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Inpatient Drug and Alcohol Detox Guide

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Detoxification (“detox” for short) centers offer a safe, supportive place where you can go through withdrawal with as little discomfort and safety risk as possible.1,2 It is often the first step for treating substance use disorders. Detox centers are designed to manage the unpleasant, upsetting, and sometimes life-threatening symptoms that go along with withdrawal.2,4

Detox can happen in different types of settings with lower or higher levels of medical oversight. This article will help you learn about the different types of inpatient detox, which takes place in a residential or specialty care center, as well as what to expect during treatment and how to choose the best treatment type for your needs.

What is Inpatient Detox?

In 2019, 20.4 million people age 12 and older met the criteria for a substance use disorder.9 Research shows that addiction treatment can improve your health. Yet despite this potential for greater quality of life, only 1 in 10 people get substance abuse treatment.10

Fear about unpleasant withdrawal symptoms may keep some people from seeking treatment. But that is one area where inpatient detox and close medical care can make a difference.

When you first stop using drugs or alcohol, you may go through a number of mental and physical symptoms such as anxiety, drug cravings, depressed mood, trouble sleeping (or sleeping too much), stomach problems, muscle aches, or bone pains.1–3 This is known as withdrawal. The goal of any detox treatment is to help keep you safe through this process and reduce symptoms as much as possible.

At inpatient detox, you live at a treatment center while you go through detox. Treatment centers could be a hospital or other setting that is able to handle severe medical issues, or it could be a standalone center with less intense medical oversight. Staff is onsite around the clock to check your progress and ensure your safety.1,5 By contrast, outpatient detox lets you live at home and attend treatment appointments at a clinic or doctor’s office while still more or less following your daily routine.1

Detox can help clear your body of drugs and alcohol, but detox alone is rarely enough to kick a substance use disorder in the long term. This is because detox doesn’t address the underlying causes of addiction—issues that are important to face to stay substance-free.6–8 Whether you choose inpatient or outpatient detox, the staff will help you find and shift to post-detox treatment for a substance use disorder.

Some things to consider as you decide the best treatment setting for you include:1,3,5

  • Are you willing and able to follow a treatment plan? It can be hard to detox while living at home, where you may need to face everyday triggers—the people, places, and things that make you want to use drugs or alcohol. Inpatient detox offers a safe place away from these stressors with no access to drugs or alcohol.
  • Do you have any other mental health issues? Mental health disorders are common among people in detox, and inpatient substance abuse treatment centers are generally able to manage people who have both mental health and substance use disorders (this is called “co-occurring disorders”). Withdrawal may worsen existing symptoms of mental health disorders or cause new symptoms to emerge.
  • Do you have any medical problems? Existing medical issues may have an impact on how bad withdrawal is and may need extra oversight or specialized care. Heart issues, chronic pain, diabetes, and pregnancy are all medical concerns that may show a need for more intensive care levels that an acute care inpatient setting is more likely to be able to offer.
  • Have you gone through medically managed withdrawal before? If you’ve tried detox in the past and relapsed (started using again), you may benefit from a more intensive care level. If you’ve been to inpatient detox before, you will most likely need to return for more treatment after detox.
  • If you’ve gone through withdrawal in the past, how severe were your symptoms? Those who have had severe withdrawal symptoms are more likely to have them again. Severe symptoms can include withdrawal seizures and delirium (intense confusion). Inpatient detox may be a good idea to keep you as safe as possible.
  • What is your living environment like? Not everyone has supportive relationships at home, or even stable, safe housing. If you live in housing that is unstable, unsupportive, or even dangerous, inpatient detox may be a better choice.

What to Expect from Inpatient Detox

Inpatient detox centers differ in location, length, cost, and treatment. The main types are:1,10

  • Hospital or acute care center detox: In this setting, your care team will watch over you at all times. This type of detox offers a safe place for people with long-term or severe substance use, those at risk of severe withdrawal, those with severe mental health disorders or those with co-occurring medical problems that need close or specialized care.
  • Standalone medical detox programs: These programs offer 24-hour medical support and, when needed, treatment medicines to help manage withdrawal symptoms. You live at the detox center during detox, after which you may enter a 30-, 60-, or 90-day addiction treatment program. Many medical detox programs are able to handle medical issues and mental health problems, so they can be a good option for people with severe substance dependence and co-occurring disorders as well.
  • Detox at the start of residential treatment: Many drug abuse rehab centers have a detox wing or a detox phase at the start of residential substance use disorder treatment. In-house detox programs offer medical support during the detox period. When detox ends, you may be moved to a different area for long-term treatment that stresses peer and social support.
  • Peer support detox: Not all residential drug rehab programs offer medical detox. In some cases, these programs conduct what is known as social detox. This type of detox has less medical oversight and stresses peer and counselor support. Social detox also doesn’t often include any type of prescription medicine. These programs should have clear processes in place for medical emergencies and for seeking medical referral if needed.

