Medical Detox Cost: What to Expect With & Without Insurance

Medical detox — medically supervised withdrawal management — is often the first step in addiction treatment. Detox costs vary dramatically based on which substance you’re withdrawing from, how long detox takes, and whether you have insurance. Understanding these costs and why medical supervision matters helps you make informed decisions and avoid the dangerous mistake of attempting home detox.

Medical Detox Cost by Substance

Different substances require different detox protocols, durations, and levels of medical intensity, resulting in significantly different costs:

Substance	Duration	Without Insurance	With PPO Insurance	With Medicaid	Medical Necessity
Alcohol	5-7 days	$1,750 – $5,600	$1,050 – $4,200	$0 – $50	Essential (life-threatening withdrawal)
Opioids (heroin, pills)	5-7 days	$2,000 – $6,500	$1,200 – $4,900	$0 – $50	Highly recommended (severe symptoms)
Fentanyl	7-10 days	$2,500 – $8,000	$1,750 – $6,400	$0 – $75	Highly recommended (severe, prolonged)
Benzodiazepines	10-14+ days	$3,500 – $12,000+	$2,500 – $9,100+	$0 – $100	Essential (life-threatening withdrawal)
Cocaine	3-7 days	$1,200 – $3,500	$600 – $2,450	$0 – $30	Recommended (psychological symptoms)
Methamphetamine	5-10 days	$1,500 – $5,500	$1,000 – $4,500	$0 – $50	Recommended (severe psychological)
Marijuana	3-7 days	$800 – $2,500	$450 – $1,925	$0 – $30	Optional (mild symptoms)

These costs reflect hospital-based or freestanding detox facilities with 24/7 medical supervision. Costs are typically charged per day.

Alcohol Detox

Alcohol is one of two substances (along with benzodiazepines) where withdrawal can be fatal, making medical supervision essential — not optional.

Why Alcohol Detox Is Dangerous

Life-threatening complications:

Seizures: Can occur 6-48 hours after last drink, potentially fatal

Delirium tremens (DTs): Severe confusion, hallucinations, autonomic instability occurring in 5% of alcohol withdrawal cases; 5-15% mortality rate without treatment

Cardiovascular complications: Dangerous blood pressure and heart rate changes

Wernicke-Korsakoff syndrome: Thiamine deficiency causing neurological damage

Alcohol Withdrawal Timeline

6-12 hours after last drink: Anxiety, tremors, sweating, nausea, insomnia

12-24 hours: Symptoms intensify, hallucinations may begin

24-48 hours: Peak seizure risk

48-72 hours: Symptoms peak, delirium tremens may develop

5-7 days: Acute withdrawal symptoms typically resolve

Post-acute: Sleep disturbances, mood changes, cravings can persist weeks to months

Alcohol Detox Protocol

Benzodiazepines: Medications like Ativan or Librium prevent seizures and reduce withdrawal severity

Thiamine and vitamins: Prevent Wernicke-Korsakoff syndrome

Vital sign monitoring: Blood pressure, heart rate, temperature every 4-6 hours

CIWA protocol: Clinical Institute Withdrawal Assessment for Alcohol guides medication dosing

Transition to MAT: Naltrexone, acamprosate, or disulfiram initiated after acute withdrawal

Alcohol Detox Costs

Without insurance:

• $250-$800 per day
• 5-7 days typical
• Total: $1,750-$5,600

With insurance:

• 60-80% coverage after deductible (PPO)
• Out-of-pocket: $1,050-$4,200

With Medicaid:

• Typically $0 copay

Learn more: Alcohol rehab cost

Opioid Detox (Heroin, Prescription Painkillers, Fentanyl)

Opioid withdrawal is not medically dangerous like alcohol or benzos, but it is extremely uncomfortable and has high relapse rates without medical support. Medical detox dramatically improves completion rates and allows immediate transition to medication-assisted treatment (MAT).

