Detoxification, or medically assisted withdrawal, is the management of symptoms and risks that can occur when a person who has developed physiological dependence reduces or stops alcohol or another substance.

What determines the treatment setting

• Amount, frequency and duration of alcohol or substance use.
• Time since last use and current withdrawal symptoms.
• Previous withdrawal seizures, delirium or complicated detoxification.
• Use of multiple substances or sedative medicines.
• Physical illness, pregnancy, age and psychiatric comorbidity.
• Suicide risk, cognition, housing, supervision and available support.

What supervised withdrawal may involve

Depending on the substance and level of risk, management may include clinical monitoring, prescribed withdrawal medication, fluids and nutrition, vitamin supplementation where indicated, treatment of associated physical complications and transfer to a higher level of medical care if required.

Detoxification is not the whole treatment

Withdrawal management treats the acute physiological phase. Longer-term outcomes depend on continuing treatment addressing cravings, triggers, co-occurring psychiatric conditions, relationships, relapse prevention, rehabilitation and recovery goals.

Seek emergency care for

Seizures, severe confusion, hallucinations with marked agitation, collapse, breathing difficulty, suspected overdose, inability to wake, severe dehydration, chest pain or another acute medical emergency require urgent medical attention.

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Clinical sources

NICE CG100: Alcohol-use disorders — physical complications and acute withdrawal
WHO mhGAP: Alcohol use disorders

This information is for general education and does not replace an individual clinical assessment or professional medical advice.