What Happens During an Alcohol or Drug Detox?

If you feel as though you have lost control over your alcohol or drug use and wish to take back your life, medical detox is an effective first step towards recovery.

This is the process of slowly cleansing the body of all substances over a period of time until eventually the individual is no longer ingesting drugs or alcohol, and can help to break the cycle of addiction while addressing the physical nature of the dependency. [1]

Do I need to undergo an alcohol or drug detox?

It can often be difficult to recognise the signs of addiction within ourselves, as they can become normalised over a period of time. However, there are a number of key signs that may indicate that a drug or alcohol detox is necessary, particularly when your body begins to develop a tolerance and display withdrawal symptoms when you are unable to ingest drugs or alcohol at your usual frequency and amount.

Common signs that may indicate a necessary drug or alcohol detox

  • Drugs and alcohol are no longer simply ‘fun’ for me – I need them in order to function throughout my daily life
  • I find myself needing to drink more alcohol or ingest more drugs in order to experience the same effects
  • I can’t imagine my life without drugs or alcohol
  • I have attempted to cut down or completely stop taking drugs and alcohol but have been unable to
  • I have experienced negative consequences related to my drug or alcohol use, but continue to repeat the behaviour
  • I often find myself lying and being deceitful about my alcohol or drug use
  • I spend the majority of my time planning, obtaining, using and recovering from drugs or alcohol
  • If I am unable to ingest drugs or alcohol, I begin to experience withdrawal symptoms
  • Friends and family members have expressed concern about my alcohol or drug use
  • If I am invited to a social event where I will not be able to use alcohol or drugs, I would prefer not to attend
  • I have noticed that my physical and mental health has taken a turn for the worse
  • I have been neglecting my work, school and relationships in favour of using drugs or alcohol

If you can relate to a number of the above signs, you may have developed a physical or psychological dependency and should consider undergoing detoxification within a rehabilitation centre or treatment programme.

What is the process of an alcohol or drug detox?

Many people are understandably apprehensive about the detoxification process, as it can be an overwhelming and uncomfortable experience depending on the severity of your addiction and any underlying issues.

However, gaining an understanding of the process can help to increase feelings of confidence and ensure that you know exactly what to expect throughout each stage of detoxification.

1. Assessment

Before any type of recovery treatment can begin, patients must be fully assessed by a medical professional in order to determine the severity of the addiction and understand any pre-existing medical needs that could potentially make the detoxification process more challenging.

The assessment process can also be helpful in diagnosing any co-occurring mental health conditions that may be contributing to the addiction. This allows the patient to tackle both issues during treatment as opposed to merely focusing on the addiction, and this approach can increase the chances of long-term recovery.

During the assessment, a doctor will ask a series of questions including which substances are being taken, how long the addiction has been occurring for and details of the last time the patient ingested a particular substance.

They may also require access to medical records and the opportunity to speak with friends and family members regarding the extent of the patient’s addiction. Other questions may include employment and relationship status, any family history of dependency or addiction and any past diagnoses by a medical professional.

Finally, most patients will be required to submit a urine and blood sample for testing. Once all of this information has been gathered, the doctor will be able to create a treatment programme that is completely personalised to the patient and their unique medical needs.

2. Withdrawal

Once the detoxification process begins, the majority of patients will experience drug or alcohol withdrawal as their body attempts to function without these substances in the system.

If an individual has been regularly using drugs or alcohol for a number of months or years, their body and brain will have become used to dealing with these substances and may have changed the way they function in order to continue to work as effectively as possible.

In cases of alcohol addiction, for example, the body’s vital organs and processes may have sped up to counterbalance the sedative effects of this substance. When the alcohol is taken away, the body continues to function in this keyed-up state which can result in a number of withdrawal symptoms. [2]

In order to avoid the more uncomfortable or dangerous withdrawal symptoms, most treatment programmes will gradually reduce the amount of alcohol or drugs that the patient is ingesting over a period of time until eventually they are no longer taking these substances.

This gives the body and brain the opportunity to slowly rebalance as opposed to a complete shock to the system, which could cause severe withdrawal symptoms such as seizures and hallucinations.

What are the symptoms of an alcohol or drug withdrawal?

Everyone experiences alcohol or drug withdrawal differently and symptoms often depend on a number of factors including the frequency and severity of the addiction, the type of substance they are addicted to and their general health and well-being.

Certain substances can result in a more intense withdrawal, while others may be merely uncomfortable. [3]

If a patient has experienced a drug or alcohol detox in the past with no dangerous or unpleasant symptoms, they must keep in mind that each experience is unique and any future detoxes could be more or less severe depending on the above factors.

Physical symptoms of alcohol or drug withdrawal

  • Flu-like symptoms including a runny nose and chills
  • High temperature or fever
  • Insomnia, difficulty falling or staying asleep
  • Nausea and vomiting
  • Excessive perspiration
  • Trembling and shaking
  • Extreme fatigue and tiredness
  • Lack of appetite
  • Seizures
  • Muscle and joint pain
  • Digestive issues including constipation or diarrhoea
  • Cramping in the arms and legs

Psychological symptoms of alcohol or drug withdrawal

  • Vivid and intense dreams or nightmares
  • Feeling restless and irritable
  • Aggression
  • Agitation
  • Depression and anxiety
  • Frequent mood swings
  • Delirium
  • Hallucinations
  • Psychosis
  • Thoughts of self-harm or suicide

The process of a drug or alcohol detox can be extremely challenging, and it’s important to keep in mind that these symptoms and uncomfortable sensations are temporary. Once the physical detoxification is complete, you will be in a clearer state of mind to move on to the psychological counselling stage.

In some cases, detoxification can be dangerous if attempted ‘cold turkey’ and without a medical professional present. If you or someone you know is experiencing severe withdrawal symptoms such as hallucinations or seizures, call 999 immediately and seek medical assistance.

How long does an alcohol or drug detox last?

Depending on the severity of the addiction, the frequency of ingestion and the type of substance you are addicted to, the length of the detoxification process can vary between individuals.

In general, the first symptoms should appear within 24-48 hours and may include trembling, perspiration and mood swings. Alcohol withdrawal usually begins fairly soon after cessation and may last for around one week, however, these symptoms can change from mild to severe very quickly and therefore all patients should be closely monitored.

If you are detoxing from a short-acting substance such as heroin, you may notice withdrawal symptoms after just a few hours. These symptoms generally build and peak within 72 hours and can last for up to 10 days.

Longer-acting substances can remain in the system for up to 48 hours before withdrawal symptoms begin to appear. The timeline of detoxification is increased in these cases, often continuing for up to one month before symptoms begin to abate.

What support is available during an alcohol or drug detox?

It is recommended that anyone attempting to withdraw from alcohol or drugs should do so within a secure and controlled environment under the supervision of medical professionals. This is usually achieved by choosing to detox at a rehabilitation centre or other medical location as a patient within an addiction treatment programme.

In general, patients receive 24/7 monitoring and support throughout the detoxification process. This can greatly increase the chances of successfully completing an alcohol or drug detox and progressing to the next stage of recovery.

Detoxification can be an uncomfortable experience and it can be helpful to have the support of staff during the process, in order for patients to feel reassured and understand exactly what is happening to them both physically and psychologically.

Professional counselling services that tackle the root cause of the addiction are usually not offered until the detoxification process is complete, however, trained counsellors and staff are on hand to provide assistance if required.


[1] https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1272349/

[3] https://www.ncbi.nlm.nih.gov/books/NBK64116/