Private medical detox for Wellington — 38 minutes, then straight into treatment.

RECO Island is 28 miles east of Wellington in Delray Beach — a 38-minute drive from Palm Beach Polo, Olympia, and Aero Club. Detox is physician-led with 24/7 nursing running CIWA-Ar and COWS at bedside, and clients transition directly into RECO's in-house residential program with the same primary therapist and plan — no third-party handoff, no waitlist gap. Census is small and admissions from Wellington are typically same-day when clinically indicated.

Wellington sits 28 miles west of RECO Island’s Delray Beach campus — roughly 38 minutes by car through the equestrian corridor and the gated neighborhoods clustered around Palm Beach Polo, Versailles, Olympia, Aero Club, and Wellington View. That distance is meaningful clinically: it is far enough inland that clients rarely commute daily to detox and residential care, which reframes the decision from “which outpatient program has openings” to “which residential detox will admit today, staff appropriately overnight, and continue the same treatment plan into the next level of care without a handoff.” Medical detox at RECO Island is built specifically for that decision.

When medical detox is the clinical indication

Medical detox is indicated when withdrawal risk crosses into the moderate-to-severe range. That includes alcohol use disorder with regular heavy consumption (particularly with a history of prior withdrawal seizures, delirium tremens, or CIWA-Ar scores above 15 on prior admissions), benzodiazepine dependence at therapeutic or supratherapeutic doses — especially short-half-life agents like alprazolam and lorazepam — opioid use disorder with daily use of heroin, fentanyl, or prescription analgesics, and polysubstance use combining any of the above. Stimulant-only withdrawal is rarely life-threatening and does not typically require inpatient detox, but supervised medical support during methamphetamine or cocaine withdrawal has documented value when depressive symptoms, suicidality, or psychosis emerge.

Level-of-care decisions are made against the ASAM Criteria across all six dimensions: acute intoxication and withdrawal potential, biomedical conditions, emotional and behavioral status, readiness to change, relapse potential, and recovery environment. A Wellington client with a stable home, mild anxiety, and a two-year drinking history is a different admission from one with cirrhosis, prior DTs, and a coexisting benzodiazepine prescription — and the two require different medication strategies, different monitoring intensities, and different aftercare architectures. Intake is where those distinctions get made.

Symptom-triggered protocols using validated withdrawal scales

Alcohol withdrawal at RECO Island is managed with the CIWA-Ar — the Clinical Institute Withdrawal Assessment for Alcohol, revised — scored across ten symptom domains at defined intervals (typically every one to four hours depending on trajectory). Benzodiazepine dosing, most often lorazepam or chlordiazepoxide, is administered when the score crosses treatment threshold rather than on a fixed q6h schedule. Symptom-triggered dosing reduces total benzodiazepine exposure, shortens the detox course by an average of one to two days versus fixed-dose regimens, and produces cleaner cognitive trajectories on discharge.

Opioid withdrawal is assessed with the COWS — Clinical Opiate Withdrawal Scale — and treated with buprenorphine induction when the score exceeds 8 to 12, with continued buprenorphine-naloxone maintenance planned into residential unless the client is a candidate for extended-release naltrexone after a full washout. Adjunctive medications — clonidine for autonomic hyperactivity, ondansetron for nausea, hydroxyzine for anxiety and sleep, loperamide for GI symptoms — are protocol-driven, not improvised. Bedside nursing running the scales is what makes this standard-of-care rather than a policy on paper.

Medical evaluation and comorbidity management

Every admission opens with a full medical evaluation: history and physical, medication reconciliation against pharmacy records where available, and a laboratory panel that typically includes CBC, comprehensive metabolic panel with LFTs, TSH, urine drug screen, urine pregnancy where indicated, and EKG when cardiovascular risk or QT-prolonging medications are on the picture. Hepatitis C and HIV screening are offered. Chronic conditions — hypertension, type 2 diabetes, hepatic disease, cardiac history, seizure disorder — are managed concurrently with withdrawal, not deferred until after discharge.

Psychiatric comorbidity is screened at intake with PHQ-9 for depression, GAD-7 for anxiety, and additional instruments as clinically indicated (ASRS for adult ADHD, PCL-5 for PTSD, YBOCS where obsessive-compulsive symptoms are prominent). Medication decisions are deliberate: SSRIs like sertraline are commonly continued or initiated; second-generation antipsychotics such as quetiapine or aripiprazole are used judiciously and not as sleep aids by default; mood stabilizers including lithium require baseline labs and are not started casually during acute withdrawal. Nutrition, hydration, and sleep are treated as clinical variables, not amenities. Thiamine, folate, and multivitamin repletion are standard for alcohol admissions to reduce Wernicke risk.

The transition into residential or PHP without gaps

The most consequential moment in any detox stay is the day the client transitions out. National data consistently show that clients discharged from standalone detox to community follow-up relapse at dramatically higher rates than those who move directly into residential or PHP care. RECO Island’s model is designed around that data point: the handoff from detox into residential happens inside the same organization, with the same primary therapist assignment established during detox continuing into residential, and the same integrated treatment plan carrying forward on day one.

Practically, that means no records transfer between organizations, no re-intake, no lost medication list, no waitlist gap of “we’ll call you when a bed opens.” The transition date is scheduled at admission, not negotiated on day five. Modalities that begin in detox — motivational interviewing, cognitive behavioral therapy for the acute cognitive distortions of early recovery, brief acceptance and commitment therapy work around craving — carry into residential, where dialectical behavior therapy skills groups, EMDR for trauma when indicated, and family systems work are added as clinically appropriate.

What Wellington clients can expect on admission day

Admissions from Wellington typically start with a phone call to verify benefits and complete a clinical pre-screen, followed by transport arranged from the Wellington address to Delray Beach the same day when clinically appropriate. On arrival, the client meets the admitting nurse and physician, completes the medical workup, hands off medications for reconciliation, and begins withdrawal monitoring within the first hour. Vitals and CIWA-Ar or COWS scoring begin immediately; treatment is initiated on the first threshold crossing.

Family communication is established that day within whatever release-of-information boundaries the client authorizes. A named case manager coordinates the residential transition from day one, so by the time the medical portion of detox is complete — typically three to seven days for alcohol, five to ten days for benzodiazepine or complicated polysubstance courses — the residential bed, therapist, and treatment plan are already in place.

Insurance and admissions from Wellington

RECO Island is in-network or negotiates single-case agreements with the major carriers Wellington clients most commonly hold, including Florida Blue, BCBS, Aetna, Cigna, UnitedHealthcare, and Humana. Benefits verification typically takes under an hour during business hours. Out-of-pocket costs, deductible status, and any prior authorization requirements are disclosed in writing before admission. There are no third-party call centers and no marketing intermediaries — the person answering the admissions line is clinical staff at the facility that will treat the client.

• No waitlist: same-day admission is the default when clinically indicated.
• Small census: nurse-to-client ratios reflect a residential-scale program, not a hospital wing.
• In-house continuum: detox, residential, PHP, and IOP under one clinical umbrella.
• Discreet campus: Delray Beach, 38 minutes from Wellington, physically separated from the client’s daily environment.

Serving residents of: Olympia, Versailles, Aero Club, Palm Beach Polo, Wellington View.