Detox plus residential treatment for Miami — one team, no gaps, 65 minutes away.

RECO Island runs medical detox and 30 to 60 day residential treatment on one Delray Beach campus, under one clinical team — for Miami clients, the 65-minute drive up I-95 provides both a physician-led medical setting and clinical distance from Brickell, South Beach, and Coconut Grove social triggers. There is no third-party detox handoff and no waitlist between phases; the primary therapist assigned during detox continues through residential and step-down. Insurance verification and ongoing authorization are handled directly with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS plans by RECO's utilization review team, not by the family during a crisis.

From Brickell, Coral Gables, or Coconut Grove, RECO Island’s Delray Beach campus sits about 50 miles north — roughly 65 minutes up I-95 in typical traffic. That distance is not incidental to the clinical work. For Miami clients, sustained physical separation from the neighborhoods, contacts, and nightlife rhythms that reinforced substance use is often the first therapeutic variable a treatment plan can actually control.

Why medical detox alone rarely produces sustained recovery

Medical detox is a defined clinical intervention: safe management of withdrawal syndrome using protocols matched to the substance and severity. It is a necessary starting point for most clients with alcohol, benzodiazepine, or opioid use disorder — untreated withdrawal from alcohol or benzodiazepines carries seizure and delirium tremens risk, and untreated opioid withdrawal, while rarely fatal in medically healthy adults, drives near-immediate return to use. But detox does not, by itself, treat substance use disorder.

Outcomes data has been consistent for decades: clients who complete medical detox and return home without structured continuing care resume use within days to weeks in the majority of cases. The reason is clinical, not motivational. The interventions that actually change trajectory — cognitive-behavioral therapy targeting use-triggering cognitions, dialectical behavior therapy skills for affect regulation, motivational interviewing to consolidate change talk, buprenorphine or extended-release naltrexone initiation and dose stabilization, family therapy, evidence-based treatment of co-occurring depression or PTSD — happen across weeks of residential and intensive outpatient care, not during the three to ten days of medically supervised withdrawal.

A detox that discharges to home without residential handoff is treatment interrupted rather than treatment completed. The physiologic dependence has been medically managed; the disorder that produced the dependence has not been addressed.

The combined 30-60 day arc at RECO Island

RECO Island operates a single continuous program of combined medical detox and residential treatment on one campus, under one clinical team. Medical detox typically runs 3 to 10 days, calibrated to substance and withdrawal severity — a CIWA-Ar-guided benzodiazepine taper for alcohol, COWS-guided buprenorphine induction for opioids, extended cross-tapered schedules for benzodiazepines. Residential then continues for an additional 30 to 60 days, with length driven by ASAM Criteria dimensional assessment rather than a fixed calendar.

Clinical continuity is the point of the model. The primary therapist assigned during detox is the same therapist who runs individual sessions through residential. Medication started during detox — buprenorphine-naloxone or extended-release naltrexone for opioid use disorder, naltrexone or acamprosate for alcohol use disorder, sertraline or another SSRI for co-occurring depression, quetiapine or aripiprazole for co-occurring bipolar spectrum illness — continues without formulary switch or dose reset. The treatment plan drafted during detox is the treatment plan executed in residential.

There is no transfer packet, no re-admission process, no waitlist between phases, and no third-party facility involved. For Miami families accustomed to fragmented behavioral-health handoffs — detox at one facility, residential at another, outpatient at a third — the practical difference is that clinical momentum is not lost twice.

What residential treatment adds to the detox foundation

Residential is where the interventions that produce durable change are delivered at clinical density. Individual therapy runs multiple sessions weekly — most often CBT for use-triggering cognitions, DBT skills training for emotion dysregulation and distress tolerance, EMDR for trauma when a PTSD diagnosis is confirmed clinically and screened with PCL-5, and ACT for values-based commitment work. Group programming — process groups, relapse prevention, Seeking Safety for trauma-substance comorbidity, dual-diagnosis psychoeducation — runs daily on a structured schedule.