Why Opioid Detox Should Be Medically Supervised

Comfort: Medications dramatically reduce withdrawal symptoms

Completion: Medical support increases likelihood of completing detox

Safety: Medical monitoring detects complications (dehydration, electrolyte imbalances)

MAT initiation: Can start buprenorphine during detox using Clinical Opiate Withdrawal Scale (COWS)

Transition: Direct connection to ongoing treatment with MAT

Opioid Withdrawal Timeline

For short-acting opioids (heroin, oxycodone, hydrocodone):

6-12 hours after last use: Anxiety, sweating, yawning, muscle aches

24-48 hours: Symptoms peak — severe muscle aches, nausea, vomiting, diarrhea, dilated pupils, goosebumps

3-5 days: Physical symptoms begin improving

5-7 days: Acute withdrawal largely resolved

For long-acting opioids (methadone) and fentanyl:

12-30 hours: Symptoms begin (delayed onset)

3-4 days: Symptoms peak

7-10 days: Acute symptoms resolve

Post-acute: Cravings, insomnia, mood disturbances persist weeks to months

Opioid Detox Protocol

Comfort medications:

• Clonidine: Reduces autonomic symptoms (sweating, anxiety, rapid heart rate)
• Loperamide: Controls diarrhea
• Ondansetron: Reduces nausea
• NSAIDs: Muscle aches
• Sleep aids: Insomnia

Buprenorphine (Suboxone) induction: Most evidence-based approach

• Started when COWS score indicates moderate withdrawal (typically 12-24 hours after last use)
• Dramatically reduces withdrawal symptoms
• Continued long-term for MAT (12-24 months minimum recommended)

Alternative: Methadone taper (rarely used; transition to methadone maintenance more common)

Fentanyl-Specific Considerations

Fentanyl detox is more complex than other opioids:

Longer duration: 7-10 days vs. 5-7 for heroin

Delayed induction: Fentanyl’s potency can cause precipitated withdrawal if buprenorphine started too early

Microdosing protocols: Many programs now use buprenorphine microdosing (starting very low doses while still using) to avoid precipitated withdrawal

Higher costs: $2,500-$8,000 without insurance due to longer duration and complex protocols

Opioid Detox Costs

Standard opioids (heroin, prescription painkillers):

Without insurance: $2,000-$6,500 (5-7 days) With insurance: $1,200-$4,900 out-of-pocket

Fentanyl:

Without insurance: $2,500-$8,000 (7-10 days) With insurance: $1,750-$6,400 out-of-pocket

Learn more: Opioid rehab cost, Heroin treatment, Fentanyl treatment

Benzodiazepine Detox

Benzodiazepine detox is the longest and most expensive due to the requirement for slow, gradual tapering. Like alcohol, benzo withdrawal can be fatal, making medical supervision absolutely essential.

Why Benzodiazepine Detox Is Dangerous

Life-threatening seizures: Abrupt cessation after prolonged use can cause seizures

Delirium: Confusion and disorientation

Autonomic instability: Dangerous changes in blood pressure and heart rate

Protracted withdrawal: Symptoms can persist for months

Never attempt home benzo detox — it can be fatal.

Benzodiazepine Withdrawal Timeline

Timeline varies dramatically by benzodiazepine type:

Short-acting (Xanax, Ativan):

• Symptoms begin 1-2 days after last dose
• Peak 2-4 days
• Acute phase 10-14 days

Long-acting (Klonopin, Valium):

• Symptoms begin 2-7 days after last dose
• Peak 2 weeks
• Acute phase can extend weeks

Protracted withdrawal: Anxiety, insomnia, sensory hypersensitivity can persist months

Benzodiazepine Detox Protocol

Slow taper is essential — no rapid detox for benzos

Substitution: Short-acting benzos converted to long-acting (Valium) for smoother taper

Taper schedule: Typically 5-10% dose reduction every 1-2 weeks

Duration: Can take 10-14 days for inpatient taper, or weeks to months for complex cases

Monitoring: 24/7 medical monitoring, vital signs, neurological assessments

Seizure precautions: Emergency protocols in place

Symptom management: Supportive medications for anxiety, insomnia (non-benzo options)

Why Benzodiazepine Detox Costs More

Longer duration: 10-14+ days vs. 5-7 for most substances

Intensive monitoring: Higher medical staffing requirements

Complex protocols: Individualized tapering schedules

Medical necessity: No shortcuts — must be slow for safety

Benzodiazepine Detox Costs

Without insurance:

• $350-$850 per day
• 10-14+ days typical
• Total: $3,500-$12,000+

With insurance:

• Out-of-pocket: $2,500-$9,100+

With Medicaid:

• $0-$100

Learn more: Benzodiazepine rehab cost

Stimulant Detox (Cocaine, Methamphetamine)

Stimulant withdrawal is not medically dangerous — you can’t die from cocaine or meth withdrawal. However, medical supervision dramatically improves completion rates and manages psychological symptoms.

