Drug detox for Highland Beach — substance-specific protocols, not one-size-fits-all.

RECO Island's Delray Beach campus is a twelve-minute drive up A1A from Bel Lido Isle, Toscana, and the Highland Beach oceanfront. Residents get physician-led medical detox with substance-specific protocols — COWS-guided buprenorphine induction for opioid use, slow long-half-life tapers for benzodiazepines, supportive management for stimulant withdrawal — followed by direct in-house transition to residential treatment, PHP, and IOP without third-party handoffs or waitlists. Small census, one clinical team, MAT continued throughout.

Highland Beach sits as the narrow oceanfront corridor between Delray Beach and Boca Raton, and the drive down A1A from Bel Lido Isle or Toscana to RECO Island’s Delray Beach campus takes about twelve minutes on an average morning. For residents of Boca Cove, Ocean Cove, and the Penthouse condominiums, the practical value of that short drive is access to the kind of clinical density — physician-led medical detox, in-house addiction psychiatry, direct step-down into residential treatment — that general behavioral-health practices in Boca cannot assemble under one roof. Drug detox at RECO Island is not a triage stop; it is the first stage of a continuous, small-census program that keeps the same clinical team from admission through PHP and IOP.

Substance-specific withdrawal protocols

Opioid, benzodiazepine, and stimulant withdrawal are clinically distinct syndromes and are managed under different protocols at RECO Island. Opioid withdrawal — from heroin, fentanyl, or prescription opioids — is intensely uncomfortable but rarely medically dangerous on its own; buprenorphine induction guided by the Clinical Opiate Withdrawal Scale (COWS) transforms the experience within hours, and methadone induction remains an option for clients with high-tolerance fentanyl exposure. Adjunctive symptomatic care during the acute phase includes clonidine or lofexidine for autonomic symptoms, ondansetron for nausea, loperamide for diarrhea, and non-benzodiazepine sleep support.

Benzodiazepine withdrawal — mechanistically similar to alcohol withdrawal — carries a real risk of seizures and delirium and cannot be managed with a rigid one-size protocol. The standard approach is conversion to a long half-life agent such as clonazepam or diazepam followed by a slow, patient-specific taper measured in weeks rather than days, with CIWA-B monitoring throughout. Stimulant withdrawal from cocaine or methamphetamine produces primarily depression, anhedonia, hypersomnia, and cognitive slowing rather than the physiologic instability of opioid or benzodiazepine withdrawal; there is no FDA-approved medication for stimulant withdrawal itself, but supportive medical management, sleep normalization, nutritional rehabilitation, and early psychiatric evaluation for underlying mood disorder are clinically essential.

Polysubstance detox and the sequencing decision

Concurrent use of alcohol, benzodiazepines, opioids, and stimulants is now the modal presentation in medical detox rather than an unusual one. The clinical principle for polysubstance detox is straightforward: identify and manage the life-threatening withdrawal syndromes first — alcohol and benzodiazepine — with an appropriate long-acting taper, initiate opioid MAT with buprenorphine once a sufficient opioid-free window has been established, and treat stimulant withdrawal supportively alongside. Sequencing errors — for example, initiating buprenorphine before a client has cleared full-agonist opioids and precipitating withdrawal, or starting a benzodiazepine taper too quickly in a client with active alcohol withdrawal — produce avoidable complications.

Every polysubstance detox at RECO Island is individualized against the actual use history: which substances, in what quantities, over what duration, with what route of administration. Toxicology confirms the pattern on admission, and the plan is documented in the medical record before the first dose is administered. The ASAM Criteria dimensions structure the assessment — acute intoxication and withdrawal potential (Dimension 1), biomedical conditions and complications (Dimension 2), and emotional, behavioral, and cognitive conditions (Dimension 3) — so that the detox plan is tied to the same framework used to justify level-of-care decisions to payers.

Medical comorbidity is the norm, not the exception

Chronic substance use produces medical comorbidity, and detox is often the first meaningful medical contact in years for a client. Injection opioid or stimulant use raises the pretest probability of hepatitis C and HIV; chronic stimulant use produces hypertension, cardiomyopathy, and dysrhythmia; heavy alcohol use produces hepatic dysfunction and thiamine deficiency; and most detox populations carry high rates of undiagnosed diabetes, malnutrition, dental disease, and untreated chronic pain that was often the original driver of the opioid use.

RECO Island’s admission workup includes a full history and physical, comprehensive metabolic panel, hepatic panel, CBC, hepatitis and HIV screening, urine toxicology, ECG where indicated, and psychiatric evaluation with instruments including PHQ-9 for depression and GAD-7 for anxiety. Findings are managed concurrently rather than deferred to outpatient primary care after discharge, because deferral is functionally equivalent to non-treatment for a population that has not seen a primary care physician in years. When chronic pain drove the opioid use, the pain management plan is rebuilt during residential care with non-opioid modalities.

The handoff into residential and MAT continuation

Detox produces safe withdrawal; residential produces early-recovery skill building; medication for addiction treatment protects the vulnerable window during and after that transition. The RECO Island model is to initiate MAT during detox where clinically indicated — buprenorphine or extended-release naltrexone for opioid use disorder after the appropriate opioid-free window, acamprosate or naltrexone for co-occurring alcohol use disorder — and to continue that medication through residential, PHP, and IOP without interruption. Handoff to community MAT maintenance is arranged before discharge, not after.

Detox as a standalone service — without residential, without MAT, without a documented continuing-care plan — has a relapse rate approaching universality in the opioid use disorder literature, and offering it that way is inconsistent with current ASAM guidance. Behavioral treatment during the residential phase draws from CBT for relapse prevention, DBT skills for emotion regulation and distress tolerance, motivational interviewing for ambivalence, and ACT for values-based commitment. Co-occurring depression and anxiety are treated with SSRIs such as sertraline or escitalopram rather than benzodiazepines, and buspirone is used when a non-controlled anxiolytic is appropriate.

What to expect on your first visit

Admission at RECO Island begins with a phone assessment covering clinical history, current use, insurance verification, and medical red flags, followed by same-day or next-day arrival at the Delray Beach campus. On arrival the client meets the admitting physician for the medical evaluation, provides toxicology, and is oriented to the small-census residential detox environment. First medication dosing is timed to objective withdrawal severity rather than a fixed schedule — COWS or CIWA scoring drives dose timing during the first 24 to 72 hours, not a wall clock.

Personal belongings are inventoried, phone use is managed under the residential policy, and clients meet the psychiatric provider within the first 24 hours for initial dual-diagnosis assessment. Family members participating in the admission are given realistic expectations for the acute phase and a written point of contact for updates under any release of information the client signs.

Insurance and admissions from Highland Beach

RECO Island is in-network or accepts out-of-network benefits from most major commercial insurers, including Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS. The admissions team verifies benefits before arrival, confirms the level of care the plan will authorize under ASAM medical-necessity criteria, and communicates any expected deductible or coinsurance obligation in writing. For Highland Beach residents, the twelve-minute drive up A1A means families can be present for the intake conversation without extended travel logistics.

Serving residents of: Bel Lido Isle, Boca Cove, Ocean Cove, Toscana, Penthouse.