When you first arrive in detox, you will go through a detailed assessment to answer questions about:1

  • substance use
  • physical and mental health history
  • treatment history
  • any social, legal, employment, or other issues you may have.

Your care team will use this information to help you make the best decisions about your care and form a treatment plan. They may also ask you to follow certain rules, such as no cell phones or computers, no weapons or violence, strict schedules, and other dress code and safety rules. Rules are generally designed to help keep you safe and reduce substance use triggers.
male doctor talks to patient about detox
A typical inpatient detox process for substance abuse lasts 3 to 5 days and is managed with medicines combined with vitamins, exercise, and sleep.10 How long detox lasts will depend on which substance(s) you used, how long you used, and the type and severity of withdrawal symptoms. Depending on these factors, doctors may also give you certain medicines to help ease any discomfort and control cravings.

Inpatient detox is the first step in a treatment journey.1,2 Staff can help you decide the next steps to take as you near the end of detox and refer you to other care as needed.1,2 This may include residential rehab or a step down to outpatient rehab, depending on your needs.2,7

24/7 Medical Care

A major benefit of inpatient detox is that medical staff are onsite to check your progress and ensure your safety.1,6 They can give prescription medicines, check your vital signs, assess your health, and offer other support as needed.1,6

After you finish detox, your care team may continue or shift your medicines to better support you while you are working on your recovery in treatment.

Choosing the Right Inpatient Detox Center

Which detox center you choose depends on a number of factors. Think about your unique needs and goals for treatment as well as:

  • Location: You may want to be near your family or workplace, or you may want to travel to a vacation-like setting (for example, the beach or countryside) where you can continue long-term treatment away from everyday triggers that can make recovery harder.
  • Special populations: You may feel more comfortable in a program that tailors its care to specific populations, such as women, LGBTQ, veterans, executives, or certain faiths or cultures.
  • The drug(s): Some detox programs may be specific to certain substances. For instance, some detox centers may have more knowledge of or be better able to manage alcohol detox than opioid detox and vice versa.
  • The long-term plan: Many detox centers are located within a larger treatment center. Transferring to long-term treatment after detox can greatly improve your chance of long-term recovery.
  • The treatments: Some centers offer medicines, 24-hour medical care, social support, counseling, behavioral health therapies, and holistic health treatment therapies. Choose one that best fits your specific needs and wants.
  • Insurance: Cost is often a major factor in choosing any type of medical treatment. Many drug treatment centers take insurance, including private insurance and Medicaid. Call your insurance company to find out what they will and won’t cover.
  • Out-of-pocket cost: If you don’t have insurance or your plan only covers part of the cost, then it’s important to find out what you will owe and learn about any payment options an inpatient program offers, such as sliding scales or payment plans.
  • Extra costs: Different inpatient centers offer different amenities, some of which charge extra for room and board, food, or other amenities. Also, consider travel costs for you and your family if the center isn’t local.

Finding Inpatient Detox

American Addiction Centers offers complete treatment for substance use and co-occurring disorders. We have treatment centers across the country to help you detox safely and then transition seamlessly into inpatient or outpatient rehab. For more information about how we can help you detox, call our confidential detox helpline at 1-888-509-8965 Who Answers? .


Sources

  1. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and substance abuse treatment.
  2. National Institute on Drug Abuse. (2018). Principles of drug abuse treatment: A research-based guide (Third edition).
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  4. National Institute on Drug Abuse. (2019). Step by step guides to finding treatment for drug use disorders.
  5. American Society of Addiction Medicine. (2020). The ASAM clinical practice guideline on alcohol withdrawal management.
  6. Zhu, H., & Wu, L.T. (2018). National trends and characteristics of inpatient detoxification for drug use disorders in the United States. BMC Public Health, 18(1073).
  7. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction.
  8. National Institute on Drug Abuse. (2013). Seeking drug abuse treatment: Know what to ask.
  9. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 national survey on drug use and health.
  10. U.S. Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Facing addiction in America: The surgeon general’s report on alcohol, drugs, and health.

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