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

RECO Island is 35 miles up I-95 from Hollywood — 50 minutes outside of rush hour, and a clinically useful separation from the neighborhoods and routines tied to active use. Detox is physician-led and small-census; buprenorphine induction, benzodiazepine tapers, and stimulant supportive care are matched to the substance rather than delivered as a single protocol. Because residential runs on the same campus, MAT initiated during detox is continued without a third-party handoff or waitlist between phases.

Hollywood to RECO Island’s Delray Beach campus is 35 miles up I-95 — roughly 50 minutes outside of rush hour. Clients from Hollywood Beach, Emerald Hills, Hollywood Lakes, Hollywood Hills, and Oakwood generally treat that distance as clinically useful rather than inconvenient; the physical separation from the streets, dealers, and daily routines tied to active use is often the first structural condition that makes stabilization possible. Drug detox at RECO Island is physician-led, small-census, and transitions directly into residential on the same campus — no waitlist between phases and no third-party handoff.

Substance-specific withdrawal protocols

Opioid, benzodiazepine, and stimulant withdrawal are three distinct clinical syndromes with three different management pathways. Running a single protocol across all three is bad medicine, and it is one reason detox-only programs produce the outcomes they do.

Opioid withdrawal — from heroin, fentanyl, oxycodone, or hydromorphone — is intensely uncomfortable but rarely medically dangerous in an otherwise healthy adult. The intervention that transforms the experience is buprenorphine induction guided by COWS scoring; the medical team waits for a COWS score in the moderate range (typically 8-12) before the first dose to avoid precipitated withdrawal, then titrates to symptom suppression over 24-72 hours.

Benzodiazepine withdrawal — like alcohol withdrawal — can produce seizures, autonomic instability, and delirium. The standard of care is conversion to a long half-life agent such as clonazepam or diazepam followed by a slow taper over weeks. Stimulant withdrawal from cocaine or methamphetamine has no FDA-approved medication protocol, but the clinical need is real: depression, anhedonia, hypersomnia, and craving are managed supportively with sleep architecture repair, nutritional stabilization, and screening for underlying mood disorder that the stimulant was suppressing.

Polysubstance detox and the sequencing decision

Concurrent use of alcohol, benzodiazepines, and opioids is now the modal presentation in South Florida detox admissions rather than the exception. Fentanyl-contaminated stimulant supplies, benzodiazepines added to street opioid supply, and combined alcohol-and-benzo use all require sequencing decisions that are made deliberately.

The general clinical principle is to manage the life-threatening withdrawal syndromes first. Alcohol and benzodiazepine withdrawal are the ones that can produce seizures or delirium in the first 72 hours; those get the appropriate taper — CIWA-Ar-guided for alcohol and symptom-triggered clonazepam or diazepam for benzodiazepines. Opioid MAT is initiated concurrently rather than sequentially, because buprenorphine can be started safely during an alcohol taper. Stimulant withdrawal is addressed supportively throughout.

Every polysubstance detox at RECO Island is documented before the first dose: which substances, in what quantities, over what duration, with what medical comorbidities, and what the sequencing plan is. The plan is reviewed daily by the attending physician and adjusted as withdrawal progresses.

Medical comorbidity is the norm, not the exception

Chronic substance use produces medical comorbidity that is routinely under-diagnosed because active use disrupts the primary care relationship. Injection opioid use carries hepatitis C exposure and endocarditis risk. Chronic stimulant use produces cardiovascular disease and cardiomyopathy that present younger than they should. Alcohol produces hepatic dysfunction, thiamine deficiency, and peripheral neuropathy. Undiagnosed diabetes, sleep apnea, and the chronic pain that often started the opioid use in the first place are common findings on admission.

RECO Island performs a full medical evaluation at admission: CBC, CMP, hepatitis panel, HIV screen, HbA1c where indicated, urine toxicology, and EKG. Findings are managed concurrently rather than deferred to outpatient follow-up that historically has not happened. For many clients, detox is the first medical contact in three to five years.

This matters clinically because withdrawal management interacts with comorbid disease. QTc prolongation risk in a patient with unrecognized cardiovascular disease is real; buprenorphine dosing in the setting of hepatic impairment requires adjustment. The medical evaluation is the foundation of a safe taper, not paperwork.

The handoff into residential and MAT continuation

Detox produces safe withdrawal. It does not, on its own, produce durable recovery. The relapse rate for detox followed by discharge to the community — no residential, no MAT, no structured outpatient — is well documented to approach universality within 90 days. The clinical response is to build a continuum that does not end at day seven.

The model at RECO Island initiates MAT during detox where indicated. For opioid use disorder, that is buprenorphine started during induction and continued through residential, PHP, and IOP with a warm handoff to community MAT maintenance at discharge. For alcohol use disorder, naltrexone — oral or extended-release injectable — or acamprosate is started after the detox window closes. Extended-release naltrexone is available for OUD patients who prefer antagonist therapy after an appropriate opioid-free window.

Because detox transitions into residential on the same campus without a third-party handoff, the medication regimen initiated during detox is not disrupted. There is no interval during which a patient can leave against medical advice, wait for a bed elsewhere, or lose the prescription. That continuity is a relapse-prevention mechanism, not a marketing feature.

What the first 24 hours look like

Arrival begins with a medical intake conducted by a physician or nurse practitioner: substance use history, medical and psychiatric history, current medications, and an ASAM Criteria assessment across the six dimensions to confirm the appropriate level of care. Vitals, EKG, and labs are drawn. If the client is already in withdrawal, symptom management begins before paperwork is complete — COWS and CIWA-Ar guide medication timing rather than a fixed clock.

A psychiatric assessment follows within 24-48 hours, including PHQ-9, GAD-7, and PCL-5 screening. Approximately 60-70% of clients presenting for detox have a co-occurring mood, anxiety, or trauma disorder that will require dual-diagnosis treatment through the residential phase. Identifying it during detox — rather than after residential admission — lets the psychiatric medication regimen (sertraline, aripiprazole, quetiapine, or a mood stabilizer as indicated) be started early alongside CBT and DBT programming.

Family is contacted with the client’s written consent under 42 CFR Part 2. The transition into residential is planned during detox rather than at discharge; the first 24 hours are the highest-risk window for leaving against medical advice and also the window in which the therapeutic alliance is built.

Insurance and admissions from Hollywood

RECO Island is in-network with the commercial payers relevant to Hollywood and Broward County: Florida Blue and BCBS plans, Aetna, Cigna, UnitedHealthcare, and Humana. Admissions verifies benefits at intake and provides an out-of-pocket estimate before the client commits. For clients between plans or on narrow-network HMO policies, single-case agreements are pursued when medical necessity supports them.

The drive from Hollywood — whether the origin is Hollywood Beach, Hollywood Lakes, Emerald Hills, Hollywood Hills, or Oakwood — is 35 miles up I-95, generally 50 minutes outside of rush hour and 75-90 minutes in evening traffic. Transportation is arranged from the Hollywood area when active withdrawal or medical instability makes driving unsafe. Same-day admission is standard when a bed is available, and because detox and residential occupy the same campus, there is no second drive between programs and no gap during which the transition can fail.

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