Alcohol withdrawal medications are essential for safely managing symptoms, preventing complications and supporting recovery after stopping heavy or prolonged drinking.
When you reduce or discontinue alcohol use, your body experiences significant changes in brain chemistry that can lead to uncomfortable and sometimes dangerous withdrawal symptoms.
This guide provides a clear overview of how clinicians assess withdrawal severity, choose appropriate medications and determine the safest treatment setting based on your risk factors.
Whether you’re seeking treatment for yourself or helping someone else, this resource outlines what to expect at each stage of care, so you can make informed decisions about alcohol withdrawal management and recovery planning.
Key Facts
- Alcohol withdrawal medications are critical for safely managing symptoms, preventing complications and supporting recovery after stopping heavy or prolonged drinking.
- Withdrawal can produce mild to life threatening symptoms, with urgent care required if you experience confusion, seizures, hallucinations, fever or unstable vital signs.
- Symptoms often follow a timeline: 6–24 hours (early signs), 24–48 hours (seizure risk) and 48–96 hours (highest risk for delirium tremens).
- Clinicians use tools like CIWA-Ar and PAWSS, along with ASAM criteria, to determine if you require inpatient vs. outpatient care and appropriate medication strategies.
- Benzodiazepines remain the first line treatment, with delivery methods such as symptom triggered dosing, fixed tapers or front loading tailored to patient needs.
- Adjunct medications (clonidine, gabapentin, phenobarbital, thiamine) may support recovery, while naltrexone after detox reduces cravings and relapse risk.
Nearby Alcohol Rehab Centers
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What is Alcohol Withdrawal?
Alcohol withdrawal occurs when your body and central nervous system react to the sudden absence of alcohol after heavy or prolonged use. This process can cause a range of symptoms that vary in intensity, making proper understanding and medical support essential for safety and recovery.
What It Is, Who’s at Risk and When to Seek Urgent Care
Your body becomes accustomed to alcohol’s depressant effects and reacts with hyperexcitability during withdrawal, leading to symptoms that can range from mild to life threatening. People with the highest risk have a history of severe withdrawal, prior seizures or delirium tremens (DTs).
People with a high alcohol tolerance, older adults and those with significant medical conditions are also more vulnerable. Early recognition and proper medical supervision are essential to manage symptoms safely and prevent serious complications during alcohol withdrawal.
Symptoms that indicate you require urgent or emergency attention include confusion, hallucinations, seizures, fever, unstable blood pressure or heart rate and persistent severe vomiting.
Symptom Timeline
Alcohol withdrawal can be life threatening without medical supervision. Early recognition of alcohol withdrawal symptoms and proper treatment are critical to preventing complications and ensure safe recovery.
- 6-24 hours: Early signs like tremors, anxiety, sweating and insomnia often appear.
- 24-48 hours: Symptoms intensify with worsening heart rate, blood pressure and possible seizures.
- 48-96 hours: Highest risk for DTs, marked disorientation, worsening heart rate, blood pressure and possible seizures.
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Assessment & Care Setting: How Clinicians Decide and What to Expect
Clinicians use evidence based guidelines, often aligned with American Society of Addiction Medicine (ASAM) criteria, to determine whether your alcohol withdrawal care should occur in an inpatient or outpatient setting.
Inpatient vs. Outpatient Care
Inpatient treatment is recommended when you have a history of:
- Severe withdrawal
- Seizures or DTs
- Unstable housing
- Polysedative use
- Pregnancy
- Significant medical or psychiatric comorbidities
- Unreliable follow up
Outpatient care may be appropriate when you have mild to moderate symptoms, stable home support and access to daily medical monitoring.
Clinical Assessment Tools
Two commonly used tools guide decisions:
- CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol): Measures withdrawal severity and informs symptom triggered medication dosing. Higher scores typically indicate that the level of inpatient care and monitoring should be escalated.
- PAWSS (Prediction of Alcohol Withdrawal Severity Scale): Screens patients before withdrawal begins to identify when you have high risk factors for complications, ensuring safer care placement and better outcomes.
