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Drug detoxification (detox), specifically for opioids, alcohol, and/or anxiolytics, is traditionally carried out in “brick and mortar” treatment facilities and is limited by “bed availability” and cost. This study examined the safety and effectiveness of telemedicine detox for patients enrolled in an outpatient dual diagnosis mental health/substance use disorder day treatment program.The patients were diagnosed with opioid, alcohol, and/or sedative-use, hypnotic-use, or anxiolytic-use disorder, mild to moderate intensity, including co-occurring serious mental illness diagnoses. Four patients were assessed as having sufficient mental and medical health stability, treatment motivation, social supports, and familiarity using a personal computer and the Internet to be included in the study. The patients were detoxed over 4 to 11 days via videoconferencing several times daily, peripheral monitoring devices for blood pressure and blood oxygen saturation measures were used, and prescribed detox medications were dispensed from a local pharmacy every 1 to 2 days.The 4 study patients successfully and safely detoxed via telemedicine without medical or psychosocial complications.Telemedicine detox treatment, for patients who are physically drug dependent and require medical management upon abstinence to prevent intolerable and dangerous withdrawal side-effects, can be a viable and safe alternative to traditional “brick and mortar” detox treatment. Advantages may include more immediate availability, one-fourth the average cost, and less life disruption afforded by treatment at home versus at a treatment facility. Future studies are suggested involving a larger number of cases along with a “head-to-head” case analysis between telemedicine detox and traditional “brick and mortar” detox.