Psychiatric care is embedded, not consultative. Co-occurring conditions are screened at intake with PHQ-9, GAD-7, ASRS, and YBOCS as clinically indicated, and medication is managed on the same campus by the treating psychiatrist. Buprenorphine-naloxone is titrated to a maintenance dose that suppresses craving without sedation. Mood stabilizers — lithium where indicated, lamotrigine, aripiprazole, olanzapine — are used only when a bipolar-spectrum diagnosis is confirmed rather than assumed. Buspirone is used for residual generalized anxiety where benzodiazepines are contraindicated by the substance use history. For treatment-resistant depression that persists after two adequate antidepressant trials, esketamine or rTMS delivered at 3000 pulses per session at 120% motor threshold is available.

Sleep, nutrition, exercise, and daily structure are treated as clinical variables. Active substance use disorganizes circadian rhythm, appetite, and executive function; residential is where those systems are rebuilt on a schedule the client will need to sustain outside the facility.

Step-down into PHP, IOP, and continuing care

Residential is not the endpoint of treatment. After the 30 to 60 day residential block, clients step down to partial hospitalization (PHP, typically 30 or more clinical hours weekly), then intensive outpatient (IOP, roughly 15 hours weekly), then standard outpatient. The same treatment team continues through each step-down when the client remains within the RECO system, which preserves the therapeutic alliance built in residential rather than restarting rapport with a new provider at each transition.

Sober-living housing on or near campus is integrated for clients whose home environment does not yet support recovery — a common circumstance for Miami clients returning to shared households, high-density social calendars, or workplaces built around alcohol. Medication-assisted treatment continues through step-down and into community maintenance, with prescribing eventually transferred to a community provider when the client is clinically stable and geographically ready.

The clinical logic of the arc is that residential is the compressed block that makes the outpatient continuation productive. Without the residential foundation, IOP alone often functions as harm reduction rather than active treatment. Without the outpatient continuation, residential gains erode within months. The full arc — detox, residential, PHP, IOP, standard outpatient, community MAT — is what the outcomes literature actually supports.

What to expect on the first day

Admission from Miami begins with a phone assessment covering substance use history, medical history, current medications, prior treatment episodes, insurance verification, and immediate safety screening. Clients arriving in acute withdrawal or with elevated CIWA-Ar or COWS scores are admitted directly to medical detox the same day when clinically appropriate. Transportation from Miami-Dade — Brickell, Coral Gables, Aventura, Pinecrest, Coconut Grove — is arranged through admissions when the client cannot safely drive.

The first 24 hours on campus involve a full medical workup, psychiatric evaluation, ASAM Criteria dimensional assessment across all six dimensions, and screening with PHQ-9 and GAD-7 at minimum. The assigned primary therapist begins treatment plan drafting before residential transition. Family contact is initiated with the client’s written consent within the first 72 hours, and family therapy is scheduled to begin during residential. Personal electronics are limited during detox for clinical reasons and reintroduced on a structured schedule during residential.

Insurance and admissions from Miami

RECO Island works with most major commercial carriers used across Miami-Dade, including Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and out-of-state BCBS plans. Verification of benefits is completed during the admissions call before any commitment. For most clients, medical detox and residential treatment are covered at comparable benefit levels once medical necessity is documented against ASAM Criteria dimensions.

For Miami families, the practical questions are usually deductible status, out-of-pocket maximum, and length-of-stay authorization. RECO’s utilization review team handles ongoing authorization directly with the carrier through detox, residential, and step-down — families are not managing authorization calls during a crisis. Where insurance does not cover the full arc through residential and sober-living, hybrid self-pay arrangements are structured in advance with a clear financial plan rather than mid-treatment surprises.

Serving residents of: Brickell, Coral Gables, Coconut Grove, Aventura, Pinecrest.