Stimulant Withdrawal Symptoms

Physical:

• Extreme fatigue (sleeping 12-16 hours daily)
• Increased appetite
• Slowed movements or agitation

Psychological (more severe):

• Profound depression
• Anhedonia (inability to feel pleasure)
• Intense cravings
• Anxiety and paranoia
• Possible psychotic symptoms (with meth)

Cocaine Detox

Duration: 3-7 days for acute phase

Timeline:

• Hours 1-24: Crash phase — depression, exhaustion, increased appetite
• Days 2-7: Withdrawal symptoms peak — cravings, mood disturbances, sleep issues
• Weeks 2-10: Post-acute symptoms — continued cravings, anhedonia

Protocol:

• Symptom management (sleep aids, mood stabilizers if appropriate)
• Nutritional support (weight gain common)
• Psychiatric monitoring (depression and suicidal ideation risk)
• No FDA-approved medications (research ongoing)

Cost without insurance: $1,200-$3,500 (3-7 days)

Learn more: Cocaine rehab cost

Methamphetamine Detox

Duration: 5-10 days for acute phase (longer than cocaine)

Timeline:

• Days 1-2: Crash — extreme fatigue, increased sleep
• Days 3-10: Withdrawal peaks — depression, anxiety, cravings, possible psychosis
• Weeks to months: Post-acute symptoms persist

Protocol:

• Extended monitoring (up to 10 days)
• Psychiatric evaluation (psychotic symptoms may require treatment)
• Nutritional rehabilitation
• Sleep normalization support

Cost without insurance: $1,500-$5,500 (5-10 days)

Learn more: Meth rehab cost

Marijuana Detox

Marijuana withdrawal is the mildest, with symptoms that are uncomfortable but not dangerous. Medical detox is optional for cannabis but can improve comfort and completion rates.

Marijuana Withdrawal Symptoms

Physical:

• Sleep difficulties
• Decreased appetite
• Headaches
• Sweating

Psychological:

• Irritability and anger
• Anxiety
• Restlessness
• Depression
• Cravings

Marijuana Detox Timeline

Days 1-2: Symptoms begin Days 2-6: Symptoms peak Days 7-14: Symptoms gradually improve Weeks 2-4: Sleep and mood continue normalizing

Marijuana Detox Protocol

Symptom management:

• Sleep aids for insomnia
• Anti-anxiety medications (non-addictive options)
• Supportive care

Duration: 3-7 days supervised detox

Cost without insurance: $800-$2,500

Learn more: Marijuana rehab cost

What’s Included in Medical Detox

Understanding what you’re paying for:

Medical Services

24/7 medical monitoring:

• Vital signs every 4-6 hours (blood pressure, heart rate, temperature, respiratory rate)
• Neurological assessments
• Emergency response capability

Physician oversight:

• Daily physician rounds
• Medication management
• Treatment of complications

Nursing care:

• Round-the-clock RN/LPN staffing
• Medication administration
• Patient assessment and documentation

Medications:

• Withdrawal symptom management
• Comfort medications
• Prevention of complications (seizures, delirium)
• MAT initiation where appropriate

Support Services

Clinical assessment:

• Comprehensive intake evaluation
• ASAM level of care determination
• Treatment planning

Care coordination:

• Discharge planning
• Connection to ongoing treatment
• Insurance coordination

Housing and meals:

• Private or semi-private rooms
• Three meals daily

Facility Costs

Licensed facilities:

• Hospital-based detox units
• Freestanding detox facilities
• Accreditation and regulatory compliance

Staff credentials:

• Addiction medicine physicians
• Psychiatric consultation
• Licensed nurses
• Certified counselors

Insurance Coverage for Detox

Federal Requirements

Under the Affordable Care Act and Mental Health Parity laws, insurance must cover medically necessary detox.

