What Happens in Alcohol Rehab?

Dr. Ximena Sanchez-Samper

Ximena Sanchez-Samper, MD is a Board- Certified Addiction Psychiatrist who obtained her degree as a psychiatrist at the Mayo Clinic in Rochester, MN and completed her Addictions Fellowship through the combined Massachusetts General Hospital, McLean Hospital / Brigham and Women’s Hospital Addictions Fellowship program in 2004.

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What Happens When You Are in Alcohol Rehab?

Alcohol rehabilitation or rehab is a thorough process to help individuals recover from alcohol addiction. But what is alcohol addiction, and why is it so destructive to an individual’s body and mind? 

What Is Alcohol Addiction?

Alcohol addiction or alcohol use disorder (AUD) is defined as an individual’s inability to control their alcohol consumption. Individuals with AUD often sustain physical damage to their bodies due to drinking and withdrawal symptoms when they don’t drink. They also often experience negative consequences because of their alcohol use. 

How Does Alcohol Addiction Alter Your Brain’s Chemistry?

One of the reasons alcohol addiction is so difficult to overcome is that it alters your brain’s chemistry. The long-term effects of alcohol on the brain can be severe. However, most of the damage is reversible by refraining from drinking and allowing the brain time to heal. There are several ways your brain’s chemistry can be affected by heavy alcohol use.


When you drink alcohol, you trigger the release of dopamine, a neurotransmitter that delivers feelings of pleasure to the body. Continuous alcohol use eventually results in the desensitization of your dopamine receptors. This desensitization means you need to consume more alcohol to get the same feelings of euphoria.

GABA Activity

Alcohol’s sedative effects typically make people feel relaxed and drowsy. This is because alcohol enhances the effects of the GABA neurotransmitters that help your body deal with stress and anxiety. When you drink alcohol in excess, your brain quickly adapts and reduces your GABA receptor activity. This reduction in activity is why alcoholics tend to experience increased anxiety when they stop drinking.

Brain Atrophy

Chronic alcohol use shrinks your hippocampus. The hippocampus is responsible for judgment and decision making. Long-term alcohol use can affect your ability to make good decisions.


Chronic alcohol use often leads to blackouts where there are significant memory gaps. People may not remember some of the negative things they did while intoxicated, reducing their motivation to seek treatment. In addition, Long-term alcohol use can eventually lead to alcohol-related dementia.


Chronic alcohol use can alter the brain’s neural pathways. The brain then begins to create new pathways based on your alcohol abuse, discarding older, healthier ones. This can make it difficult for alcoholics to recover from alcohol addiction. 

What Are the Signs of AUD?

If you or someone you know is suffering from alcohol addiction, specific signs may indicate an issue. Here are some of the indicators of AUD:

  • Cravings: People with AUD tend to have an intense craving to consume alcohol all the time. 
  • Tolerance: Individuals struggling with AUD may need more alcohol to feel the same effects. 
  • Withdrawal symptoms: Some withdrawal symptoms people experience when they stop drinking are shaking hands, nausea, anxiety, mood swings, and sweating.
  • Denial: People with AUD may deny they have an alcohol-related problem. 
  • Continued use: People may continue to drink despite legal consequences and performance issues at work or school. 
  • Failed attempts to quit: People with AUD may have tried to quit drinking but continue to consume alcohol despite their best intentions.
  • Drinking alone: Some people prefer to drink alone, away from others, to avoid judgment. 

What Happens When You’re Admitted to Alcohol Rehab?

If you have come to terms with your drinking problem and you are ready to enter alcohol rehab, here is what happens when you check into a facility.

Assessment and Intake

The assessment and intake stage is the first step you go through when you are admitted to an alcohol rehab program. The rehab center will gather all your information, such as your vital signs, current condition, and how much you have been drinking. 

A medical professional will then conduct an assessment. These tests will give the center a good overview of your medical condition. The medical evaluation helps the center make informed decisions during your detoxification process. 

You will also get a psychological assessment. This assessment will look at your addiction history, your alcohol use patterns, and how much you consume daily. The evaluation will also note any co-occurring mental health disorders. The psychological assessment helps rehab centers tailor a treatment plan for their clients.

Counselors at the rehab center will also talk with you to get an overview of what kind of support system you have outside the center, whether it’s family or friends. Counselors will get a feel for your desire to change as well. 


The detoxification (detox) stage is where all the alcohol leaves your system. This is an essential and sometimes frightening stage, especially if your body has become dependent on alcohol. 

