Drug detox for Fort Lauderdale — substance-specific protocols, not one-size-fits-all.

RECO Island runs a small-census, physician-led medical detox 40 minutes north of Fort Lauderdale on I-95 — close enough that Las Olas and Victoria Park families stay involved, far enough that Delray Beach offers real separation from active-use environments. Detox transitions in-house to residential on the same day medical stabilization is complete, with no waitlist and no third-party handoff. Buprenorphine, naltrexone, and benzodiazepine tapering protocols continue seamlessly into residential and PHP rather than stopping at detox discharge.

From Las Olas, Victoria Park, or Rio Vista, RECO Island’s Delray Beach campus is a 40-minute drive north on I-95 — close enough that families stay involved through visitation and family therapy, far enough that geographic separation from the dealers, bars, and neighborhoods tied to active use has real clinical value in the first weeks of recovery. Fort Lauderdale clients present most often with opioid use disorder, benzodiazepine dependence, stimulant use, or — increasingly — polysubstance patterns combining two or three of those categories. This page describes how medical detoxification at RECO Island is structured, why it is substance-specific rather than one-size-fits-all, and how detox connects directly into the residential and MAT continuation that determines whether detox actually produces recovery.

Substance-specific withdrawal protocols

Opioid, benzodiazepine, and stimulant withdrawal are clinically distinct syndromes with distinct risks and distinct medication responses. Running a single protocol across all three is not simplification — it is bad medicine, and it is one reason repeat detox admissions are so common.

Opioid withdrawal is intensely uncomfortable but rarely medically dangerous in an otherwise healthy adult. RECO Island uses COWS-guided buprenorphine induction — typically initiating buprenorphine/naloxone once the COWS score confirms adequate withdrawal (generally 8-12 or above) to avoid precipitated withdrawal, then titrating over 24-48 hours to a dose that resolves craving and physiologic symptoms. For clients transitioning to extended-release naltrexone at discharge, we manage the required opioid-free window with symptomatic care (clonidine for autonomic symptoms, ondansetron for nausea, non-benzodiazepine sleep support).

Benzodiazepine withdrawal — like alcohol withdrawal — is one of two withdrawal syndromes that can kill. Seizures and, in severe cases, delirium are real risks, and abrupt cessation is contraindicated. Protocol is a slow taper, generally converting short half-life agents (alprazolam, lorazepam) to a long half-life equivalent (clonazepam or diazepam) and reducing by roughly 10-25% per week, longer for chronic high-dose use. Stimulant withdrawal is a different problem entirely — no seizure risk, no FDA-approved pharmacotherapy for the withdrawal itself, but real depression, anhedonia, hypersomnia, and craving that require supportive medical management and early psychiatric assessment for post-stimulant depressive symptoms that don’t resolve on their own.

Polysubstance detox and the sequencing decision

Concurrent use of alcohol, benzodiazepines, opioids, and stimulants — in some combination — is now closer to the rule than the exception. A client using fentanyl, alprazolam bought off the street, and cocaine has three distinct withdrawal syndromes to manage, and the sequencing is not obvious.

The clinical principle is straightforward: address the life-threatening syndromes first. Alcohol and benzodiazepine withdrawal get CIWA-guided or symptom-triggered management (long-acting benzodiazepine loading for alcohol, structured taper for benzodiazepines) as the top priority. Opioid MAT is initiated concurrently — there is no reason to defer buprenorphine induction because the client is also being tapered off benzodiazepines, and untreated opioid withdrawal creates additional physiologic stress that makes the alcohol or benzodiazepine picture worse. Stimulant withdrawal is managed supportively in parallel.

Every polysubstance detox plan at RECO Island is individualized based on which substances were used, in what quantities, over what duration, with what last-use timing — and the plan is documented by the admitting physician before the first dose is given. The plan is revised in real time based on CIWA, COWS, vital signs, and clinical exam.

Medical comorbidity is the norm, not the exception

Chronic substance use produces medical problems that outpatient primary care rarely catches, because the patients aren’t going to primary care. Detox admission is often the first medical contact in years. RECO Island’s admitting medical evaluation is built for this — comprehensive metabolic panel, CBC, hepatic function, hepatitis B and C serology, HIV screening, urine drug screen with confirmation, EKG, and pregnancy testing where indicated.

What we find, routinely: untreated hepatitis C from prior or current injection use, cardiovascular findings from stimulant use (LV hypertrophy, arrhythmia, undiagnosed hypertension), significant malnutrition, undiagnosed type 2 diabetes, chronic pain that was under-treated by the medical system and became the pathway into opioid dependence, and sleep disorders that no one asked about. These are managed concurrently during detox and residential rather than deferred to a post-discharge PCP appointment that, historically, doesn’t happen.

Psychiatric evaluation runs in parallel using PHQ-9, GAD-7, and, when indicated, PCL-5 for trauma symptoms and ASRS for adult ADHD. Substance-induced mood and anxiety symptoms typically improve over the first two to four weeks of abstinence; primary psychiatric conditions that persist beyond that window are treated on their own terms — SSRIs (sertraline, escitalopram) for depression and anxiety, aripiprazole or quetiapine for mood instability where indicated, buspirone as a non-controlled anxiety option, and structured psychotherapy (CBT, DBT skills, EMDR for trauma, ACT for chronic distress).

The handoff into residential and MAT continuation

Detox produces safe withdrawal. It does not, on its own, produce recovery. Detox alone — without immediate transition into structured residential or PHP care and, where indicated, without MAT continuation — has a documented relapse rate that approaches universal in opioid use disorder.

RECO Island’s model addresses this directly. There is no discharge from detox to “call us when you’re ready for residential.” Detox transitions in-house, on the same campus, to residential treatment on the day medical stabilization is complete. MAT initiated during detox continues seamlessly — buprenorphine/naloxone for OUD, extended-release naltrexone for AUD or for OUD after the required opioid-free window, acamprosate for AUD as adjunct, disulfiram in appropriately selected cases.

The residential phase runs CBT, DBT, motivational interviewing, and trauma-focused work (EMDR, CPT) alongside continued medical monitoring. ASAM Criteria dimensions drive level-of-care decisions at each transition — detox to residential, residential to PHP, PHP to IOP — rather than fixed program lengths. Community MAT prescribers in Broward County are engaged before discharge so there is no medication gap.

What to expect on the first day

Admission from Fort Lauderdale typically runs same-day or next-day. Insurance verification is completed by phone before arrival — Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS plans are the most common — and the admitting clinician has the intake, medical history, substance use history, and last-use timeline before the client walks in the door.

On arrival, the client is medically assessed by the admitting physician or physician assistant, baseline COWS and CIWA are documented, labs are drawn, EKG is performed, and the substance-specific protocol begins. Belongings are inventoried, phones are addressed per the residential program’s policy, and the client is oriented to the unit. Family is contacted per the client’s release of information.

Insurance and admissions from Fort Lauderdale

RECO Island is in-network with major commercial insurance plans including Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS. Verification of benefits is completed before admission, and specific out-of-pocket estimates (deductible, coinsurance, out-of-pocket maximum) are provided in writing before the client commits to admission. Ground transportation from Las Olas, Victoria Park, Coral Ridge, Rio Vista, or Wilton Manors can be arranged.

Serving residents of: Las Olas, Victoria Park, Coral Ridge, Rio Vista, Wilton Manors.