Alcohol Detox and Rehab Programs: What to Know

If you have a problem with alcohol, you have more ways than ever to get help. That’s important because everyone has different needs when it comes to treating alcohol use disorder (AUD). AUD is the name doctors give to the range of issues people have with drinking.

The care you’ll need depends in part on where you fall in that range. Alcoholism is on the more serious end of the scale. It means your body has learned to depend on alcohol, and once you take it away, the physical effects can be hard to deal with. That’s where detox comes in.

What Is Detox?

Detox isn’t treatment, but it’s the first step to getting better. It’s when you stop drinking and your body gets rid of the alcohol, which leads to withdrawal symptoms. If you’ve been drinking heavily for a long time, you can start detoxing within 6 hours of your last drink.

Withdrawal symptoms are mild for some but much more serious for others. You may have:

  • Anxiety
  • Delirium tremens (DTs), a life-threatening issue where you feel confused and on edge
  • Depression
  • Hallucinations, where you see or hear things that aren’t there
  • Problems sleeping
  • Shakiness, especially in your hands
  • Unstable changes in blood pressure and heart rate

Do I Need a Detox Program?

If you need alcohol for your body to feel normal, then you likely need help. Getting through detox isn’t just a matter of willpower, and stopping "cold turkey" is never recommended. In some cases, withdrawal can put your life at risk. Even when it’s not as serious, it’s still a big challenge.

A program gives you support to guide you through the withdrawal. That often includes medicine to help ease symptoms as well as care for medical and mental health conditions.

Detox may last a week or more, with symptoms hitting their worst within 24-48 hours. You’re more likely to stick with it when you have lots of help.

What Happens During Detox?

Usually, you can expect a detox program to include these basic things:

  • An intake exam so the detox team can see what kind of support you’ll need. You may get blood work, talk about your health and drinking history, and have tests to check your physical and mental health.
  • Detox support, which may include medicine for withdrawal symptoms and care for other issues that come up. The goal is to help you get mentally and physically stable. You may have your temperature, blood pressure, heart rate, and breathing checked regularly during this process.
  • Help getting into treatment so you can learn to break your addiction.

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Types of Programs

When you think about detox programs, it helps to look a step ahead to rehab. That’s because you’ll also need treatment to break your addiction, and some programs combine the two.

Your two basic options for detox programs are:

Inpatient, where you live at a hospital, detox clinic, or rehab center during the process. You’ll have care around the clock to help you through.

Outpatient, where you get some treatment during the day but live at home. This might be as simple as visiting your doctor regularly to get meds.

Inpatient usually offers more services, but it tends to cost more. Outpatient works best if your health is good, your home is stable, and you don’t have a long history of problem drinking.  

Rehab programs can include a range of services from medical care and counseling to life skills training and help preventing a relapse.

Inpatient treatment at a hospital or medical center isn’t as common as it used to be, but these programs make sense if you have serious medical or mental health issues.

Residential rehab, where you live at a center, usually runs for 1-3 months. These are good if you have a more serious problem and struggle to stay sober.

Partial hospitalization or day treatment is where you live at home but spend 4-8 hours a day in a hospital or clinic. It usually lasts at least 3 months. This type of rehab is most helpful when you need medical care and you have a stable home life with supportive family and friends.

Intensive outpatient involves 9-20 hours a week in treatment for at least 2 months, sometimes up to a year. These programs are good if you have a solid home life and a lower chance of relapse.

How to Choose a Program

Start with a list of your needs. For example, if you have a medical or mental health condition, you’ll want services for that. Or if you’ve struggled for years and don’t have a strong support network, an inpatient program might make sense.

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From there, you can look at quality and cost. Ideally, you want to find a program you can afford that has licensed, trained staff and a high success rate.

You might want to make a list of questions to ask the programs you're considering, such as:

  • What types of insurance do you take?
  • How is your staff trained? Are they licensed?
  • Can you send me a sample treatment plan?
  • Do you offer counseling and medical services?
  • How do you help prevent a relapse?
  • Is there aftercare when I’m done with the program?

Insurance Coverage

Usually, some services will be covered, but how much you’ll have to pay out of pocket depends on your health plan and the program you choose. Your insurer will cover only medically necessary services. It looks at your specific case and decides the type of treatment you qualify for.

For those 65 and older, Medicare Part A covers mental health care, including alcohol treatments, in hospitals. Medicare Part B pays for outpatient services for alcohol problems.

Your best bet is to grab a pen and paper to take notes and call your health plan. Ask about:

  • Copays and other costs
  • Services your plan covers, such as detox and inpatient or outpatient rehab
  • How it decides what to cover

Follow-up Care

Once you get back into the swing of your normal life, it might be easy to relapse and start drinking again. So you’ll likely want follow-up care for at least a year. You have lots of options, including 12-step programs, private therapy, and group counseling.

WebMD Medical Reference Reviewed by Neha Pathak, MD on July 19, 2018

Sources

SOURCES:

National Institute on Alcohol Abuse and Alcoholism: “Support and Treatment,” “Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5.”

HelpGuide.org: “Alcoholism and Alcohol Abuse,” “Overcoming Alcohol Addiction.”

Recovery.org: “Drug and Alcohol Detoxification Process,” “Alcohol Detox Treatment Programs and Process,” “Alcohol Withdrawal,” “Drug Rehab Treatment Information,” “Partial Hospitalization and Day Treatment Programs for Substance Abuse,” “Intensive Outpatient Treatment for Substance Abuse,” “Using Insurance to Help Cover Addiction Recovery Costs.”

Medscape: “Delirium Tremens (DTs) Clinical Presentation.”

Substance Abuse and Mental Health Services Administration: “What Is Substance Abuse Treatment?” “Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol (pdf),” “A Quick Guide to Finding Effective Alcohol and Drug Addiction Treatment.”

American Addiction Centers: “Drug Rehab Guides for Addiction and Mental Health.”

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