Rehabilitation should not be identical for every drug. The assessment, withdrawal plan, medication options, therapy priorities and overdose precautions differ according to the substance, pattern of use and the person’s physical and mental health.
A person may use more than one substance, including prescribed medicines and alcohol. Treatment therefore begins with a complete history rather than focusing only on the drug that first brought the person to care.
Urgent warning: Severe confusion, seizures, hallucinations, loss of consciousness, slowed or stopped breathing, chest pain, extreme agitation or immediate risk of harm require emergency medical care. Do not wait for a routine rehab admission.
What stays the same across substance use disorders?
Most treatment plans share several core elements:
- medical, psychiatric and substance-use assessment;
- the safest appropriate level of care;
- withdrawal management when needed;
- evidence-based medication where available and suitable;
- structured psychological treatment;
- care for co-occurring mental and physical conditions;
- overdose and harm-reduction planning;
- family, social and practical support;
- continuing care after intensive treatment.
The important differences are the medical risks, treatments with the strongest evidence and what needs to be monitored.
Alcohol rehabilitation
Alcohol use disorder can range from mild to severe. Treatment may occur in primary care, outpatient therapy, specialist programmes, residential services or hospital care.
Withdrawal considerations
Alcohol withdrawal can be life-threatening, particularly after prolonged heavy drinking or in someone with previous seizures or delirium. A clinician should assess whether stopping can be managed as an outpatient or requires monitored residential or hospital care. Withdrawal management is only the beginning of treatment.
Ongoing treatment
Evidence-based care can combine behavioural therapies, medication and mutual-support groups. Medications used internationally include naltrexone, acamprosate and disulfiram, although availability and approval differ by country. The person’s liver and kidney health, medicines, treatment goal and ability to take medication consistently affect the choice.
Read the full guide to alcohol rehabilitation and treatment options.
Opioid rehabilitation
Opioids include heroin and opioid pain medicines. Treatment must address overdose risk as well as dependence, withdrawal, pain, mental health and infectious-disease risks.
Medication treatment
Methadone, buprenorphine and naltrexone are evidence-based medication options for opioid use disorder, subject to clinical suitability and local regulation. SAMHSA’s TIP 63 reviews all three. Methadone and buprenorphine can reduce withdrawal and cravings; naltrexone blocks opioid effects after the person has completed an opioid-free period.
Medication is not merely “replacing one drug with another.” Properly prescribed medication is a treatment for a medical disorder. Requiring rapid discontinuation without a clinical reason can increase risk.
Why detox alone is risky
After a period without opioids, tolerance falls. Returning to a previous dose can cause a fatal overdose. Withdrawal-only treatment should therefore connect the person immediately with ongoing medication, psychological treatment, naloxone access where available and overdose education.
Stimulant rehabilitation
Stimulants include cocaine, methamphetamine and other amphetamine-type drugs. Acute problems may include chest pain, severe agitation, overheating, sleep deprivation, paranoia, hallucinations or depression. These symptoms may require urgent medical or psychiatric care.
Evidence-based treatment
There is no medication with broad international approval specifically for stimulant use disorder. Behavioural treatment is central. Contingency management has the strongest established evidence and may be combined with cognitive-behavioural therapy, community reinforcement, motivational interventions and practical recovery support.
Clinicians should also assess sleep, nutrition, cardiovascular risk, psychosis, suicide risk and other substance use. Medication may be used for co-occurring conditions or in carefully selected specialist care, but a programme should not advertise an experimental drug as a guaranteed cure.
Cannabis rehabilitation
Cannabis use disorder can involve cravings, difficulty cutting down, impaired functioning and continued use despite harm. Withdrawal may include irritability, sleep problems, low mood, restlessness and reduced appetite. Although usually not medically dangerous in the way severe alcohol withdrawal can be, symptoms can be distressing and may contribute to renewed use.
There is no medication with broad international approval specifically for cannabis use disorder. Treatment commonly uses motivational approaches, cognitive-behavioural therapy, contingency management and attention to sleep, mood, anxiety, psychosis risk and the person’s environment.