First Line Alcohol Withdrawal Medications: Benzodiazepines
Benzodiazepines are the gold standard treatment for managing alcohol withdrawal syndrome (AWS), because they effectively control agitation, tremors, seizures and the risk of delirium tremors (DTs). The treatment approach varies depending on symptom severity, setting and comorbidities.
By calming overactive brain activity, these medications help stabilize you during withdrawal. Clinicians carefully select the appropriate medication, dosage and treatment strategy based on symptom severity, co occurring conditions, medical history and care setting to ensure safety and improve recovery outcomes.
How Treatment Is Delivered

Alcohol withdrawal treatment can be delivered in several ways, with the approach tailored to symptom severity and care setting. Methods vary from symptom based dosing to scheduled tapers, front loading strategies and different routes of administration to ensure safety and effective recovery.
- Symptom Triggered Dosing: Preferred when close monitoring is possible. Medication is given only when symptoms emerge based on CIWA-Ar scores, reducing total drug exposure and recovery time.
- Fixed Tapers: Scheduled doses gradually decrease over several days. This is used when frequent monitoring isn’t feasible, such as in outpatient settings.
- Front Loading: High initial doses for long acting benzodiazepines rapidly stabilize severe withdrawal and prevent complications in high risk patients.
- Routes of Administration: Oral (PO) is preferred for stable patients, while IV or IM dosing is reserved for severe agitation, vomiting or poor absorption.
Benzodiazepine selection depends on withdrawal severity, comorbidities and monitoring capacity. Choosing the right agent and dosing strategy improves safely, reduces complications, and supports a smoother recovery.
Diazepam (Valium)
- Advantages: Rapid onset and long half life make diazepam ideal for front loading protocols and seizure prevention.
- Cautions: Use lower doses in hepatic impairment and older adults to avoid oversedation or respiratory depression.
Chlordiazepoxide (Librium)
- Advantages: A long acting option commonly used in outpatient tapers. It provides smoother withdrawal with fewer breakthrough symptoms.
- Cautions: Heavily metabolized by the liver. Dose adjustments are needed for liver dysfunction. You must avoid alcohol and be warned about operating machinery.
Lorazepam (Ativan)
- Advantages: Intermediate half life and reliable IM/IV absorption make it useful for symptom triggered protocols and when you have nausea or vomiting.
- Cautions: Preferred in older adults and those with liver disease since it bypasses extensive hepatic metabolism.
Clonazepam (Klonopin)
- Advantages: Can help reduce anxiety and tremor when other benzodiazepines are contraindicated or are insufficient.
- Cautions: Less studied as a first line AWS treatment. It’s generally used as an adjunct or when standard agents are contraindicated. Monitor closely for cumulative sedation.
Adjuncts & Alternatives
Adjunctive medications can help manage alcohol withdrawal symptoms but are not substitutes for benzodiazepines, which remain the first line treatment. These drugs are used selectively to target specific symptoms, reduce overall medication needs and manage complications when appropriate.
In certain cases, they also improve your comfort, support stabilization and address co-occurring mental health conditions or underlying medical issues during the withdrawal process. Adjunctive therapies should be customized to your needs and used only under medical supervision to optimize safety and outcomes.
Clonidine
Clonidine helps ease autonomic symptoms such as rapid heart rate, hypertension and sweating. It is used only as an adjunct therapy in your alcohol withdrawal and not independently, since it does not prevent seizures or DTs. Your blood pressure should be monitored closely because of the risk of hypertension.
Gabapentin
Gabapentin may be considered if you have mild alcohol withdrawal symptoms or to manage sleep disturbance and anxiety during your early recovery. In some cases, it can reduce benzodiazepine requirements.
However, there is a potential for misuse, and it can cause addictive sedation, especially when combined with alcohol or other depressants. Your renal function should be assessed before treatment.
Phenobarbital
Phenobarbital, a barbiturate, is reserved for severe or benzodiazepine refractory withdrawal, often in ED or ICU settings under close supervision. It has a narrow therapeutic window and increases the risk of respiratory depression. Using phenobarbital requires continuous monitoring by experienced clinicians.
Thiamine (Vitamin B1)
Thiamine is essential for preventing Wernicke’s encephalopathy(a neurological emergency caused by lack of thiamine [vitamin B1]), especially if you have malnutrition, liver disease or homelessness.