What’s covered:

• Medical detoxification for all substances
• Medications used in detox
• Medical monitoring
• Transition to ongoing treatment

Parity requirement: Detox covered at same level as other medical care

Learn more: Does insurance cover rehab?

Coverage by Plan Type

PPO Plans:

• Coverage: 60-80% after deductible
• Example out-of-pocket: $1,200-$6,500 depending on substance
• Carriers: Aetna, Cigna, UnitedHealthcare

HMO Plans:

• Coverage: 70-85% after deductible (often lower deductible than PPO)
• Must use in-network facilities
• Example: Kaiser Permanente uses copay structure

Medicaid:

• Coverage: Typically $0 copay
• Example: Molina Medicaid in 15 states

Medicare Advantage:

• Coverage: Varies by plan, often copay-based
• Example: Humana Medicare Advantage

Preauthorization

Most insurance requires preauthorization for planned detox, though emergency detox is covered.

Emergency exception: If you go to ER in acute withdrawal, insurance covers emergency stabilization.

Detox vs. Treatment

Critical understanding: Detox is NOT treatment.

Detox: Manages withdrawal symptoms, stabilizes you medically (3-14 days)

Treatment: Addresses underlying addiction, teaches coping skills, provides therapy (30-90+ days)

Statistics: Detox alone has >90% relapse rate within days to weeks without ongoing treatment.

Recommendation: Detox should immediately transition to inpatient, PHP, or IOP treatment.

Learn more: Types of rehab programs

The Danger of Home Detox

Many people consider home detox to save money. This is dangerous and ineffective.

Why Home Detox Is Dangerous

For alcohol and benzodiazepines: Can be fatal due to seizures and delirium

For all substances:

• No medical monitoring of complications
• No medications to reduce symptoms
• Extreme discomfort leads to early relapse
• Dehydration and electrolyte imbalances
• No transition to ongoing treatment
• No MAT initiation for opioid use disorder

Relapse and Overdose Risk

Immediate relapse: Most people relapse within hours to days of attempting home detox due to severe symptoms

Overdose risk: After period of abstinence (even days), tolerance drops dramatically. Using the same dose after detox can cause fatal overdose.

Statistics: Overdose risk is highest in weeks and months after detox without ongoing treatment and MAT.

Financial False Economy

Perceived savings: “I’ll save $2,000-$8,000 by detoxing at home”

Actual costs of failed home detox:

• Medical costs if complications occur (ER visit: $1,500-$3,000)
• Continued substance use costs ($50-$200+ daily)
• Repeating cycle multiple times
• Risk of overdose death (priceless)

Insurance covers detox: There’s no financial reason to risk home detox if you have insurance.

Finding Detox Facilities

Types of Facilities

Hospital-based detox:

• Medical hospital detox units
• Highest level of medical supervision
• Often most expensive

Freestanding detox centers:

• Specialized detox-only facilities
• Medical staff on-site 24/7
• Most common type

Residential treatment with detox:

• Detox is first phase of residential program
• Seamless transition to ongoing treatment
• Most efficient model

Verifying Insurance Coverage

Before entering detox:

1. Call behavioral health number on insurance card
2. Verify facility is in-network
3. Confirm detox coverage (typically covered at inpatient rate)
4. Understand your out-of-pocket costs
5. Get preauthorization if required (or confirm emergency coverage)

Most facilities offer free benefits verification.

What Happens After Detox

Successful recovery requires continuing to appropriate level of care:

Step-down progression:

1. Medical detox (3-14 days)
2. Inpatient/residential treatment (30-90 days)
3. Partial hospitalization (2-4 weeks)
4. Intensive outpatient (8-12 weeks)
5. Standard outpatient (ongoing)
6. MAT continuation (12-24+ months for opioids)

Total costs: Learn more about how much rehab costs for the full continuum.

Sources

• American Society of Addiction Medicine (ASAM). “The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management.” 2020.
• National Institute on Drug Abuse (NIDA). “Principles of Drug Addiction Treatment.” 2024.
• Substance Abuse and Mental Health Services Administration (SAMHSA). “Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol.” 2024.
• World Health Organization. “Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.” 2024.
• Centers for Disease Control and Prevention (CDC). “Opioid Overdose Prevention.” 2024.