Frequently asked questions about detox
Who can advise me on the type of detoxification program to use?
Your health care provider can assess your situation and suggest a level of medical detoxification care. In recommending a medical detox placement, providers may look at your situation as it relates to these factors:
- Current and past substance use and potential to experience withdrawal.
- Physical health conditions and complications.
- Mental health conditions and complications.
- Readiness to recover from dependence on alcohol or other drugs.
- Potential for returning to substance use.
- Your home or living environment during recovery.
Different drugs carry different risks of serious withdrawal symptoms. Alcohol and benzodiazepine withdrawal can lead to seizures, unstable vital signs, confusion, and even death. In contrast, opioid withdrawal, while deeply uncomfortable, is rarely medically serious.
What types of detoxification programs are there?
If you have or expect to have mild or moderate withdrawal symptoms, you could undergo medical detox on an outpatient basis with minimal supervision. If your symptoms are more intense or life-threatening, you may need to be supervised for withdrawal in a hospital. If you have been diagnosed with both a substance use disorder and another mental health disorder, you may require a level of care that offers more intensive counseling.
The American Society of Addiction Medicine defines five categories of withdrawal management programs: Level 1-WM, Level 2-WM, Level 3.2-WM, Level 3.7-WM, and Level 4-WM.
Level 1-WM, or ambulatory withdrawal management, is completed on an outpatient basis for mild withdrawal. Your care is monitored daily or every few days by a health care professional.
Level 2-WM is the next level of outpatient withdrawal management, sometimes undertaken at a day hospital. Your extended care for moderate withdrawal is monitored by credentialed health care professionals for the entire day, but you go home at the end of each day. With this type of care, it is important to have supportive household members to watch over you at night.
Level 3.2-WM is clinically monitored withdrawal management for moderate symptoms. You stay at a residential facility where staff and peer support is available 24 hours a day.
Level 3.7-WM is medically monitored inpatient management of severe withdrawal. You receive 24-hour nursing care, and a physician is available as needed.
Level 4-WM is the most intensive type of inpatient treatment for severe withdrawal and is known as medically managed withdrawal. You receive 24-hour nursing care plus daily physician visits to treat medically unstable symptoms in a hospital or a similar setting.
Learn more about these levels of care at the American Society of Addiction Medicine website.
How much does alcohol and drug detox cost?
The cost of detox varies depending on the number of days in treatment, the level of services, the location, and other factors. It’s possible to get help with paying for this type of care, however. Sources of support include:
Health insurance marketplaces. The Affordable Care Act considers mental and behavioral health services “essential health benefits.” This means substance use disorder (SUD) treatment is covered at least in part through insurance offered on the federal, state, and District of Columbia health insurance marketplaces, including through Medicaid.
Medicare Part A. The insurance program for people 65 and older covers some SUD-related services if certain conditions are met.
Government funding. The Substance Abuse and Mental Health Services Administration distributes block grants to programs in all 50 states, the District of Columbia, and the U.S. territories. These funds supplement prevention, treatment, and recovery services covered by private insurance, Medicaid, and Medicare.
Why is it not advised to quit without medical support?
Many people who decide to stop using alcohol or other drugs try to do so “cold turkey” and without medical support. It’s tempting to want to stop using substances on your own. And there is a long-standing misconception that the most effective way to stop substance use is through willpower alone.
However, trying to quit cold turkey without any medical support has a lower chance of success than seeking medical support and supervision to stop substance use. This is partly due to the way dependence affects the brain, undermining the parts of it concerned with willpower and decision-making. In addition, quitting cold turkey can result in dangerous withdrawal symptoms that lead to serious medical complications — particularly with alcohol and benzodiazepines. Withdrawal from other substances, such as heroin and other opioids, can be very uncomfortable and painful. Without medical support, this discomfort could cause you to return to substance use.
Medical support can provide you with medications and therapies to manage withdrawal symptoms, connect you with treatment, and help sustain your recovery. So, although you may want to go it alone, it’s often a good idea to seek out medical care when quitting a substance.
Why is a mental health assessment an important part of the detox process?
As part of the detox process, a trained medical professional will evaluate your mental health to better understand how stopping substance use and entering treatment could affect you. This is designed to answer questions such as:
- Are you at risk of harming yourself or others in the process of withdrawal?
- Do you need treatment for a mental health condition that’s occurring alongside your dependence on substances?
- Do you need counseling to cope with the psychological effects of withdrawal?
- Are you taking any medication that can interact with medications to manage withdrawal symptoms?
Getting answers to these and other questions can improve your chances of success in alcohol and drug detox and treatment.
