One of the most common questions asked about alcohol rehabilitation is “How long will it take?”. The answer is always “It depends”. There are a number of factors which impact the duration of the rehabilitation process. Read on to learn more about what’s involved.
Understanding Alcohol Rehabilitation
To understand alcohol rehabilitation we need to understand Alcohol Use Disorder (AUD). Alcohol addiction is a chronic relapsing disorder. It is characterized by:
- Compulsive alcohol drinking
- The loss of control over how much is consumed
- A negative emotional state when alcohol is no longer available.
There is an impaired ability to stop despite adverse circumstances. Alcohol addiction refers to the moderate to severe end of the AUD spectrum.
Drinking over time causes changes to the structure and function of the brain. They can affect the brain in a way that causes the transition from controlled, occasional use to chronic misuse which can be difficult to control. These changes can endure long after you stop drinking and can contribute to relapse in drinking.
Addiction is understood to be a repeating cycle of three stages [1].
1. Binge/Intoxication Stage: Reward, Incentives, and Habits
During this stage, a person experiences the rewarding effects of alcohol, such as:
- Euphoria
- Reduction of anxiety
- Easing of social interactions
Alcohol drinking behavior is reinforced in the brain, increasing the likelihood of repeated consumption. This happens with incentive salience neurocircuits which link the pleasurable, rewarding act of drinking with “cues” that become motivationally significant.
Changes are triggered in how you respond to stimuli associated with drinking alcohol, such as people, places, things and descriptions of drinking. Over time, these stimuli can trigger powerful urges to drink alcohol and become habit forming, contributing to compulsive use
2. Negative Affect/Withdrawal Stage: Reward Deficit/Stress Surfeit
Here you feel anxious, uneasy and irritable. You feel you need alcohol for relief from discomfort and emotional pain. If you are addicted to alcohol and stop drinking, you experience withdrawal. The symptoms are the opposite to those when you are drinking—both physical and emotional. The negative feelings are thought to come from two sources:
- Lowered activation in the reward systems (reward deficit), makes it difficult to experience the pleasure of living.
- Increased activation of the brain’s stress systems (stress surfeit), contributes to anxiety, irritability and unease.
You now no longer drink alcohol for the pleasurable effects (“the high”), but rather to escape the “low” feelings of chronic alcohol abuse.
3. Preoccupation/Anticipation Stage: Craving, impulsivity, and executive deficits
In this stage, after a period of abstinence, you seek alcohol and become preoccupied with finding it. The part of the brain responsible for executive function (planning, managing time, decision making) is compromised.
Once someone decides to stop their alcohol abuse, they go through detoxification (“detox”), withdrawal and recovery.
4. Detox and Withdrawal
During this phase you have decided to stop drinking and enter detox. This involves withdrawal from alcohol abuse. While it is possible to do so alone, it can be dangerous depending on the amount you have been drinking and circumstances of your withdrawal. Medically-assisted detox is recommended where healthcare professionals can provide a safe, supervised process with medications as needed..The typical length for alcohol detox is 3-5 days.
5. Recovery
Recovery is an individual process where you pursue two clinical goals: stopping heavy drinking and the subsiding of AUD symptoms except craving. Recovery is where the longer process of healing begins, following detox. Ideally it takes place in a residential treatment (rehab) setting with supportive therapeutic staff. While this treatment typically lasts from 30-90 days. Recovery usually takes from 3-5 years.
Factors That Affect the Length of Alcohol Rehabilitation
Alcohol rehab takes a varying length of time depending on the individual. There are a number of factors, including:
- Length of time someone has been abusing alcohol
- The severity of their addiction
- Whether they have co-occurring mental health disorders
- Their physical health
- Their past alcohol treatment history
- The level of care needed
- How motivated they are to quit drinking
- Insurance coverage and ability to pay
How Long Does Alcohol Recovery Take?
Research has shown that length of stay in treatment is a significant predictor of success, including decreases in unemployment and crime rates. Longer recovery periods have these benefits:
- More recovery time: Longe stays allow you to immerse yourself more deeply in the recovery process and support groups.
- Deeper engagement in the process: Given the range and depth of therapeutic activities, you will have more time to participate in the healing process
- Improved outcomes: Combining the above allows you to have a more successful outcome with extended treatment, a more solid basis for recovery, a repertoire of relapse prevention methods and a well developed support group.
Any program for becoming sober should not be entered into lightly. Staying sober means abstinence from using alcohol or drinking in moderation in a “controlled drinking” program. Since alcohol is a central nervous system depressant, alcohol withdrawal involves changes in the brain to adapt.
Detox from alcohol typically takes about 3 to 7 days. Withdrawal symptoms can start as early as two hours after the last drink and peak within the first 24 to 48 hours. During this peak, individuals may experience mild symptoms. A few will develop alcohol withdrawal delirium (DTs).
After the peak, symptoms generally begin to decrease but can persist in a milder form for several weeks. The length and severity of alcohol detox can be influenced by factors like:
- Duration of alcohol use
- Amount consumed
- Presence of co-occurring mental health or medical conditions.
Full recovery from alcohol abuse can take 3 to 5 years, depending on the individual. Typically there will be some relapses during this time which are viewed as part of the process, not as failures.
For Inpatient Care
Inpatient treatment for withdrawal typically involves benzodiazepines and/or phenobarbital to manage symptoms. This may be done with a fixed dose or as-needed doses. This is usually followed by residential care of 30-60-90 days.
For Outpatient Care
In an outpatient setting, mild alcohol withdrawal can be treated using a tapering plan of either benzodiazepines or gabapentin, administered by a support person. This may be done with a fixed dose or as-needed doses available. This may be accomplished typically in 3 to 7 days for detox.[2]. There are usually three options:
- Standard outpatient programs may only require attending a few hours a week.
- Intensive outpatient programs meet several times a week from 10-20 hours
- Partial hospitalization programs may typically be 20 hours
Does Length Affect Payment?
Yes it does. Inpatient care is typically more expensive than outpatient treatment. Insurance companies may set limits on various aspects of care covered.
Also note that inpatient care is typically more expensive than outpatient treatment. As such, insurance companies may set limits on inpatient care. For example, some may only pay for outpatient care, others limit inpatient care to certain circumstances, and still others cap the number of inpatient days covered, etc.
Alcohol Rehabilitation FAQs
What happens in detox treatment?
Detox is the process of getting rid of substances from the body. During detox you will be medically supervised 24/7 where vital signs will be monitored and medication may be prescribed to reduce withdrawal symptoms.
How long is a detox program?
This can vary for each individual based on the substance, frequency and length of use. Most alcohol detox programs last 3-7 days.
What medications are used during detox?
Sometimes we provide Medication-Assisted Treatment during detox to alleviate withdrawal pain and discomfort. Medications prescribed depend on the individual. For alcohol withdrawal this may include benzodiazepines and/or phenobarbital.
Does insurance pay for detox?
The Encino Detox & Recovery Center accepts most major insurances including Aetna, Cigna, Bluecross Blueshield and more. Get in touch with our admissions team to verify your insurance and find a treatment plan that works for you.
Safe Detox in Los Angeles
At the Encino Recovery and Detox Center in Los Angeles we don’t just treat addiction. We nurture the spirit, heal the mind and help you to regain your life. If you or a loved one is seeking a way out of substance abuse, private, confidential help is just a call away. Reach out to our Admissions team now.
Sources
[1] National Institute on Alcohol Abuse and Alcoholism. 2021. The Cycle of Alcohol Addiction.
[2] Canver BR, Newman RK, Gomez AE. 2024. Alcohol Withdrawal Syndrome. [Updated 2024 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
