Inpatient Alcohol Detox

Detoxing from alcohol can be uncomfortable and, in some cases, dangerous. If you have been drinking heavily for a long time, you may need support if you decide to stop drinking. After drinking heavily for an extended time, you can become dependent on alcohol, which means that your body relies on alcohol to function normally and will experience withdrawal symptoms without it. ¹ Inpatient alcohol detox can help you detox from alcohol safely and more comfortably.
In this article:

• What is Inpatient Alcohol Detox?
• Who Needs Inpatient Alcohol Detox?
• How Long is Inpatient Detox?

What is Inpatient Alcohol Detox?

Inpatient alcohol detox involves residing at a facility, where you will receive various interventions, such as medical care, with the goal of managing alcohol withdrawal symptoms and obtaining a medically stable, substance-free state. Other interventions may include:¹

• Alcohol withdrawal medications, such as benzodiazepines
• Supportive medical care, such as intravenous fluids
• Adjunctive medications
• Detox counseling
• Case management

You may detox from alcohol in several inpatient settings, including:¹

• Psychiatric hospital
• Free-standing detox clinic
• Inpatient alcohol rehab

Inpatient detox is different from outpatient detox centers because inpatient facilities provide 24/7 supervised care while you are there. You live at the facility for the duration of your treatment. Inpatient centers tend to offer more services and medical supervision than outpatient centers, making it a safer option for those with a severe alcohol addiction or co-occurring mental health or medical conditions.

Some inpatient alcohol detox centers provide short-term services. For example, you may just stay there for a few days or a week while you detox and get through the withdrawal symptoms. Other facilities, like inpatient rehabs, may follow up detox support with other supportive services. Treatment in inpatient rehab is typically longer than detox and may last several weeks to a few months.

Therapy in Inpatient Alcohol Detox

Although the primary focus of alcohol detox is to manage alcohol withdrawal and keep you safe, some detox programs may integrate various therapies into the detox plan, particularly toward the end of detox once you’ve begun to stabilize.

These alcohol addiction therapies used in detox may include:^2,3,5

• Cognitive behavioral therapy (CBT) is a therapy approach that aims to help people recover from substance misuse by helping them develop coping skills and healthy ways of thinking. A therapist using CBT can help you identify and address problematic thought patterns to develop healthier ways of thinking that can help during your recovery process.
• Motivational enhancement therapy (MET) is a type of therapy that focuses on enhancing your motivation for recovery. This can help keep you on track with your treatment goals, especially during challenging phases of your recovery. This can be especially helpful during the initial phases of treatment, such as during detox.
• Group therapy may include various models, such as CBT groups; psychoeducational groups, which teach patients about alcohol misuse; skills development groups, which help patients to learn and practice skills they need to avoid relapse; and interpersonal process groups, which allow patients to recreate their pasts in a safe environment, enabling them to understand reframe relational issues that may have led to alcohol misuse.

Alcohol Detox Medications

Certain medications can help during the detox process. A few different types of medications can help with alcohol withdrawal and detox, but the gold standard for alcohol detox remains benzodiazepines.⁴ Benzodiazepines are shown to reduce the severity of withdrawal symptoms and decrease the risk for more severe withdrawal symptoms, such as seizures or delirium tremens.⁴

There are several different kinds of benzodiazepines, but all are proven to be equally as effective.⁴ The most used benzodiazepines used for alcohol detox include:⁴

• Chlordiazepoxide
• Diazepam
• Lorazepam
• Oxazepam

Doctors and other medical professionals may prescribe certain benzodiazepines depending on your unique needs. For example, if you have liver issues, your body may tolerate certain medications better than others.

