How Long Is Alcohol Rehab?

It probably started small — a round of margaritas with friends on the weekend, then a glass or two with dinner. Then the glass became a bottle. Excuses started cropping up in your mind (“If it fits in two glasses, it counts as two drinks!” “If I’m in an airplane, it doesn’t count at all — we’re between time zones!”) 

You hoped that people didn’t notice. You chewed gum to mask the smell, hid booze in your coffee thermos, and stashed bottles of wine in the back of your closet. And it’s true, many people didn’t notice, attributing the emotional outbursts to stress, lateness to an unfortunate personality quirk, and the smell — well, who knows. That’s getting a bit too personal anyway.

But some of them did notice. In fact, one friend handed you a list of alcohol treatment options, including an inpatient rehab. You stashed it in the back of the closet (right under those wine bottles), but one day you decide to dig it back out. It’s warped, folded, and grimy with wine-colored rings stamped on top, but you can still see everything clearly. It looks nice in the pictures, like a resort (don’t they all?) and it sounds … well, you’re starting to feel like it might be your best option. But then questions start flooding your mind: how long does alcohol rehab take? And how long do people stay in rehab? Can you leave early? Can they make you say against your will? (Eek! You hope not.) Let’s explore what alcohol rehab is all about, how long it takes, and what the alternatives are.

The Road to Rehab

First things first: what are we dealing with? And how did we get here? 

AUD: A Sneak Attack

Alcohol use disorder (AUD) might look a bit different in each case, but there are some hallmark features at play. 

• Alcohol disrupts our brain chemistry. From the moment we swallow those first sips of wine (whether we’re hiding in the back of the closet or pouring it out in the open at a family dinner), it floods our brain with dopamine. The result? A brief rush of pleasant feelings, which trigger the brain’s reward system and keep us coming back, sometimes with devastating results. Alcohol also increases GABA and lowers glutamate, two neurotransmitters that trigger relaxation and stimulation, respectively.
• Over time, misuse can lead to dependence. As our brain adjusts to the “new normal” of alcohol use, it alters the natural production of neurochemicals in response. The result? Our tolerance keeps inching up and we might experience withdrawal if we suddenly stop drinking. (Check out “Alcohol Withdrawal: A Timeline of What To Expect” and “Alcohol Misuse vs. Dependence: What's the Difference?”)
• Once we’re dependent on alcohol, the rest of our life takes a hit. Responsibilities fall by the wayside, relationships get strained, and others are noticing that we’re out of sorts, drifting farther from our usual selves. Still, there always seems to be a reason to keep drinking. We can “cut back if we want to,” we tell ourselves. And yet we don’t. 
• Our health suffers as well. We’re likely to find that our sleep is less restful, our blood pressure and heart rate are on the rise, and we feel queasy and anxious at the drop of a hat. Waking up with a headache (and frequent colds) has become the norm. We hope our mirror (and scale) are both broken, as we look years older and keep gaining weight in spite of eating as much as we usually do (at least as far as we remember what we ate on a given day). Our doctor might have warned us about elevated liver enzymes and keeps asking about our drinking habits. We think, “How nosy!” And yet we persist — drinking more in an ironic attempt to quiet our own fears about the future.

All in all, AUD sets in motion a vicious cycle that can feel well-nigh impossible to get out of. But there’s hope!

Where Does Rehab Come In?

At the heart of AUD, there’s a frustrating paradox: we want more and more of something (booze) that we wish we didn’t want. Here’s how addiction specialist Allen Carr describes it: “What you really enjoy in an alcoholic drink is not the drink itself, but the ending of the irritation of wanting that drink. Nondrinkers enjoy that all the time.”

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes this situation as a three-step cycle. We drink excessively, experience withdrawal (along with all the negative repercussions of our habit), and begin obsessing over and craving alcohol. Eventually, the craving pushes us back to the very thing that gave rise to it in the first place — booze.

The main purpose of rehab? Interrupting the cycle by dealing with withdrawal and cravings while learning new coping skills and developing a strong support system to rely on once we’re back in the “real world.” In other words, rehab provides the much-needed space that temporarily takes booze out of the picture entirely. The result? An opportunity to hit the “pause” button on everything except our recovery so we can return to our life and responsibilities rested, recalibrated, and more resilient.

Do We Have That Kind of Time?