It must be administered before glucose and given parenterally in moderate-to-severe withdrawal or if you have poor nutritional status. After IV administration, it can be followed by oral maintenance therapy.
THC (Cannabis)
Although this is commonly used to self medicate for sleep or anxiety THC is not recommended during withdrawal. Evidence is insufficient and it may worsen cognition, anxiety and may have interactions with sedatives. Safer recovery focused alternatives should be discussed instead.
Safety, Interactions & Special Populations
Alcohol withdrawal management requires careful attention to your medication safety and individualized risk factors.
Clinicians must assess your medical history; substance use patterns and co occurring conditions to select the appropriate medications and dosages. These medications can interact with other drugs you are taking, which increases your risk of adverse effects.
Personalized treatment plans and continuous monitoring improve safety, reduce complications and ensure better outcomes during withdrawal management, especially for vulnerable populations.
High Risk Drug Combinations
Avoid combining benzodiazepines with alcohol, opioids or other sedatives, as they can cause severe respiratory depression, coma or death. You and your clinician should review medication lists and substance use before prescribing.
Clinicians typically start with lower doses and titrate slowly in older adults because of an increased sensitivity to drugs and the risk of falls. Lorazepam is preferred if you have hepatic impairment since it relies less on liver metabolism. A safe home environment and reliable supervision are also critical for outpatient care.
Pregnancy, Postpartum & Co Occurring Substance Use
If you are pregnant or postpartum your care should be managed in higher acuity settings with OB collaboration for fetal monitoring and breastfeeding safety.
When there’s co use of opioids, stimulants or other sedatives, clinicians should integrate overdose prevention strategies, provide naloxone education and coordinate comprehensive treatment plans for your and your infant’s safety.
After Alcohol Withdrawal: Medications for Alcohol Use Disorder

After the withdrawal phase, certain medications can support your long term recovery by reducing cravings and the risk of relapse. Naltrexone is one of the most prescribed options, helping to block the rewarding effects of alcohol and promote sustained sobriety.
Naltrexone (Role After Detox; Oral vs, XR)
Naltrexone is a first line option for relapse prevention after completing alcohol withdrawal.
It works by reducing your cravings and lowering the risk of heavy drinking days. Treatment should begin only after acute withdrawal resolves and opioid free status is confirmed to avoid precipitated withdrawal.
Two forms are available:
- Oral naltrexone (daily dosing) offers flexibility and is easier to discontinue if side effects occur.
- Extended release (XR) naltrexone is given monthly by injection to improve adherence in patients struggling with daily compliance.
Before starting therapy, clinicians should check your liver enzymes, discuss opioid blockage effects and provide education on integrating naltrexone with counseling, peer support and behavioral therapies for best outcomes.
FAQs
Home detox is not recommended when you have moderate to severe alcohol withdrawal symptoms or a high risk history (e.g. seizures, DTs, unstable vitals or liver disease).
Complications can be life threatening without supervision. If detoxing at home, safety improves with a clinical assessment, daily monitoring, home support and a clear escalation plan in case symptoms worsen.
Chlordiazepoxide (Librium) and diazepam (Valium) are long acting benzodiazepines.
Diazepam acts faster, making it ideal for front loading protocols, while Librium is commonly used in outpatient tapers. When you have liver disease, lorazepam may be a safer alternative.
No, gabapentin may help with mild withdrawal, anxiety and sleep disturbances, but it’s not reliable for a seizure or DTs prevention. It should only be used under a clinician’s supervision and monitor for sedation or misuse risk.
Giving glucose first can trigger Wernicke’s encephalopathy (a neurological emergency caused by lack of thiamine [vitamin B1]) in thiamine deficient patients. Thiamine protects the brain and is given before glucose, often by IV in high-risk patients.
Not recommended. THC may worsen anxiety, paranoia and sedation risks when combined with other medications. Safer, non sedative sleep strategies should be discussed with a clinician.
Lorazepam is preferred for AWS in hepatic impairment, while long acting benzodiazepines should be used cautiously. Coordinate care with hepatology and monitor closely for over sedation.
Find Treatment & Medications for Alcohol Withdrawal Near You
Finding the right treatment center for alcohol withdrawal and recovery can feel overwhelming, but help is available.
