance Abuse and Mental Health Services Administration. (2006). Quick Guide for Clinicians- Detoxification and Substance Abuse Treatment.
2. Hayashida, M. An Overview of Outpatient and Inpatient Detoxification. Alcohol Health & Research World.
3. Substance Abuse and Mental Health Services Administration. (2008). Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis.
4. Bayard, M., Mcintyre, J., Hill, K., Woodside, J. Alcohol Withdrawal Syndrome. American Family Physician, 69 (6), 1443-1450.
5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
6. Jones, E. S., Moore, B. A., Sindelar, J. L., O’Connor, P. G., Schottenfeld, R. S., & Fiellin, D. A. (2009). Cost Analysis of Clinic and Office-based Treatment of Opioid Dependence: Results with Methadone and Buprenorphine in Clinically Stable Patients. Drug and Alcohol Dependence, 99(1-3), 132–140.
7. Department of Health and Human Services. (2016). Medicare Coverage of Substance Abuse Services.
8. American Addiction Centers. (2017).
9. Australian Government Department of Health. (2004). The Cocaine Withdrawal Syndrome.
10. Hunter, K. & Ochoa, R. (2006). Acamprosate (Campral) for Treatment of Alcoholism. American Family Physician, 74(4), 645-646.
11. Substance Abuse and Mental Health Services Administration. (2017). Implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA).