The word “detox” gets used for three different things, and confusing them costs people time. It can mean a bed for a few nights. It can mean a medical stage inside a treatment program. Or it can mean a product sold online that has nothing to do with either. This page is about the second one.
Our nearest campus to Philadelphia is The Recovery Village Cherry Hill at Cooper, in Cherry Hill, New Jersey. It is across the Delaware River in Camden County, which raises a coverage question this page answers directly. What follows covers what supervised withdrawal does, which substances need it, how the first days run, and why the period straight afterwards carries the highest risk. Our Philadelphia treatment page covers the wider picture.
What “Medical Detox” Means and What It Does Not
Medical detox is the supervised management of withdrawal. Staff monitor, measure and treat symptoms so that a person gets through it safely and can start treatment.
It is not treatment for a substance use disorder. Most people need long-term treatment after detox [7]. Booking detox and nothing else is the most common planning error at this stage.
It is also not an emergency department. An ER in Philadelphia will stabilize someone in crisis, and that is genuinely life-saving, but it is not a detox program and it does not hand anyone into ongoing care. Different services, different jobs.
And it is not a product. Nothing bought over a counter manages withdrawal from alcohol or benzodiazepines, both of which can produce seizures.
What detox buys is a safe passage and a start. Our page on medical detox covers what a stay involves.
Which Substances Need Medically Supervised Withdrawal
The answer varies by substance, and the reasons differ more than people expect.
If someone is having a seizure, is unresponsive or has trouble breathing, call 911. For a mental health crisis, call or text 988.
Opioids come up most often in Philadelphia. Opioid withdrawal is severe and is scored with the Clinical Opiate Withdrawal Scale, which assesses 11 signs and symptoms [1]. It is administered by a clinician observing the person, not filled in at home, and this page does not publish its score bands for that reason: a number someone reaches alone is not the thing the scale is for. The greatest danger sits just after it rather than during it. Withdrawal reduces a person’s tolerance, so someone who has just gone through it can overdose on a much smaller amount than they used to take, and most opioid overdose deaths occur in people who have just detoxed [7].
Alcohol is a different case, because the withdrawal itself can be fatal. Seizures and delirium tremens are outcomes in severe alcohol dependence that can lead to fatal consequences [2]. The majority of alcohol withdrawal seizures occur within the first 48 hours after drinking stops or is reduced [2].
Benzodiazepines carry a comparable seizure risk, and any change is planned by a prescriber rather than attempted alone.
If someone is having a seizure, is unresponsive or has trouble breathing, call 911. For a mental health crisis, call or text 988.
Stimulant withdrawal usually does not involve medical danger or intense patient discomfort [2]. The exception is the one federal guidance calls potentially lethal and often overlooked: a profound dysphoria that can include suicidal thoughts or attempts, with amphetamine users in particular to be monitored closely for signs of suicidality during detoxification [2]. Supervision here is about safety and continuity rather than physical danger.
If someone is having a seizure, is unresponsive or has trouble breathing, call 911. For a mental health crisis, call or text 988.
Federal guidance is that for alcohol, sedative-hypnotic and opioid withdrawal, hospitalization or some form of 24-hour medical care is generally the preferred setting for detoxification [2].
An assessment sorts which of these applies, usually inside one phone call.
The Cherry Hill Campus and the Step Into Treatment
The Recovery Village Cherry Hill at Cooper publishes medical detox, residential and inpatient treatment, a partial hospitalization program, an intensive outpatient program, standard outpatient care and aftercare.
Detox and the levels after it, across the river
The Recovery Village Cherry Hill at Cooper in Cherry Hill, New Jersey runs medical detox, residential treatment, a partial hospitalization program, intensive outpatient care, standard outpatient care and aftercare. Having every level on one campus means the step out of withdrawal is into the next stage rather than into a gap.
Check your coverage and admissions
Verify your insurance
The Recovery Village Cherry Hill at Cooper is part of our family of treatment centers. See the Recovery Village Cherry Hill at Cooper campus.
That full range is the reason it is worth crossing the river for. The riskiest moment in this whole sequence is the hour after detox ends, when a person is physically clear and has nowhere booked. On a campus running every level, that hour does not exist as a decision point.
It also means one team holds the case throughout. No re-telling the history at each stage, and no handover for something to fall through. Our page on inpatient rehab covers the stage that follows withdrawal, our Cherry Hill campus page has the detail on this site, and our guide to the levels of care explains what each stage is for.
Getting There From Philadelphia
Cherry Hill is in Camden County, New Jersey, directly east of Philadelphia across the Delaware River. The Ben Franklin Bridge and the Walt Whitman Bridge are the two usual crossings, and PATCO runs rail services from Center City into Camden County.
Cherry Hill is about 6 miles east of Philadelphia in a straight line and farther by road, in the same metro area. For a detox admission that distance is short, which matters practically. A family member driving over is a trip rather than an expedition, and the same is true for family sessions later.
