Medical detox
Detox is where recovery starts for many people: a few days of 24/7 medical care that make withdrawal safe and far less miserable. Here’s who needs it, what happens and what comes next.
- Free and confidential
- Answered 24/7
- Insurance checked free
Updated October 2026
Medical detox, or medically managed withdrawal, is short-term care that helps your body clear alcohol or drugs safely. Doctors and nurses watch your vital signs, treat symptoms with medication and step in fast if something goes wrong.
Who needs medical detox
Withdrawal from some substances can be dangerous; from others it’s mainly uncomfortable. Detox is strongly recommended if:
- You drink heavily every day, or have had withdrawal seizures or delirium tremens (DTs) before
- You take benzodiazepines (Xanax, Klonopin, Valium, Ativan) daily
- You use opioids and feel sick without them, especially if you want to start buprenorphine or methadone
- You use more than one substance, or have serious medical or psychiatric conditions
Cocaine, meth and cannabis don’t usually cause dangerous physical withdrawal, though some people still need a safe, supervised place for the first days.
How long withdrawal lasts
| Substance | Symptoms start | Worst | Mostly over | Main risk |
|---|---|---|---|---|
| Alcohol | 6–24 hours | Days 1–3 | 5–7 days | Seizures, delirium tremens |
| Benzodiazepines | 1–7 days | Weeks 1–2 | Weeks to months, with a taper | Seizures |
| Heroin & fentanyl | 8–24 hours | Days 1–3 | About a week | Dehydration; overdose if you relapse |
| Methadone | 1–2 days | Days 3–8 | 2–3 weeks | Long, hard withdrawal; relapse |
| Cocaine & meth | Hours | Days 1–3 | 1–2 weeks | Depression, suicidal thoughts |
Don’t wait to see if it passes. These are medical emergencies.
What happens in detox
- AssessmentA nurse and doctor review what you use, your health, medications and any past withdrawal.
- Medication and monitoringStaff score symptoms with standard scales (CIWA for alcohol, COWS for opioids) and dose medication to match.
- Rest and recoveryFluids, food, sleep and check-ins. Counselors start talking with you about what comes next.
- A plan for the next stepA warm handoff to residential, PHP, IOP or outpatient care, plus medication if it’s part of your plan.
Medications vary by substance. For alcohol and benzodiazepines, long-acting benzodiazepines or other medications prevent seizures and ease symptoms. For opioids, buprenorphine or methadone relieve withdrawal and can continue long term.
Inpatient or outpatient detox?
Inpatient detox, in a hospital or a dedicated detox unit, is the safest choice when withdrawal could be severe. For milder cases, some people detox as outpatients with daily check-ins and medication. A clinician should make that call with you, not a website.
Detox isn’t the finish line
Detox treats withdrawal; it doesn’t treat addiction. People who go straight home after detox relapse often, and after opioid detox that’s especially dangerous because tolerance drops. The best detox programs plan your next step before you leave. We help you line that up in advance.
Sources
- American Society of Addiction Medicine, clinical guidelines on alcohol withdrawal management
- SAMHSA, FindTreatment.gov
Questions people ask us.
Don’t see yours? Call or text (305) 701‑0439. There are no wrong questions, and nothing you tell us leaves the call.
How long does detox take?
Usually 3 to 7 days for alcohol and short-acting opioids, and sometimes longer for methadone, benzodiazepines or mixed use. Your care team adjusts the plan to how your body responds.
Is detox painful?
Withdrawal is uncomfortable, but medical detox exists to make it bearable. Medications treat symptoms like anxiety, nausea, aches and insomnia, and staff check on you around the clock.
Can I have my phone in detox?
Policies vary. Many programs hold phones for the first day or two, then allow limited use. Ask when you call, and we’ll tell you what each program allows.
Does insurance cover detox?
Most plans cover medically necessary detox. We can check your benefits and what you’d owe before you go.
Related guides
AlcoholAlcoholSafe detox, medication that reduces cravings and therapy that lasts.
Read more
Fentanyl, heroin & opioidsFentanyl & opioidsMedication plus counseling, the standard of care for opioid addiction.
Read more
Level of care · 02Residential treatmentLive on site with daily therapy, away from triggers.
Read moreTalk it through with someone who knows Miami’s programs.
Free, private and no pressure. A real person answers day or night.