Adolescents need developmentally appropriate assessment and family involvement when safe and appropriate.
Benzodiazepine and sedative rehabilitation
Benzodiazepines are prescribed for conditions such as anxiety, insomnia or seizures, but physical dependence can develop with regular use. Physical dependence does not automatically mean a substance use disorder.
Benzodiazepines should not usually be stopped suddenly after regular use. Abrupt discontinuation can cause severe withdrawal, including seizures and delirium. The 2025 joint clinical guideline led by ASAM recommends a patient-centred, gradual taper that is adjusted according to symptoms and clinical risk.
Treatment should review why the medicine was prescribed, current dose and duration, alcohol or opioid use, seizure history, pregnancy, sleep, anxiety and access to follow-up. Some people need a higher level of care for tapering or withdrawal management.
Tobacco and nicotine treatment
Tobacco use is often overlooked in rehabilitation even though it contributes substantially to illness and death. Behavioural support can be combined with nicotine-replacement therapy and other medicines where appropriate and available.
Treating tobacco use does not have to wait until treatment for alcohol or other drugs is complete. The plan should respect the person’s priorities and avoid overwhelming them with multiple unsupported demands.
Hallucinogens, inhalants and other substances
There is no single standard “detox” for every substance. Treatment may focus on acute medical or psychiatric complications, psychological therapy, monitoring cognition and organ health, and preventing further exposure.
Inhalants can cause serious heart, brain, liver, kidney and nerve injury. Hallucinogen-related problems may involve panic, accidents, persistent perceptual symptoms or psychosis. A medical and psychiatric assessment is more important than placing the person automatically into a generic residential programme.
Polysubstance use
Many people use combinations such as opioids with benzodiazepines, alcohol with sedatives, or stimulants with opioids. Combined use can change withdrawal and overdose risk. For example, opioids combined with alcohol or sedatives can suppress breathing.
A treatment programme should record all substances, prescribed medicines and supplements. It should not treat one drug in isolation while ignoring another substance that creates greater immediate risk.
Co-occurring mental-health conditions
Depression, anxiety, trauma-related symptoms, psychosis, attention problems and sleep disorders may precede, follow or interact with substance use. Intoxication and withdrawal can also imitate psychiatric symptoms. Integrated treatment coordinates addiction, medical and mental-health care and revises the diagnosis over time.
How the level of care is chosen
The name of the drug alone does not decide whether a person needs outpatient or residential treatment. The assessment should also consider:
- current intoxication and withdrawal risk;
- medical and psychiatric instability;
- overdose history and route of administration;
- ability to take medication safely;
- home environment and exposure to substances;
- support, housing and transport;
- previous treatment response;
- the patient’s preferences and ability to engage.
The plan should use the least intensive setting that can still manage the person’s needs safely, with reassessment if risks change.
Questions to ask a rehab about substance-specific care
- Which substances and combinations does the programme have experience treating?
- Who assesses withdrawal and medical risk?
- Are evidence-based medications available for opioid or alcohol use disorder?
- Does the stimulant programme use contingency management or another structured evidence-based approach?
- How are benzodiazepines tapered and monitored?
- How are psychosis, depression, trauma, pain and other conditions treated?
- What overdose-prevention education and naloxone access are provided?
- What happens after withdrawal management or residential discharge?
Related guides
- What is a drug rehab center?
- Phases of drug rehabilitation
- Evidence-based therapies for substance use disorders
- Alcohol rehabilitation and treatment options
Authoritative sources
- SAMHSA TIP 63: Medications for Opioid Use Disorder
- SAMHSA: Treatment Options for Substance Use Disorder
- NIAAA: Treatment for Alcohol Problems
- National Institute on Drug Abuse: Cocaine Research Report
- World Health Organization: Brief Psychosocial Interventions for Drug Use Disorders
- Joint Clinical Practice Guideline on Benzodiazepine Tapering
Last clinically reviewed: 29 July 2026.