Two things still need settling. Someone else should drive if withdrawal risk has been flagged. And the car needs a plan, since a person admitted for detox is not driving back that evening.
The state line has one real consequence, and it is not about roads. It is about insurance networks, because a Pennsylvania plan may treat a New Jersey facility differently from one in Bucks or Delaware County. That is worth resolving before admission rather than after, and it is covered further down. Our guide to how to get into rehab covers the rest.
The First 24, 48 and 72 Hours
Opioid and alcohol withdrawal run on different clocks [1] [2]. So the shape of those first days depends entirely on what is being stopped.
For opioids, the curve rises early and hard. TIP 45 gives the figures per drug rather than for opioids as a class. Heroin withdrawal typically begins 8 to 12 hours after the last heroin dose and subsides within a period of 3 to 5 days [2]. Methadone withdrawal typically begins 36 to 48 hours after the last dose, peaks after about 3 days, and gradually subsides over a period of 3 weeks or longer [2]. Timing also decides when certain medications can start, which is a prescriber’s judgment rather than something to plan yourself [1]. Staff score progress on the Clinical Opiate Withdrawal Scale through the stay [1].
For alcohol, the course is less predictable than people expect. Federal guidance describes it as extremely variable: one person improves slowly through partial symptoms, another resolves abruptly, and another presents with a seizure or hallucinations [2]. The majority of alcohol withdrawal seizures occur within the first 48 hours after drinking stops or is reduced [2]. Because the course cannot be predicted confidently in advance, monitoring continues past the first days rather than stopping on a schedule [2].
If someone is having a seizure, is unresponsive or has trouble breathing, call 911. For a mental health crisis, call or text 988.
Sleep is bad across both and is usually the last thing to recover. Knowing that in advance makes the third night less frightening. Our alcohol withdrawal timeline sets out those stages in order.
Detox Medications and Monitoring
Monitoring runs against scales, and the scales are what separate supervised withdrawal from waiting it out.
For opioids it is the COWS, an 11-item assessment repeated through the stay [1]. For alcohol it is the CIWA-Ar: medication is given when the score crosses a set threshold, and the person is reassessed a short time later [2].
Medication follows the score. For opioid withdrawal, methadone and buprenorphine act on opioid receptors and double as ongoing treatment [3]. Supporting medications handle specific symptoms, and the FDA approved lofexidine hydrochloride in 2018 for use during acute opioid discontinuation [1]. For alcohol, benzodiazepines are the class used in supervised settings [2].
One medication is worth understanding before discharge rather than after. Naloxone rapidly reverses an opioid overdose by attaching to opioid receptors and blocking the effects of other opioids, and it can restore normal breathing when breathing has slowed or stopped [4]. It has no effect on someone without opioids in their system, and it is not a treatment for opioid use disorder [4]. Naloxone works in the body for only 30 to 90 minutes, and many opioids stay in the body longer than that, so a person can slip back into an overdose after it wears off and may need more than one dose [4]. Call 911 first, every time, even if the person wakes up. The signs it is needed include unconsciousness, very small pupils, slow or shallow breathing, limp limbs and purple lips or fingernails [4].
This page gives no amounts or schedules. Those belong to the treating clinician.
What Detox Costs in Pennsylvania and What Plans Typically Do
Detox is usually covered, and it is usually authorized in short blocks reviewed as they run.
Commercial plans sold in Pennsylvania, including Blue Cross and Blue Shield products, sit under federal parity law. Copays, coinsurance and treatment limits on substance use benefits cannot be more restrictive than those on comparable medical and surgical benefits, and separate limits applying only to those benefits are prohibited [5]. The law does not require a plan to offer the benefit at all; it governs how the benefit is covered when a plan does offer it [5]. Parity has a scope worth knowing. It applies to non-federal governmental plans with more than 50 employees, to private employer group plans with more than 50 employees, and to individual-market coverage [5]. Plans from small employers are not covered directly; they get comparable protection through the Affordable Care Act’s essential health benefits requirement.
Marketplace plans must cover substance use disorder treatment as an essential health benefit, with no annual or lifetime dollar limits and no higher price for a pre-existing condition [6]. Authorization requirements fall inside parity protections too [6].
The Philadelphia-specific question is the state line. Ask three things when you call: whether the New Jersey facility is in network for your plan, what the out-of-network benefit pays for detox and residential care if it is not, and whether a single case agreement is possible where network options nearby are thin.
Add a fourth question if you are on Pennsylvania Medicaid, because behavioral health there runs on its own track. Under the behavioral health component of the HealthChoices program, each member is assigned a Behavioral Health Managed Care Organization based on their county of residence, and members then choose behavioral health providers within that organization’s network [8]. So the plan that authorizes a detox admission is the county behavioral health plan, which is not necessarily the plan whose name is on the front of your card. Ask which Behavioral HealthChoices organization serves your county, and put the question to that organization rather than to the physical-health plan. Our pages on insurance coverage for rehab and what rehab costs explain the mechanisms, and our Pennsylvania treatment overview covers in-state options.
