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

West Palm Beach families reach RECO Island's Delray Beach campus in 28 minutes down I-95 — the nearest small-census, physician-led medical detox with direct in-house transition to residential and PHP/IOP. Withdrawal protocols are substance-specific: COWS-guided buprenorphine induction for opioids, long-half-life tapering (clonazepam or diazepam) for benzodiazepines, and supportive management for stimulant withdrawal. Medical comorbidity is worked up on admission rather than deferred, and MAT is initiated during detox and continued through discharge to a community prescriber — not stopped at the door.

West Palm Beach sits 18 miles north of RECO Island’s Delray Beach campus — a 28-minute run down I-95 or Federal Highway outside rush hour. For residents of El Cid, Flamingo Park, Northwood Hills, SoSo, and Downtown WPB, and for the broader Palm Beach County population south of Okeechobee Boulevard, the Delray campus is the nearest small-census, physician-led medical detox program with direct in-house transition to residential treatment — no waitlists, no third-party handoffs.

Substance-specific withdrawal protocols

Opioid, benzodiazepine, and stimulant withdrawal are three clinically distinct syndromes. Treating them with a single protocol is not simplification — it is bad medicine, and it produces the outcomes bad medicine tends to produce: incomplete detox, unnecessary suffering, and early relapse.

Opioid withdrawal is intensely uncomfortable but rarely medically dangerous in an otherwise healthy adult. RECO Island’s opioid detox uses COWS-guided buprenorphine induction — the Clinical Opiate Withdrawal Scale is administered at intake and repeated on a defined interval, with induction beginning once the score crosses the threshold for meaningful withdrawal (typically a COWS of 12 or greater). Buprenorphine is titrated to symptom control and maintained through residential; where clinically indicated, extended-release naltrexone can be initiated after an appropriate opioid-free window.

Benzodiazepine withdrawal is a different problem. Like alcohol withdrawal, it can produce seizures, delirium, and hemodynamic instability. RECO Island’s benzodiazepine detox converts short-acting agents such as alprazolam and lorazepam to a long half-life equivalent — typically clonazepam or diazepam — and tapers over weeks rather than days, adjusted to symptom emergence rather than run to a rigid calendar. Stimulant withdrawal from cocaine or methamphetamine presents as profound anhedonia, hypersomnia, and depressive symptoms without a specific medication protocol; supportive medical management, sleep normalization, nutritional repletion, and PHQ-9 tracking for emerging major depression are the clinical priorities.

Polysubstance detox and the sequencing decision

Concurrent use of alcohol, benzodiazepines, and opioids — often with a stimulant layered on top — is an increasingly common admission pattern. Sequencing matters, and the plan is documented before the first dose is given.

The general clinical principle is to manage life-threatening withdrawal syndromes first. Alcohol and benzodiazepine tapers begin at admission, guided by CIWA-Ar scoring for alcohol and symptom-driven dosing for benzodiazepines. Buprenorphine induction for opioid use disorder proceeds concurrently once opioid withdrawal is present on COWS — with careful attention to induction timing to avoid precipitated withdrawal. Stimulant withdrawal is managed supportively in parallel.

Every polysubstance detox at RECO Island is individualized based on which substances were used, in what quantities, over what duration, and what the client’s medical history and prior withdrawal course looked like. The plan is documented, communicated to the client where possible, and adjusted daily based on how the withdrawal actually unfolds — not on how a textbook says it should.

Medical comorbidity is the norm, not the exception

Chronic substance use produces medical consequences. Injection opioid use carries hepatitis C, endocarditis risk, abscess history, and vein damage. Chronic stimulant use produces cardiovascular strain — hypertension, arrhythmia, and in some cases premature coronary disease. Chronic alcohol use carries hepatic disease, pancreatic disease, and thiamine deficiency. Nearly every chronic-use admission carries some combination of malnutrition, sleep disorder, chronic pain that was self-medicated, and undiagnosed hypertension or diabetes.

RECO Island’s admission evaluation includes a full medical history, physical exam, comprehensive labs (including hepatic panel, hepatitis serologies where indicated, CBC, comprehensive metabolic panel, and thyroid function), and an assessment against the six ASAM Criteria dimensions. Comorbid conditions are managed concurrently on-site — not deferred to outpatient primary care after discharge, where they typically go unaddressed for another decade.

For many clients, detox is the first sustained medical contact in years. Treating it as only an addiction problem misses the actual clinical picture.

The handoff into residential and MAT continuation

Detox produces safe withdrawal. It does not produce recovery. Discharging a client from a five-to-ten-day detox back to their original environment, without residential treatment and without medication-assisted treatment, produces a relapse rate that borders on universal for opioid use disorder in particular.

RECO Island’s model is integrated by design. MAT is initiated during detox where indicated — buprenorphine or extended-release naltrexone for opioid use disorder, extended-release naltrexone or acamprosate for alcohol use disorder — and continued through residential, PHP, and IOP. Behavioral treatment during residential includes cognitive behavioral therapy for substance use (CBT-SUD), motivational interviewing, dialectical behavior therapy skills where clinically indicated, and trauma-focused work (EMDR or cognitive processing therapy) once acute withdrawal has cleared. Co-occurring depression, anxiety, PTSD, and bipolar disorder are treated concurrently with SSRIs (sertraline, escitalopram), mood stabilizers (lithium, lamotrigine), or atypical antipsychotics (quetiapine, aripiprazole) as indicated — not sequenced after the substance use “is fixed.”

At discharge, MAT is handed off to a community prescriber — not stopped. The clinical evidence on MAT continuation for opioid use disorder is unambiguous: sustained buprenorphine or methadone treatment reduces overdose mortality by roughly 50 percent. RECO Island does not discharge clients off medication that is protecting their life.

Admission from West Palm Beach — what the first 48 hours look like

An admission call from West Palm Beach typically produces same-day or next-day intake. The pre-admission conversation is clinically driven and covers:

• Substances used, quantity, duration, and time of last use
• Prior detox history and any prior withdrawal complications, particularly seizure history
• Current prescribed medications and any recent dose changes
• Co-occurring psychiatric symptoms — mood, anxiety, trauma, sleep
• Chronic medical conditions and last documented medical contact

Insurance is verified in parallel — most PPO plans authorize detox and residential without meaningful delay when the clinical presentation is documented against ASAM Criteria. On arrival at the Delray campus, the client is medically evaluated, labs are drawn, ASAM Criteria are scored across all six dimensions, and PHQ-9 and GAD-7 are administered to screen for co-occurring depression and anxiety. A dedicated room, monitored vitals on a defined interval, and 24-hour nursing coverage are baseline. The first 48 hours are the highest-acuity window for most withdrawal syndromes; staffing, monitoring, and physician availability are calibrated accordingly.

Insurance, cost, and the practical logistics

RECO Island is in-network with the major PPO carriers covering Palm Beach County — Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS national plans. Verification of benefits is completed before admission; out-of-pocket exposure (deductible, coinsurance, and any prior authorization requirements) is quoted in writing before the client arrives. There are no surprise bills issued after discharge for services that were represented as covered.

For West Palm Beach residents without transportation, admissions coordinates a driver — the 18-mile trip down I-95 or Federal Highway is not a barrier to entry. Family involvement, communication expectations, HIPAA and 42 CFR Part 2 privacy protections, and visitation policy are covered during the admission call so families arrive with the same information the client does.

Serving residents of: El Cid, Flamingo Park, Northwood Hills, SoSo, Downtown WPB.