Use a trusted directory where you can search and compare treatment centers based on your specific needs. You can filter options by location, level of care, insurance coverage and special programs to find a facility that matches your situation.
If you’re unsure where to begin, support is just a phone call away. Call
800-985-8516
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today to speak with someone who can explain your treatment options, answer your questions and guide you toward safe, effective care.
Starting treatment is an important step toward recovery. Whether you need detox, inpatient rehab, outpatient care or specialized programs, having the right resources makes the process easier and more personalized to your needs.
Top Rated Centers for Alcohol Addiction Treatment
| Name / Address / Rating | Description | Treatments / Payments / Programs | Review / Contact | Images |
|---|---|---|---|---|
1
Top 10 in Alcoholism
| Boca Recovery Center in Pompano Beach, Florida is located just 10 miles north of Fort Lauderdale. We provide comprehensive rehabilitation services ranging from medical detoxification and residential treatment to specialized programs that meet your unique needs. Boca Recovery Center in Pompano Beach, is an addiction treatment facility in Florida. Th | Treatments Programs Payment Options | Great experience!
All the staff is great
Thank you for everything Nikki!
Eric Bryant
2 days ago
I have had the pleasure of working closely with Boca Recovery Center in Florida for years, and they continue to set the bar high. The team is professional, compassionate, and always focused on doing what’s best for their clients. Their consistency and integrity make them one of the most trusted names in the field, and I’m proud to recommend them without hesitation.
Ali Moore
2 days ago
This place is absolutely amazing. I was treated with respect and dignity by every single staff member and they did not give up on me although I left and came back multiple times.
Santiago Gamboa
3 days ago
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1
Top 10 in Alcoholism
| Soberman’s Estate, located in Cave Creek, Arizona, is an alcohol and drug rehab center that provides addiction treatment services to adult men, professionals, and public figures. They are a discrete, luxury rehab for individuals aged 30 to 80 years old. This location caps their treatment center at ten men at a time. Soberman’s Estate focuses on | Treatments Programs Payment Options | I had a great experience overall and would recommend it to anyone wanted to jump start their sobriety!!
Kevin Crawford
1 month ago
Very professional, great counselors, and a very good learning experience. Gave me structure and coping skills. Additionally, the psychiatric counseling was top notch.
Gregory Gheen
4 months ago
When it came to the realization I needed help to overcome my addiction, I ended up choosing to go to Sobermans. I couldn’t have been more grateful for this choice and the experience. I can’t say enough about the accommodations, setting, and food. However those things mean nothing without the proper staff. The best thing about Sobermans is their people. The care I received from each and every member of staff there was overwhelming. I’ve since returned for some aftercare and Alumni events, and upon my return, it feels like home. I would highly recommend Sobermans for any man that needs help with addiction or getting your mind cleared. I promise, if you put in the effort that their staff does, you will leave different person!
backfortyhunter Rose
5 months ago
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5 5
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1
Top 10 in Alcoholism
| Symetria – Hurst Outpatient Rehab and Suboxone Clinic in Hurst, Texas, is a private drug rehabilitation clinic for adults. The CARF accredited clinic offers various withdrawal medications to help clients get started with their recovery journey. You’ll also have access to treatments such as the intensive outpatient program (IOP), one on one | Treatments Programs Payment Options | BEST PLACE EVER. I have tried various other doctors/clinics and none of them even begin to compare to this one. The staff here is absolutely amazing. I can’t even make a single complaint. Dr Son is the best as well. He explains everything and you truly feel like he understands you. I can proudly say this, this place saved my life. If you or someone you know needs help getting off opiates do it right the first time and come here. You won’t be disappointed. If you are specifically struggling with fentanyl please don’t waste your time with other ways. I have tried 6 other methods from lazer therapy to having the earpiece to suboxone. Methadone is the key to our current fentanyl crisis. This clinic makes recovery possible again!
Mason
1 month ago
Entire staff was friendly, helpful and supportive throughout the whole process from reception to nurses to counselors
William Maddux
2 months ago
The nurses at the hurst location and also Samantha the receptionist are all so kind and compassionate!! They all go above and beyond the call of duty. They should all be praised for their hard work and their kindness to their patients!!