The short answer is that yes, barring outside obstacles, we do have the time to spend on finding our footing — no matter how long it takes. We’re dealing with a powerful threat to our health and well-being, and if our dependence has reached life-threatening levels, we should do whatever we need to in order to break the cycle. There’s always time to deal with something that’s putting our life in danger.

Plus, think of all the time alcohol has taken from us — anything from the time we spend thinking about booze, buying it, hiding it, arguing about it, and cleaning up the mess it leaves in our lives on a daily basis. A few weeks doesn’t even begin to compare.

That said, life can get tricky and sometimes there are practical obstacles in the way. Don't worry, we’ll address some alternatives and potential solutions later on.

Why Go to Rehab?

Why do people go to rehab in the first place? In general, rehab is all about creating a new way of living. Most programs have several specific goals:

• Getting booze out of our system and restoring our health. First order of business? We need a clean slate. Some rehab centers include a medical component of detoxification to manage withdrawal symptoms. We might need medications to deal with anxiety, insomnia, and nutrient depletion. We might also be prescribed meds to keep cravings at bay (again, it’s all about clearing some mental space to address the underlying problem without distractions). 
• Understanding our drinking patterns. Rehab gives us a chance to step back and look at our drinking patterns in a safe setting. It’s a judgment-free zone that’s all about understanding why we drink and helping us uncover emotional patterns around our behaviors.
• Developing coping strategies. If you’re thinking, “Here we go — this one’s going to be about taking bubble baths or making collages to represent your feelings,” don’t worry. Coping skills are simply ways to deal with life’s twists and turns without booze. Just as crucially, they’re about dealing with the cravings to drink — a practice known as “urge surfing.”
• Setting ourselves up for future success. Finally, rehab usually involves creating a prevention plan and building up our support system — medical professionals, therapists, and peers who can help us stay on track once we leave.

As we can see, rehab is all about interrupting the cycle and creating a shift. Once our mindset has shifted and our new routine is in motion, things get easier!

How Long Does Alcohol Rehab Take?

It’s all about establishing healthy habits, which takes at least a month, according to scientists. However, sometimes it might take quite a bit longer. 

How long is rehab for alcohol? The initial detoxification takes 7–10 days, followed by several weeks of rehabilitation, with most residential programs running 30–90 days.

However, the exact answer depends on a few factors.

1. Severity of Addiction: Getting Out of the Woods

As we pointed out from the get-go, alcohol is a sneaky character. While misuse tends to escalate over time, it can take a while.

Some people compare the process to walking through the woods. If we spent 10 years walking in one direction, it’s only natural that we’ll have a longer way to go when we reverse our course. (Don’t worry, we’re not talking 10 years of rehab here — the point is that if we drank for a while, we might need a few more weeks to revamp our physical and mental patterns.)

Once again, the answer has to do with the brain. The neurological changes that set in once alcohol becomes a regular presence can take years to develop, gradually changing the circuits involved in reward, motivation, memory, and judgment. And while the brain can recover through the power of neuroplasticity, the new “new normal” takes time to develop.

2. Biological Factors: When It Runs in the Family

The question of whether AUD is triggered by genetics or lifestyle and environment is one for another day (to take a deep dive, check out “Alcoholism: Genetic Disease or Lifestyle Choice? Debunking Myths”).

The short answer is, probably a bit of both. It’s clear that some people do seem to have a genetic predisposition that makes AUD more likely. They might metabolize alcohol differently, leading to a higher tolerance for booze. They might also have differences in the neurochemistry related to the dopamine-driven reward system that puts them at greater risk.

Either way, certain biological features can make it more difficult to leave AUD in the past. The result? We might be looking at the higher end of the 30–90 day rehab stay.

3. Psychological Factors: Seeing the Whole Picture

Part of the rehab experience is building up our inner resources to deal with life in more productive ways. It’s only natural that this process takes time (and that it takes longer in some cases than in others). 

It took us time to master the unhealthy route, and it will take time to develop a new go-to set of tools. For example, many people find cognitive behavioral therapy to be a great asset in overcoming alcohol misuse. This method is all about disclosing our own automatic thought patterns and distortions, and replacing the ones that drive us

Moreover, the process is more complex if there are additional mental health challenges in the picture. For example, many with AUD struggle with other psychological and psychiatric problems, such as bipolar disorder, depression, anxiety, OCD, or eating disorders. All of them can team up with AUD, forming a neurological alliance working against us. Dismantling this task force and figuring out how the different parts fit together, in turn, can be a lengthier process.

