Alcohol detox, and where it actually happens

Why alcohol is different from almost everything else

People are often surprised that heroin withdrawal is rarely dangerous while alcohol withdrawal can be. It is deeply unpleasant to come off opioids and it very seldom kills anyone. Alcohol is the other way round.

Alcohol suppresses the central nervous system. Drink heavily for long enough and the brain compensates by turning its own excitatory systems up to stay level. Take the alcohol away suddenly and that compensation is left unopposed, so the nervous system runs hot. In its mild form that is tremor, sweating and dread. In its severe form it is a seizure, or delirium tremens, which involves confusion, hallucinations, fever and cardiovascular strain, and which still carries a real mortality even when it is treated properly.

The other reason for medical supervision is thiamine. Heavy drinking depletes vitamin B1, and a depleted brain given a sudden glucose load can develop Wernicke's encephalopathy, which can become permanent. Hospitals give thiamine, often by injection, as a matter of routine. It is one of the clearest illustrations of why a detox is a medical event rather than a test of resolve.

What the withdrawal timeline usually looks like

Not everyone goes through every stage. Risk rises with how much and how long you have been drinking, with age, with other health conditions, and above all with whether you have had a complicated withdrawal before. UK clinical guidance from NICE treats a history of seizures or delirium tremens as a clear indication for a medically assisted withdrawal rather than a community one.

How the referral works, step by step

There is nothing complicated about it, and none of it costs anything until you decide to go ahead.

England or Spain, and why it matters

The detox hospital can be in England or in Spain, and the right answer depends on your circumstances rather than on our convenience.

England. Close to family, familiar to your GP, and frequently covered by private medical insurance that will not extend to treatment abroad. If you have a consultant already involved in your care, keeping the detox in the same system is usually simpler. You then fly out once you are through it.

Spain. One journey rather than two, and it puts distance between you and the environment the drinking is tied to, which for some people is the point. If the hospital is in Málaga province, something happens that is unusual and worth understanding properly.

What actually happens during a hospital detox

The picture people carry around is usually worse than the reality. A properly run detox is dull, which is exactly what you want.

On admission you are assessed and your withdrawal is scored, typically using a scale that rates tremor, sweating, agitation, nausea and similar signs. Medication is given against that score, most often a long-acting benzodiazepine such as chlordiazepoxide, either on a reducing schedule or in response to your symptoms. The dose comes down over the days that follow and stops. Thiamine is given to protect against Wernicke's encephalopathy, frequently by injection at first. Fluids, blood tests and observations run alongside.

Benzodiazepines are used here precisely because they act on the same system alcohol does, which lets the nervous system down gradually instead of all at once. Their use is short, supervised and tapered. That is a different thing from a benzodiazepine prescription that continues for months, and it is the reason a detox needs a doctor rather than a friend with leftover diazepam.

Detox is not treatment, and this is the part that gets skipped

A detox clears alcohol from the body and gets you safely through withdrawal. It does not address why you were drinking, and on its own the relapse rate afterwards is high. It is the anaesthetic, not the operation.

What follows here is a 28-day residential programme: three structured group sessions a day, individual therapy, a curriculum that covers relapse, trauma, family and the practical business of a life without drinking, and an aftercare plan written weeks before you leave rather than handed over on the last morning. You can read the full programme or the breakdown of what it costs to run.

What it costs

The residential programme is published at £9,900 for 28 days, with a private room as standard. The hospital detox is arranged and billed separately, because it is delivered by a hospital and not by us, and the figure depends on where it happens and how long you need. Medical, psychiatric and laboratory costs are also separate. You get an itemised written quotation before you commit to anything, and we neither pay nor accept referral fees for sending anyone anywhere.

When we will tell you not to come

Some people need more medical support than a residential centre in the countryside can provide, and the assessment exists partly to catch that.

We will say so if you need a hospital rather than us: an unstable physical health condition, a psychiatric presentation that needs inpatient care, a withdrawal history severe enough that the risk sits beyond what any residential setting should carry, or a situation where the safest place for you this week is an emergency department. Being turned down by us is not being turned away from help, and we will point you at where the help actually is.

Frequently asked questions

Does Sierra Recovery Spain do alcohol detox?

No. We are entered in the Registro Andaluz de Centros, Servicios y Establecimientos Sanitarios (the Andalusian register of health centres, services and establishments) under N.I.C.A. 67331, authorised for atención sanitaria a drogodependientes (healthcare for drug dependency, authorised care unit U.71). That is a registered health centre with a supervised treatment residence. It is not a hospital and it is not a detox unit. Every detox we arrange happens in a hospital before your stay begins.

How long does an alcohol detox take?

Usually seven to ten days as an inpatient. The acute physical withdrawal is largely over within three to five days, and the remainder is stabilisation and getting the medication down to nothing. Sleep, mood and concentration take considerably longer to recover, which is what the residential programme is for.

Can I detox at home instead?

Sometimes, but that is a decision for a doctor who knows your history, not one to make from a website. Community detox is a recognised route for people whose dependence is milder and whose home is stable and alcohol-free. It is not appropriate if you have had a withdrawal seizure or delirium tremens before, if you drink very heavily, or if you would be doing it alone.

Will my insurance cover the detox?

Often, if the detox is in England, and often not if it is abroad. That is one of the main reasons people choose an English hospital for this stage and travel out afterwards. Check the wording with your insurer before you book anything, and tell us what they say so the plan fits it.

What if the detox hospital is in Málaga?

Then our therapists travel to the hospital and start therapy with you there, so the psychological work begins while you are still an inpatient rather than after discharge. You arrive at the centre already known to your therapist and already inside the programme.

What happens if I have tried detox before and gone back to drinking?

It is the most common history we hear, and it is not evidence that treatment does not work for you. It is usually evidence that a detox happened and nothing followed it. A detox with no therapy behind it is a physical reset in an unchanged life. What changes the odds is what comes after: sustained therapy, a treated mental health condition, and a relapse plan written before it was needed.

How do I start?

Call +44 1202 653136 and you will reach our admissions team, all of them clinicians, or ask for an assessment. You can also go to your GP or a free local alcohol service, and if that is the better route for you we will say so.