Alcohol detox for Hollywood — CIWA-Ar-guided, medically supervised, discretion assured.

RECO Island's Delray Beach campus sits 50 minutes up I-95 from Hollywood — close enough for families in Emerald Hills or Hollywood Lakes to stay involved, far enough to separate treatment from the environment of active use. Alcohol detox is physician-led with 24/7 nursing, CIWA-Ar-scored symptom-triggered benzodiazepine tapers, and parenteral thiamine on day one. When the acute phase ends, transition to residential happens in-house on the same medical record and with the same treating physician — no third-party handoff, no gap where relapse lives.

The drive from Hollywood to RECO Island’s Delray Beach campus runs 35 miles up I-95 — roughly 50 minutes outside of rush hour. For clients coming from Hollywood Beach, Emerald Hills, Hollywood Lakes, Hollywood Hills, or Oakwood, that distance functions clinically: enough separation from the environment tied to active use to allow supervised medical detox to work, without placing family so far away they cannot participate in treatment planning.

Alcohol withdrawal is the one substance withdrawal that can kill you

Unlike opioid or stimulant withdrawal — profoundly uncomfortable but not lethal in otherwise healthy adults — untreated alcohol withdrawal carries a genuine mortality rate. The mechanism is grand-mal seizures, delirium tremens, and cardiovascular collapse driven by unopposed sympathetic hyperactivity. Historical case series place mortality in unsupervised severe DTs between 5 and 15 percent; contemporary inpatient management drives that below 1 percent, but only with the protocols that define medical detox.

Risk stratification at intake identifies the predictors that matter: prior withdrawal seizures or DTs (the strongest single predictor of recurrence), high daily volume, long duration of daily use, age over 40, hepatic or cardiac comorbidities, and concurrent benzodiazepine or barbiturate use. Clients scoring high are moved to closer monitoring intervals and started on a more aggressive loading dose from admission rather than waiting for scores to escalate. This is why medical detox is the standard of care for alcohol use disorder — not a preference and not an upsell.

CIWA-Ar scoring and symptom-triggered benzodiazepine protocols

The Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar) is the validated instrument that governs benzodiazepine dosing throughout detox. Ten symptom domains are scored at defined intervals — nausea and vomiting, tremor, paroxysmal sweats, anxiety, agitation, tactile disturbances, auditory disturbances, visual disturbances, headache, and orientation. Nursing reassessment ranges from every hour in acute withdrawal to every four hours as the client stabilizes.

Benzodiazepine choice is clinical. Chlordiazepoxide is a standard first-line agent for its long half-life and self-tapering pharmacokinetics; diazepam is used when aggressive loading is indicated; lorazepam is preferred when hepatic function is compromised, since it lacks the active metabolites that accumulate in liver disease. Dosing is triggered when scores cross the treatment threshold rather than administered on a fixed schedule.

Symptom-triggered protocols consistently outperform fixed-schedule dosing across every measured endpoint — shorter length of stay, lower total benzodiazepine exposure, equivalent or better symptom control. Minimizing benzodiazepine exposure during detox matters because it reduces the risk of a secondary dependence pattern that would otherwise have to be unwound later in treatment.

Thiamine, folate, and prevention of Wernicke-Korsakoff syndrome

Chronic heavy alcohol use produces thiamine (vitamin B1) deficiency through impaired gut absorption, reduced dietary intake, and increased metabolic demand. Untreated, thiamine deficiency causes Wernicke’s encephalopathy — the triad of ophthalmoplegia, ataxia, and confusion — which if uncorrected progresses to Korsakoff’s syndrome, a permanent amnestic disorder. The neurologic damage does not reverse.

Admission protocol includes parenteral thiamine 100 mg IM or IV on day one, continued daily through the acute phase, with folate 1 mg, a multivitamin, and magnesium replacement. Parenteral rather than oral, because gut absorption is unreliable in this population. This is not an optional add-on. It is the standard of care in every published guideline, and the cost of missing it is measured in permanent cognitive impairment.

MAT initiation during detox and the handoff to residential

Detox is a medical event; alcohol use disorder is a chronic condition. The bridge between the two is medication-assisted treatment, and the decision to start MAT is made during the detox stay rather than deferred to whoever picks the client up next. Three FDA-approved agents are on the table for alcohol use disorder.

Naltrexone — 50 mg oral daily or 380 mg intramuscular monthly (Vivitrol) — blocks opioid receptors and blunts the reinforcing effect of alcohol. It requires a 7-10 day opioid-free window before initiation, which the detox stay provides cleanly. Acamprosate — 666 mg three times daily — modulates glutamatergic tone and is initiated once abstinence is stabilized, typically in the residential phase. Disulfiram is a behavioral tool for the highly motivated client with a stable support structure; it is not first-line. The MAT decision is documented in the treatment plan the client carries into residential, not left for someone else to raise.

Direct transition to residential — no third-party handoff

Most detox referrals in South Florida follow a familiar pattern: a client stabilizes at one facility for five to seven days, is discharged, and is expected to arrange residential admission independently. The gap between detox discharge and residential admission is when relapse happens.

RECO Island runs detox and residential on the same campus. A client admitted from Hollywood for alcohol detox transitions in-house to residential treatment on the same medical record, with the same treating physician and the same nursing team. There is no re-intake, no separate insurance authorization, no ambiguity about medications, and no window during which the client is between facilities. For a diagnosis where the transition point carries the highest relapse risk in the treatment course, that continuity is the point of the model.

Insurance and admission from Hollywood

RECO Island is in-network with or accepts out-of-network benefits from Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and Blue Cross Blue Shield plans. Verification of benefits typically completes within two to four hours and produces a written out-of-pocket estimate before admission — no surprise billing after discharge.

Admissions from Hollywood are direct. A clinician completes a phone screening for medical stability and CIWA-Ar risk, insurance is verified in parallel, and when clinically appropriate, admission is same-day. Transportation from Hollywood — 50 minutes up I-95 — can be arranged when a family driver is not available. There is no waitlist for medically necessary alcohol detox.

What the first 24 hours look like

On arrival, the client is seen by a nurse for vitals, a focused physical assessment, and the initial CIWA-Ar score. A physician evaluates within the first hour and writes the detox orders — benzodiazepine protocol, thiamine and vitamin replacement, comfort medications for nausea and insomnia, and any additional agents indicated by comorbidities (antihypertensives for uncontrolled blood pressure, anticonvulsants where prior seizure history is documented, IV fluids for volume depletion).

Rooms are private or shared depending on preference and availability. Personal electronics are permitted with reasonable restrictions. Family contact begins within 24 hours in most cases. The census is intentionally small — this is not a hospital detox unit and it is not a high-volume warehouse. It is medical care delivered in a residential setting, by clinicians who know each client by name.

Serving residents of: Hollywood Beach, Emerald Hills, Hollywood Lakes, Hollywood Hills, Oakwood.