Understanding drug detox and where it's available in Europe

For many people, withdrawal is the part of detox they feel most anxious about. It’s also the hardest part to predict, because the experience changes with the substance, the length of use, and the person. You may experience some combination of the following physical symptoms:

• Nausea, vomiting, and diarrhoea
• Sweating, tremors, hot and cold flushes
• Muscle aches and headaches
• Disturbed sleep

And the following psychological symptoms:

• Anxiety, irritability, and low mood
• Intense cravings
• Restlessness and difficulty concentrating
• Vivid dreams, particularly during cannabis or stimulant withdrawal

The picture varies by drug class. For example, according to the World Health Organization clinical guidelines, opioid withdrawal timelines depend on the type of opioid. Symptoms begin 8-24 hours after the last dose of a short-acting opioid such as heroin, and 12-48 hours after a long-acting one such as methadone. 

Benzodiazepine withdrawal can begin within one to two days and continue for several weeks. 

Cocaine withdrawal crashes tend to start immediately, and are marked by strong cravings, low mood, and disturbed sleep.

Most drug detoxes at Castle Health run for 7-10 days. That’s the window in which the body clears the substance and the worst of the physical withdrawal subsides. Cravings and low mood can last longer, which is why detox flows directly into the wider treatment programme, rather than stopping when the medical phase ends.

The drug withdrawal timeline depends on several things:

• The substance, and whether it is short-acting or long-acting
• How long you have been using, and in what quantity
• Your general physical health, including any liver or heart conditions
• Any co-occurring mental health condition
• Other medications you take

Medical supervision means a clinician is present for the parts of detox people are most anxious about.

At Castle Health, every drug detox begins with a comprehensive assessment by a Consultant Psychiatrist. This includes a detailed medical history, a mental health review, and blood tests to identify any complications. From that assessment, an individualised prescription and care plan is built.

Your personalised plan accounts for the substance you’ve been using, your level of dependence, and your wider physical and mental health. No two plans are the same.

Across the withdrawal and detox period, the medical team monitors vital signs, adjusts medication as withdrawal changes, and is present around the clock if anything shifts. Where medication is clinically indicated, common options include:

• Buprenorphine, or in some cases methadone, for opioid withdrawal
• A gradual tapering of benzodiazepines for benzodiazepine dependence, with anticonvulsants where seizure risk is present
• Antipsychotic medication where stimulant use has produced psychotic symptoms
• Symptomatic medication for nausea, disturbed sleep, and anxiety

You can read more about our medically-led approach to safe drug detox and our admissions process.

Therapy begins during the detox phase, alongside the medical work. Approaches such as Cognitive Behavioural Therapy (CBT) and trauma-focused therapy run in parallel with the clinical care. By the time the withdrawal subsides, the foundations of the recovery work are already laid.

Detoxing from drugs at home isn’t the same as cutting back, and can carry real medical risk that most people underestimate. For example, withdrawal from alcohol, benzodiazepines, and GHB can produce severe and life-threatening complications – including seizures and cardiovascular collapse.

The harder part is that withdrawal severity is difficult to predict in advance. Two people with similar use patterns can have very different experiences, so medical supervision is what makes that variability safe to manage.

Detoxing alone, in the environment where the use happened, also often means there’s no support when cravings peak and no clinical option when symptoms get harder. 

That’s when many home detoxes come undone, and why it’s the medical and emotional scaffolding of a residential clinic that helps make the recovery process hold sustainably.

The first call isn’t a sales call. Someone on the admissions team will talk through what you’re dealing with and what kind of support would actually help. That may be residential detox at Castle Health, or it may be something else. 

Some people need inpatient detox, some need an outpatient detox programme, and some need a longer assessment before any of that is decided. You can read more about our admissions process on the dedicated page.

Once a placement is agreed, you are assessed in person by a Consultant Psychiatrist, with full medical history, blood tests, and a mental health review. That assessment shapes:

• Your individual detox plan
• Prescriptions given (if any)
• An aftercare plan, and 
• How the rest of treatment is paced for you

No. You don’t have to stop or even cut down before getting in touch. Many people who call us are still using when they make that first contact. We can carry out an assessment and plan your detox while you’re still using, and the team will agree the safest point to begin. Trying to stop on your own before an assessment can be risky. Unsupervised withdrawal from alcohol or benzodiazepines can be life-threatening, with seizures and serious cardiovascular complications. Unsupervised opioid withdrawal isn’t usually life-threatening in itself, but it’s intensely difficult, often leads to relapse, and shouldn’t be attempted without clinical guidance.

Detoxing from drugs during pregnancy is more medically complex, and needs specialist input from the start. Some standard detox medications aren’t safe in pregnancy. Research published in the American Journal of Obstetrics and Gynecology has associated unsupervised opioid withdrawal during pregnancy with an increased risk of stillbirth, fetal distress, and premature labour.

 World Health Organization guidance specifically advises against opioid withdrawal in pregnancy, recommending methadone maintenance treatment instead. At Castle Health, each case is assessed individually by our Consultant Psychiatrist, working closely with maternity services where needed.

Rapid detox is an accelerated withdrawal process, often carried out under anaesthesia and most often associated with opioid dependence. Castle Health doesn’t offer this because the medical risks are higher than standard medically supervised detox. Relapse rates afterwards are also higher, because there’s no time to build the therapeutic foundations recovery actually rests on. 

A safe detox is one that sets you up for the treatment that follows.

Yes, in some cases. The specific medication depends on the substance and your medical history. Opioid withdrawal is typically managed with buprenorphine or methadone, benzodiazepine dependence with a tapered withdrawal, supported by anticonvulsants where seizure risk is present. All prescribing decisions sit with the Consultant Psychiatrist. Medication is one part of the plan. Monitoring, therapy, and clinical supervision do the rest.

Detox flows directly into our residential treatment programme, with the same clinical team continuing care. Therapy, group sessions, family work, and aftercare planning begin while you are still in detox and continue throughout your stay. By the time you complete treatment, an aftercare plan is in place. You can read more about treatment for drug addiction, after detox on the dedicated page.

One important safety point sits inside that aftercare plan, particularly after opioid detox. Tolerance drops quickly during a period of abstinence, so a relapse with the dose someone was using before detox carries a real risk of overdose. Discharge planning includes this conversation, so you leave aware of the risk and with a plan in place if cravings build.

Many patients also stay connected to peer-support fellowships such as Narcotics Anonymous, which sustain the recovery community after you leave the clinic.

Drug detox costs vary depending on the clinic, the length of stay, and the level of care needed. We don’t publish a flat price, because the assessment shapes the plan, and the plan shapes the cost. The admissions team can give you an accurate figure once they have a clearer picture of what’s needed. The first call is free and carries no commitment.