Debbie Tyler
2 months ago
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5 5
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1
Top 10 in Alcoholism
| The Steps To Recovery addiction treatment center is situated in Levittown, Pennsylvania. At this drug rehab center, patients can expect to engage in a unique treatment approach that focuses on helping individuals recover through authenticity, intimacy, community connection, and transparency. Steps to Recovery offers a serene and private environ | Treatments Programs Payment Options | Great experience, professional staff, and flexibility of program was perfect for me! Feel like a new person. Thank you!
Doug Bradley
1 month ago
Steps to recovery was a great program. The bhts were great and understood what I was going through with a lot of them being in recovery as well. As well as the therapists being well trained and met my needs. Overall a wonderful program that I would return to.
Omi Floyd
1 month ago
My treatment here was absolutely a success. I came here highly depressed with a negative outlook on life with zero hope. In combination with group therapy and individual therapy, my whole perspective was changed. I’m leaving here refreshed and ready for what life has in store for me. Would absolutely recommend to anyone who is struggling with substances and or their mental health.
Abronah Chandler
1 month ago
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2
Top 10 in Alcoholism
| The Boca Recovery Center is a luxury alcohol and drug rehab center for adults in Bloomington, Indiana. They specialize in cutting edge addiction treatment provided in a residential setting. One unique part of this alcohol and drug rehab in Indiana is the peaceful, secluded setting. If recovering in a clinical hospital setting doesn’t sound very a | Treatments Programs Payment Options | Staff was amazing. Very comforting and friendly. Made me feel at home while going through a difficult time. Thank you Boca Recovery Center
Mandy Jo
3 days ago
Great living space, great food, great groups, amazing staff. I have no complaints at all. The staff would do anything possible to make your stay as comfortable as possible.
Dustin Adams
3 days ago
Boca has helped me tremendously with my addictions that I’ve had, All of their staff has been wonderful and very professional, and I would recommend anybody that has any type of problems with any type of addictions or mental health to get into Boca. They certainly helped me..🙂
Roger Burkholder
3 weeks ago
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1
Top 10 in Alcoholism
| If you’re looking for a Christian-based men’s drug rehab center, S2L Recovery in Woodbury, Tennessee, might be the place for you or your loved one. Located at the top of Short Mountain, and overlooking the green hills of Middle Tennessee, this residential and detox clinic boasts a one-to-one staff/patient ratio so there’ll always be someone t | Treatments Programs Payment Options | Come here with a open mind and heart. It can and WILL change your life in all ways. Trust the process and trust God! Could go on and on about how amazing this place, I’ll forever be grateful!
Trevor Woodard
1 month ago
Everything about this place is great. Anyone struggling with addiction and wants to build a relationship with Jesus Christ this is the place to come.
Zach Walman
2 months ago
S2l recovery saved my life spiritually emotionally and physically speaking all classes and staff are very friendly and supportive people with my best in mind… Food is excellent… Lots of support and love here people are great
Andrew
2 months ago
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1
Top 10 in Alcoholism
| Located in Watsonville, California, Elevate Addiction Services provides alcohol and drug rehab services to men and women suffering from addiction. Their levels of care include detox, inpatient treatment, and outpatient treatment. Elevate Addiction Services provides a wide continuum of care that meets each person where they are in their recovery pro | Treatments Programs Payment Options | I recently completed the 30 day Core Peogram at Elevate Addiction Services in Watsonville. After two relapses following decades of previous sobriety, I knew I could benefit from an intensive inpatient residential program to set me bsck on the right path again. I’m so grateful I found Elevate right away. The 12 Steps originally got me sober, and I have no issues with AA/NA, but Elevate is based on SMART Recovery, which is built on a different foundation from the 12 Step program. I gained new insights through the intensive workbooking and structured group sessions, as well as my time spent with my on-site therapist. There’s a big emphasis on Mindfulness at Elevate, so be prepared to meditate and practice breathwork frequently. The rural location is serene, with spectacular views of the Pajaro Valley, and the wildlife is abundant. If you enjoy nature, this is a wonderful, peaceful location. The ranch-style property doesn’t look or feel institutional at all. The facilities are a bit worn (it was originally built 50+ years ago as a retirement home for nuns), so if you’re looking for a luxury rehab, this probably isn’t the place for you. But if you could benefit from delicious meals, CrossFit and yoga, volleyball and pickleball and a well-stocked game, book and DVD library, look no further! Every single employee has gone through the program themselves, so they really understand what you’re going through. Many people opt to stay on past their 60-90 day programs to train as staff members. The facilitators are caring, kind and helpful. The folks in the detox center are supportive and gentle. The security staff are strict but reasonable. Monday-Saturday, the schedule is very structured, with plenty of breaks and evening free time, and Sundays are completely free all day and night. You will be expected to do chores and follow rules. After an initial 7 day “blackout” period, clients have access during free time to shared cell phones in a common room, and once a week you have an opportunity to use your personal cell phone/laptop in a more private space. Visits from friends/family are limited, subject to pre-approval and only take place on Fridays from 3-6pm. The structure and rules are in place to help keep you focused on what you came there to do in the first place: get clean and sober! Overall, Elevate offers clients the opportunity to hit “pause” on the chaos of using and drinking, the tools to gain clarity and insight, and the strength and will to go back to living a clean and sober, productive life.