After someone completes the detox process, their treatment provider may also start them on other medications as part of Medication-Assisted Treatment (MAT). These medications can be used to support someone’s long-term recovery after detox so they can actively participate in other aspects of treatment, such as therapy. The most common medications used to treat alcohol use disorder are:²

• Acamprosate is used to help prevent people from drinking alcohol by minimizing cravings and urges to do so.
• Disulfiram treats chronic AUD by causing acute unpleasant reactions when combined with alcohol. It also helps reduce cravings for alcohol. This can be useful during the beginning phases of recovery.
• Naltrexone blocks the intoxication feeling someone gets from drinking, which can make drinking unappealing since the pleasant side effects of alcohol use are removed.

Case Management During Alcohol Detox

Inpatient alcohol detox centers may offer case management services. A case manager can help you coordinate your treatment. For example, if you attend a detox-only center, a case manager can give you referrals for a formal alcohol addiction treatment program, where, with the help of a treatment team, you can begin addressing the underlying factors that motivated your alcohol misuse in the first place.

A case manager can also help you coordinate other supportive services that you may need during detox or AUD treatment, such as medical care or mental health care for another mental health condition.

Who Needs Inpatient Alcohol Detox?

Alcohol detox is uncomfortable for everyone who goes through it. However, it may be more uncomfortable and potentially dangerous for certain people—these individuals may benefit from an inpatient alcohol detox program that offers around-the-clock medical care and oversight.

You may need inpatient alcohol detox if you have:^4,5

• Moderate to severe alcohol withdrawal symptoms
• A history of severe alcohol withdrawal symptoms
• A polysubstance addiction
• Tried to control or cut back on alcohol use multiple times
• Medical complications, such as delirium tremens or seizures
• Another mental health condition that requires treatment, such as depression, posttraumatic stress disorder, or schizophrenia
• Limited social support outside treatment

How Long is Inpatient Alcohol Detox?

Each alcohol detox program is different, and your length of stay will likely depend on many factors, such as:

• The severity of your alcohol withdrawal symptoms
• Your individual physiology
• Whether you have gone through withdrawal before
• Whether you use any other substances besides alcohol

If you attend an inpatient rehab program that offers detox services, your length of stay will also depend on how long it takes for you to complete your treatment goals.

Research shows that programs that combine detox services with therapy are more effective if they last at least 90 days.⁶ However, if you just want to complete detox, it may take a few days to a few weeks.¹

What Happens After Detox?

After detox, research shows that receiving treatment for AUD or alcohol misuse is most effective in preventing relapse.² You can talk with the treatment providers at the inpatient detox center to see what they would recommend for you. Treatment options after detox may include:⁵

• Inpatient rehab programs typically last several weeks to a few months. You would live at the facility. This type of program might be a good fit for you if you require 24/7 support to continue making progress in your recovery and have limited support outside of treatment.
• Partial hospitalization programs serve as a good bridge between inpatient and outpatient care, providing many hours of treatment for five to seven days per week. It may be beneficial for someone who needs the structure of an inpatient program but cannot reside at the facility for whatever reason.
• Intensive outpatient programs typically provide care several hours per day, for three to five days per week. This type of program may be a good fit if you have good support outside of treatment.
• Standard outpatient programs may include a few hours of treatment per week, meeting one or two times. These programs are the least intensive and may be beneficial for someone with a mild alcohol addiction and a strong motivation to quit drinking.

If you think you could benefit from an inpatient alcohol detox program, call 800-996-6135(Who Answers?) to speak with a specialist.

Resources

1. National Library of Medicine. (2021, January 17). Alcohol withdrawal
2. Substance Abuse and Mental Health Services Administration. (2022, March 4) MAT Medications, Counseling, and Related Conditions.
3. National Institute on Drug Abuse. (2018, January). Motivational Enhancement Therapy: A Research-Based Guide
4. Sachdeva, A., Choudhary, M., & Chandra, M. (2015). Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. Journal of clinical and diagnostic research : JCDR, 9(9), VE01–VE07. https://doi.org/10.7860/JCDR/2015/13407.6538
5. National Institutes of Health. (2018, January). Types of Treatment Programs.
6. National Institute on Drug Abuse. (2012, December). Principles of Drug Addiction Treatment