What happens during medical detox?
Medical detox is supervised withdrawal from alcohol, opioids or benzodiazepines in a clinic, where doctors monitor you around the clock and use medication to keep withdrawal safe. Alcohol detox usually takes several days. Opioid withdrawal and benzodiazepine tapers take longer.
By the Switzerland Recovery editorial team · Updated · 6 min read
Why detox must be supervised
Withdrawal from alcohol and benzodiazepines can cause seizures and delirium. Opioid withdrawal is intensely unpleasant. Medical supervision makes withdrawal safer and more tolerable.
About half of people with alcohol use disorder who abruptly stop or cut down develop withdrawal symptoms (AFP, 2021). Delirium tremens, the most severe complication, has a mortality rate of 5% to 10% (AFP, 2021).
Benzodiazepine dependence can develop after several days to weeks of steady use, even as prescribed (FDA, 2020). In 2022, 2.1% of the Swiss population took sleeping pills or sedatives daily or almost daily (FOPH, 2022).
Who needs inpatient detox
Withdrawal from benzodiazepines and opioids follows its own rules; our guides on benzodiazepine addiction and opioid addiction signs and recovery cover them in detail.
Not everyone needs a clinic bed for detox. NICE advises considering inpatient or residential alcohol withdrawal for people who drink over 30 units a day (NICE, 2011). The same applies to people with a history of epilepsy, withdrawal seizures or delirium tremens (NICE, 2011).
Other reasons include withdrawal from several substances at once, serious physical or mental illness and an unstable home situation. A doctor makes this decision after an assessment.
“Benzodiazepines are a first-line therapy for patients experiencing moderate withdrawal symptoms.”
Typical timeline
The exact course depends on the substance, the dose and your health. Alcohol withdrawal symptoms begin 6 to 24 hours after the last drink. Seizures typically occur at 24 to 48 hours and delirium tremens at 48 to 72 hours (AFP, 2021). A typical alcohol detox follows this pattern:
- Day 0: admission, blood tests, ECG, medication plan
- Days 1 to 3: peak withdrawal risk, close monitoring
- Days 4 to 7: symptoms ease, sleep and appetite return
- Week 2 onward: focus shifts to therapy and restoration
Medication during detox
Medication is matched to the substance. Benzodiazepines are the first-line treatment for moderate alcohol withdrawal (AFP, 2021). Benzodiazepines themselves are stopped with a gradual taper, because abrupt withdrawal can be dangerous (FDA, 2020).
For opioid dependence, maintenance with methadone or buprenorphine has the strongest evidence (WHO, 2026). All-cause mortality during opioid agonist treatment is less than half the rate seen out of treatment (JAMA Psychiatry, 2021). Doctors weigh maintenance treatment against withdrawal for each person.
Detox is not treatment
Detox removes the substance. It does not treat the addiction. Detox alone is rarely sufficient for long-term abstinence, so patients should continue treatment afterwards (NIDA, 2018).
Our guide to the first 72 hours at a Swiss rehab clinic shows how detox fits into admission. Detox, rehab or psychiatric clinic explains which level of care comes next.
Related treatment pages
Frequently asked questions
How long does detox take?
Alcohol detox usually takes several days. Opioid withdrawal and benzodiazepine tapers take longer, because the dose is reduced step by step.