Detox Is Not Treatment: What Comes Next for Philadelphia Residents
The days after detox are the most dangerous in the whole sequence, and almost nobody is told that.
The reason is tolerance. Withdrawal reduces a person’s tolerance, so someone who has just gone through it can overdose on a much smaller amount than they used to take, and most opioid overdose deaths occur in people who have just detoxed [7]. Naloxone reverses an opioid overdose but does nothing for someone without opioids in their system, and it is not treatment for opioid use disorder [4]. It is a rescue, not a plan.
The plan is continuing care. Most people need long-term treatment after detox [7]. This is chronic-condition management, not a one-off repair.
Where opioids are involved, the medication decision belongs at the end of detox rather than months later. Methadone for opioid use disorder is only available through approved opioid treatment programs, while buprenorphine can be prescribed by many doctors, nurse practitioners and physician assistants with no special clinic [3]. Which is workable in Philadelphia shapes the plan.
At Cherry Hill the next stages sit on the same campus, so the step down runs through residential care, a day program, intensive outpatient and then outpatient rehab without a handover. Get it written before discharge with names and dates.
Frequently Asked Questions
How long does medical detox take? It depends on the substance and on measured severity rather than on a set number of days. Opioid withdrawal is scored by a clinician on the Clinical Opiate Withdrawal Scale rather than by a clock. For alcohol, federal guidance describes the course as extremely variable between people, and the majority of alcohol withdrawal seizures occur within the first 48 hours after drinking stops or is reduced. If someone is having a seizure, is unresponsive or has trouble breathing, call 911. For a mental health crisis, call or text 988.
Is there a detox center in Philadelphia? Our nearest campus is The Recovery Village Cherry Hill at Cooper, in Cherry Hill, New Jersey, across the Delaware River in Camden County rather than in Philadelphia. It runs medical detox plus residential treatment, a partial hospitalization program, intensive outpatient care, standard outpatient care and aftercare planning, so the stage after withdrawal is on the same site.
Will Highmark Blue Cross Blue Shield pay for detox in Pennsylvania? That depends on your specific plan rather than on the insurer. Federal parity law requires that copays, coinsurance and treatment limits on substance use benefits are no more restrictive than those on comparable medical and surgical benefits. It does not reach small employer plans directly, though the Affordable Care Act essential health benefit rule covers those plans instead. Ask specifically whether a New Jersey facility is in network for your plan.
Can I detox as an outpatient and keep working? Sometimes, but the assessment decides and the substance matters a great deal. Alcohol and benzodiazepine withdrawal can escalate to seizures, and the majority of alcohol withdrawal seizures occur within the first 48 hours after drinking stops or is reduced. If a seizure happens at home rather than in a supervised setting, that is a 911 call. Federal guidance is that for alcohol, sedative-hypnotic and opioid withdrawal, hospitalization or some form of 24-hour medical care is generally the preferred setting.
What happens after detox ends? Treatment starts, and the timing matters more than people realize. Withdrawal reduces tolerance, so someone who has just gone through it can overdose on a much smaller amount than before, and most opioid overdose deaths occur in people who have just detoxed. If someone is unresponsive or has trouble breathing, call 911. For a mental health crisis, call or text 988. Naloxone is a rescue rather than a plan. Most people need long-term treatment after detox, so the next stage should be booked before discharge.
Sources
- Shah, M., & Huecker, M. R. (2023). Opioid Withdrawal. StatPearls, National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK526012/
- Substance Abuse and Mental Health Services Administration. (2006). Chapter 4. Physical Detoxification Services for Withdrawal From Specific Substances. Detoxification and Substance Abuse Treatment, Treatment Improvement Protocol (TIP) Series, No. 45. NCBI Bookshelf, National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK64116/
- National Institute on Drug Abuse. Medications for Opioid Use Disorder. National Institutes of Health. https://nida.nih.gov/research-topics/medications-opioid-use-disorder
- National Institute on Drug Abuse. Naloxone DrugFacts. National Institutes of Health. https://nida.nih.gov/publications/drugfacts/naloxone
- Centers for Medicare & Medicaid Services. The Mental Health Parity and Addiction Equity Act (MHPAEA). https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity
- HealthCare.gov. Mental health and substance abuse health coverage options. Centers for Medicare & Medicaid Services. https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/
- MedlinePlus. Opiate and opioid withdrawal. National Library of Medicine. https://medlineplus.gov/ency/article/000949.htm
- Pennsylvania Department of Human Services. Behavioral HealthChoices: Behavioral Health Managed Care Organizations (BH-MCOs). Commonwealth of Pennsylvania. https://www.pa.gov/agencies/dhs/resources/medicaid/bhc/bhc-mcos
This page is for general information and is not medical advice. Only a licensed clinician who knows your history can tell you what is right for you. If you or someone you know is in immediate danger, call 911. For free, confidential support 24/7, call or text 988.
Author
Chief Medical Officer,
The Recovery Village
