What Is the Difference Between Rehab and Detox?


Sometimes the terms are used interchangeably in casual conversation. But there is a distinct difference between detox and rehab, even when the two are combined into a single treatment program.


Detox is short for “detoxification” and is the process of clearing the body of the addictive substance, and handling the immediate medical consequences of withdrawal. Because withdrawal times vary, the detox phase also varies. Some drugs, like cocaine, clear the system fairly quickly and the physical withdrawal is similarly quick. Others, like heroin or alcohol, can take much longer.

The consequences of detox depend on many factors, including –

* How long someone has been an addict. Longer use means the body has become accustomed to getting the drug and adapted to it. It also usually means the person is taking a higher than average dose.

* When the last dose was taken. If a person knows they will be going in for treatment, they sometimes go on “one last binge” and take a dose to prepare. Of course, this is nuts and just extends the time needed to detox. But addiction is nuts anyhow, so that shouldn’t be a surprise.

* How much a patient is taking. It’s a simple matter of a higher dose taking longer to clear out.

* Other factors like age, body weight and metabolism make a difference, with young and otherwise healthy meaning a quicker detox.

* By addiction type -- because some types of detox are very dangerous, doctors may extend the time to get completely off the substance for safety reasons. Alcoholics can suffer life-threatening seizures (the DTs) and need to be monitored carefully, even giving a little alcohol during withdrawal to mitigate symptoms. This is, however, more rare than in the past. Other drugs, like benzodiazepines (Xanax, Valium and others) require a lessening of the dose over several weeks to prevent a serious side effect from just stopping outright.


If detox is clearing the drug from the body, rehab can be thought of as clearing the drug from the mind. Here’s where the real work begins.

Since patients may still be suffering cravings and some symptoms of withdrawal, rehab (short for rehabilitation) sometimes starts slow, with these added problems in mind.

* The purpose of rehab is about education and changing the way an addict thinks about drug use.

* Information about their drug of choice and addiction in general will be shared.

* Personal problems should be addressed in a customized fashion – the same rehab won’t fit every person who needs help.

* Patients need to be assessed regularly, both to make sure they aren’t cheating and to see if they are absorbing what’s being offered. Assessments about other problems (for example: depression, malnourishment) will be taken as well.

* A follow-up, or after care plan is developed and customized to each patient’s situation outside of treatment.

These are just the highlights. Rehab has been found most useful when it goes at least three months, followed by outpatient group therapy (like AA or NA) and monitoring to detect relapse.


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