4. Social and Economic Factors: When Life Gets in the Way

Support from family and friends is crucial, and having a strong network we can rely on can speed things up a bit. Family members might even participate in meetings with our treatment team. The more planning we can do in advance, the smoother the journey will be later on!

If we don’t have a strong support network or live in a high-risk environment, the rehab process could end up taking longer — and that’s okay, too! For example, if we live with others who are struggling with alcohol misuse themselves (or don’t support our journey for whatever reason), there might be more strategic planning to do. Our treatment team can connect us with people on a path similar to our own. Support groups in our area are also excellent places to build relationships. Don’t worry, the support is there — it just might take a some digging on our part to find it.

On the other hand, there are also practical considerations at play when it comes to social factors and the length of our rehab stay. For example, a single mother without a strong family support network in the area might not be able to spend 30 days in a rehab facility. Likewise, someone might not be able to afford a longer stay for financial reasons — for example, if taking more than 30 days off results in job loss or homelessness. Those cases call for some creative planning and searching for alternative options (more on that later).

Rehab Alternatives

That said, rehab might not be for everyone. Luckily, there are plenty of alternatives to rehab for those who find it’s not for them. (For a deep dive into the reasons, check out “Why Does Addiction Rehab Fail for Some People?”)

1. Outpatient Programs: Rehab “From Home”

For those who aren’t quite up for a full-on rehab stay (or simply can’t do it for the reasons we mentioned earlier), there’s outpatient rehab. Similar in structure to inpatient and residential programs, it has one major difference: you get to go home in the evening. 

The program itself will probably involve individual therapy, group therapy, and various workshops to hone coping skills and iron out our relapse prevention plan. We’ll get exposed to the same tools and techniques, including mindfulness, cognitive restructuring, journaling, urge surfing, and more. 

2. Therapy: Talking Through Your Troubles

In addition to traditional talk therapy, there are plenty of options to choose from these days.

• Cognitive behavioral therapy. As mentioned earlier, cognitive behavioral therapy (CBT) is all about reframing our thought patterns around alcohol. For instance, we might uncover cognitive distortions such as this example of “fortune-telling” or “jumping to conclusions”: “If I don’t drink at happy hour, none of my coworkers will like me.” Once we dig deeper, we can see that there’s no real-world evidence behind this thought — we don’t have to believe it!
• Dialectical behavioral therapy. The brainchild of Marsha Linehan, a psychology researcher at the University of Washington, DBT was originally developed to treat borderline personality disorder (BPD). However, its four modules — mindfulness, emotional regulation, interpersonal effectiveness, and distress tolerance — work wonders for AUD and other forms of substance misuse.

While CBT and DBT are often part of alcohol rehab, there are many qualified therapists who can work with you on an outpatient basis. Look around!

3. Bibliotherapy: Between the Lines

And for book lovers out there, there’s bibliotherapy! Reading about others’ experiences can provide crucial insights into our own journey. For example, This Naked Mind: Control Alcohol, Find Freedom, Discover Happiness & Change Your Life by Annie Grace, Between Breaths: A Memoir of Panic and Addiction by Elizabeth Vargas, and The Unexpected Joy of Being Sober by Catherine Gray are all great places to start.

4. Technology: Typing, Tracking, and More

These days, support for your alcohol journey is right there in the palm of your hand! Apps such as Reframe have revolutionized the landscape of addiction recovery. A state-of-the-art neuroscience resource, toolkit, and support system all in one, it’s an excellent choice for those whose alcohol misuse might not require hospitalization. Likewise, it’s a perfect tool to use after your rehab stay to maintain your progress.

“Power of the Pause”

All in all, what we really need in order to deal with our dependence on alcohol is a pause. Here’s how Amy Johnson describes it in The Little Book of Big Change: “There’s power in the pause.” A pause — whether it means going for a walk, counting to 10, or taking a month off to go to rehab — can give us the power we need to get outside of our present situation and change it. In fact, when it comes to interrupting a habit, it’s one of the most powerful tools out there.

A pause allows us to step back and make an intentional shift in our path. And sometimes — whether or not that happens by going to rehab or simply by becoming more mindful of our patterns — that’s all we need for our lives to take a turn.