Guides
What happens in detox
Not knowing what detox is like keeps a lot of people from starting. Here is what a typical stay looks like.
A typical timeline
| When | What usually happens |
|---|---|
| Arrival | Intake, a health check, a drug test, and a talk about your history |
| First 24 to 72 hours | Withdrawal is often strongest. Staff check you often and give medication for symptoms |
| Days 3 to 7 | Symptoms ease. Sleep and appetite start to return. You meet counselors and plan next steps |
| Discharge | A warm handoff to residential, PHP or IOP care |
Every substance and every person is different. Your team will explain your plan.
Common withdrawal symptoms
- Anxiety, restlessness and trouble sleeping
- Sweating, chills, aches
- Nausea or upset stomach
- Cravings
- For alcohol or benzodiazepines: shaking, and sometimes seizures, which is why medical care matters
Withdrawal by substance
| Substance | Typical timing | Why medical care matters |
|---|---|---|
| Alcohol | Starts 6 to 24 hours after the last drink, peaks around days 1 to 3 | Seizures and delirium tremens (DTs) can be life-threatening |
| Benzodiazepines | Can start days later and last weeks | Stopping suddenly can cause seizures; doses are tapered slowly |
| Opioids and fentanyl | Starts within hours, peaks around days 2 to 3 | Severe discomfort; starting buprenorphine or methadone helps and lowers overdose risk |
| Stimulants (meth, cocaine) | Days to a couple of weeks | Exhaustion, low mood and sometimes depression or suicidal thoughts need watching |
These are general patterns. Your own timeline depends on how much and how long you used, other substances, and your health.
Medications that may be used
Detox staff may use medications to keep you safe and more comfortable, for example benzodiazepines on a careful schedule for alcohol withdrawal, buprenorphine for opioid withdrawal, and medicines for nausea, sleep or anxiety. Ask the program which medications they use, and whether a doctor or nurse practitioner sees you.
What detox feels like
Most people describe the first days as rough: tired, achy, anxious and restless, with poor sleep. Staff check on you often, sometimes every few hours. By the end of the first week, many people feel clearer and start thinking about what comes next. It helps to know that the hardest part is usually short.
Families can usually call to check that you arrived safely, but staff need your written permission to share details about your care.
Questions to ask a detox program
- Is a doctor or nurse on site or on call 24/7?
- Which medications do you use for withdrawal?
- What happens if I have a medical emergency?
- Can you start medication for opioid or alcohol use disorder before I leave?
- Will you help arrange my next level of care?
Before you call a program
- Ask for the DHCS license or certification number and check it.
- Ask which levels of care they provide on site.
- Ask what your insurance covers and what you will owe.
- Ask where you would go next when this level of care ends.
Frequently asked questions
Is detox painful?
It is often uncomfortable, but medical detox is designed to make withdrawal safer and more bearable with medication and monitoring.
Can I have visitors during detox?
Usually not in the first few days, so you can rest and staff can monitor you. Ask the program about its policy.