N. D.
1 week ago
Elevate was such a great program, it’s really changed my way of thinking for a positive
Thank you Elevate!!!
michael gonzales
2 weeks ago
It was the best program I could ever ask for going in at 18 I wasn’t courted to do anything the work is straight forward and really helped me to grow and mature thank you so much elevate you made me feel welcomed comforted and made me want to stay
Jayden Evans
2 weeks ago
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5 5
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1
Top 10 in Alcoholism
| Avenues Recovery Center in Clarksville, Indiana, is an inpatient drug and alcohol detox and rehab center. They strive to provide individuals receiving treatment with a loving environment and attentive medical care. You’ll be away from toxic environments and triggers and have the opportunity to focus on developing life skills that will support you | Treatments Programs Payment Options | Great groups and staff very good people here
Bryan Johnson
1 week ago
They helped me immensely.
Learned a lot about myself.
Charles Meadows
1 week ago
So grateful for avenues clarksville, they helped me start a journey that.i couldn’t have been more grateful, they saved my life. Shout out to all the staff. 😍
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1 week ago
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Top 10 in Alcoholism
| Clients seeking treatment for alcohol addiction may be required to undergo detox first. The detox process ensures any abused substances are out of a client’s system and that they are in a healthy frame of mind when they enter residential treatment. Detox is overseen and closely monitored by medical staff. The residential program takes clients | Treatments Programs Payment Options | Going to avenues was the absolute best move I could have made..First thing I noticed was alot of people actually cared not gonna lie it was a struggle I wanted to leave more than once but I was always talked down from the caring staff that was around..There isn’t a better place the food is good, played a ton of basketball and threw the football around the fires and speakers at nite very cool only thing that was hard was the gender ban but it was that way for a reason.. Today im over a year clean and doing great in life and I can’t thank avenues enough..Its a great place but you have to give it a chance its not easy have to be ready to just give in and learn a new way of life!
sean hunter
1 week ago
Staff was friendly and seemed to really care, the day was broken up well, food was acceptable. Overall a positive experience as far as rehabilitation can go…
Conor Smith
1 week ago
The staff was always great! They helped me through many situations while I was in treatment. They game me the upmost care! They helped me find my way home.
Dark
1 week ago
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5 5
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1
Top 10 in Alcoholism
| Boca Recovery Center – Galloway is a drug and alcohol rehab in Galloway, NJ. They provide inpatient addiction treatment and medical detox. Boca Recovery’s New Jersey Drug & Alcohol Rehab, located in Galloway, New Jersey offers residential addiction treatment, medical detox, and medication-assisted treatment in an immersive treatment s | Treatments Programs Payment Options | It was a fine everyone was helpful and nice food was good too
Eric Kantor
1 day ago
Had a great experience at Boca recovery everyone was so helpful thanks to all staff members and clinical members
Harripersaud Subick
2 days ago
Boca Detox saved my life quite literally. I recommend if you are struggling that you reach out to these people. Sissy is my favorite person here so shout out to her..but honestly all the staff are great and they care about saving lives
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2 days ago
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