Guide
The First 72 Hours of Medical Detox: What to Expect
The first 72 hours in a detox unit are the most acute — and the most important. Here is a realistic, hour-by-hour picture of what happens.
Hours 0–4: intake
Vitals, brief physical, mental status exam, urine drug screen, medication reconciliation, and safety screening. You’ll meet the nurse who will be with you overnight.
Hours 4–24: stabilization
Medications for withdrawal begin, often on a CIWA-Ar or COWS schedule. Fluids, electrolytes, and thiamine correct the most common deficiencies.
Hours 24–72: peak risk
Alcohol seizure risk peaks in this window. Opioid withdrawal peaks in intensity here too. Nursing checks may be every two hours or more.
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