During this time, you may experience dangerous withdrawal symptoms. For this reason, your detox will be supervised by healthcare professionals. They will monitor your health to ensure you don’t experience seizures or other harmful withdrawal symptoms. 

If your withdrawal symptoms are particularly strong, you may have to go through medication-assisted detox. Some medications can help smooth out the complications and discomfort caused by withdrawal symptoms. 

Detox usually takes a few days to a week, though it may take longer for those who have drunk heavily for an extended period. However, once your detox is complete, you are ready to move on to the other stages of treatment, such as therapy and counseling. 

Treatment Planning

The next stage of alcohol rehab is your treatment. Treatment plans are tailored to each individual, and this stage is a collaborative effort between the client and the professionals at the rehab center. Although there is no cure for addiction, treatment plans are designed to give you the tools to fight your addiction to effectively lead a sober life.

Length of Stay

As you start your treatment plan, the length of your stay will depend on different factors. Some of these are your drinking history, your support outside the center, and your individual needs. 

  • Short-term rehab: Short-term rehab programs usually last for about a month. A short-term stay is suited for those with a strong support system to turn to after finishing the program.
  • Medium-term rehab: Medium-term rehab programs usually last for two to three months. They are designed for individuals with more severe addictions. 
  • Long-term rehab: Long-term rehab is typically three or more months. These programs are designed for individuals with a significant history of problems with alcohol and who have trouble staying sober. Long-term rehab is also suited for those with co-occurring disorders.

Aftercare Planning

Once you have chosen your treatment plan and are in therapy, you will need to focus on finding ongoing support after you leave the facility. Healthcare professionals can help you when you’re directly under their care. However, once you leave the center, you must develop tools to maintain your sobriety independently. Alcohol rehab centers can help with your aftercare planning in several ways:

  • Continued therapy and support: After completing your rehab program, you can continue to attend one-on-one counseling sessions. These sessions may be particularly beneficial if you’re experiencing cravings or feeling tempted to return to your previous life. 
  • Support groups: Rehab centers strongly recommend support groups, such as Alcoholics Anonymous (AA). Besides providing a solid sense of community, they are places you can share your experiences and learn from others with similar addiction issues. 
  • Recovery plan: While in rehab, you will work on a recovery plan that provides strategies to help maintain your sobriety. You will learn to recognize what triggers you and how to develop skills to manage your stress, anxiety, and cravings.
  • Healthy lifestyle practices: Alcohol rehab centers often encourage their clients to adopt a healthier lifestyle, such as eating healthier, exercising, and getting enough rest. Being healthier physically can help reduce cravings. 
  • Family and friends: Aftercare planning usually involves the family and friends of the person with AUD. Family therapy can help address many issues that may have led to the individual’s drinking behavior. 

The Different Therapies Offered in Alcohol Rehab

Each client in an alcohol rehab center will receive a personalized treatment plan combining various therapies. Several therapies have been proven to be effective in treating AUD.

Cognitive-Behavioral Therapy

The goal of Cognitive-Behavioral Therapy (CBT) or talk therapy is to focus on identifying and changing negative thought patterns and turning them into positive thought patterns in order to combat alcohol addiction. Rather than focus on why you have your problems, CBT teaches you to focus on finding solutions. 

Dialectical Behavior Therapy

Another type of therapy is Dialectical Behavior Therapy (DBT), which combines CBT with mindful practices. DBT helps individuals focus on healthy solutions while also acknowledging their painful past. The goal is to help patients feel validated while working on positive skills.

Motivational Enhancement Therapy (MET)

The goal of MET is to help individuals build up their motivations to change their addictive behaviors. Individuals are strongly encouraged to set goals and to believe that those goals are achievable.

Group Therapy

Group therapy provides an environment where individuals can heal as a group. A community of like-minded individuals shares their experiences and successes. 

Holistic Therapies

Some individuals respond well to holistic therapies, such as art therapy, music therapy, yoga, and meditation. Holistic therapies can help people in recovery cope with anxiety and stress. 

Trauma-Informed Therapy

Some individuals who have suffered trauma need trauma-informed therapy to help them address their traumatic experiences. This kind of therapy can help pinpoint their reasons for turning to alcohol. 

Charles River Recovery

Charles River Recovery offers detox and treatment plans in Weston, Massachusetts. We focus on evidence-based approaches that are personalized to each client. If you or a loved one suffers from AUD, contact us to enroll in our alcohol use disorder treatment plan. We can help on your journey to sobriety.