How Long Does Alcohol Detox Take? Timelines by Substance

Four things, in roughly this order of influence.

The substance itself, because withdrawal timelines differ by drug and are reasonably predictable within each one.

How long and how heavily it has been used. Years of daily use produces more physical dependence than months of intermittent use.

Whether more than one substance is involved. Alcohol plus a benzodiazepine is not two separate detoxes running side by side; it is a more complicated single one.

Other medical conditions. An untreated infection, a heart condition or a previous withdrawal seizure all change the plan, and usually lengthen it.

That is why every admission starts with a medical assessment rather than a booking. Nobody can quote you a length before knowing those four things.

It depends on which opioid, and the difference is large.

Short-acting opioids such as heroin, oxycodone and most fentanyl exposure produce withdrawal that starts within 8 to 24 hours, peaks around day two or three, and largely resolves inside a week.

Longer-acting opioids such as methadone start later, often 24 to 48 hours, and run longer — sometimes two weeks or more.

Opioid withdrawal is severe and rarely dangerous by itself, which is the opposite of alcohol. The National Institute on Drug Abuse describes the symptom set. What medication does here is make the week survivable, which matters because the most common reason a detox ends early is that somebody could not tolerate day three. Opiate and opioid detox covers the options.

Methamphetamine and cocaine produce no medically dangerous withdrawal in most people, so there is no taper to manage. The acute phase is usually three to five days.

What takes longer is sleep, appetite and mood. Exhaustion and depression commonly run for two to four weeks, and that stretch is when the risk of returning to use is highest. Methamphetamine detox exists to cover it with structure rather than medication alone.

Detox treats physical dependence. It does not treat the reasons the use started, which is why it is the first step rather than the whole treatment.

Somewhere in the last day or two, the conversation turns to what follows — residential treatment, an intensive outpatient program, or sober living. What comes after detox sets out the options, and what to expect from our detox covers the admission itself.