Medical detox for Wellington — supervised, then straight into treatment.

Wellington families typically pair detox with a stay in RECO's sober-living network rather than a daily 38-minute commute from Olympia or Palm Beach Polo back to Delray. That structure gives the clinical team uninterrupted access during the highest-risk first weeks while keeping the client physically separated from the routes and contacts tied to active use. The detox-to-residential-to-PHP handoff happens inside one coordinated organization, so no records get lost between providers.

Wellington is about 28 miles west of RECO’s Delray Beach campus — roughly a 38-minute drive across the canals and farm corridors that separate the equestrian neighborhoods from the coast. For families in Olympia, Versailles, Aero Club, Palm Beach Polo, or Wellington View, that distance is meaningful. It’s far enough that a daily PHP commute from Wellington is rarely the right structure for someone just out of withdrawal, which is why Wellington admissions to RECO’s detox partners are typically paired with placement in RECO’s sober-living network for the first stretch of clinical treatment. The clinical depth stays at the Delray campus; the physical separation from old patterns — the route past the polo grounds, the familiar parking lot, the friend who always texts at 4pm — comes from the geographic move east.

Detox itself is short. Medical stabilization usually runs three to seven days depending on substance, dose history, and co-occurring conditions. What happens immediately after detox is what determines whether the person actually recovers, and that handoff is where most fragmented systems fail. RECO’s model is built specifically to close that gap.

When medical detox is the right starting point

Not every substance use disorder requires medically supervised withdrawal, but several do. Alcohol withdrawal can produce seizures, delirium tremens, and autonomic instability that are genuinely life-threatening — this is not a category where “white-knuckling it at home” is a reasonable plan. Benzodiazepine withdrawal carries similar seizure risk and, because of long half-lives, often requires a carefully tapered protocol that can stretch over weeks. Opioid withdrawal is rarely fatal in otherwise healthy adults but is severe enough that most people relapse within 72 hours without medical support, and the loss of tolerance during that window makes post-relapse overdose a real danger.

Stimulant withdrawal — cocaine, methamphetamine, prescription amphetamines — is a different picture. The physical syndrome is mild compared to alcohol or opioids, but the psychological crash, the anhedonia, and the suicidality risk in the first 96 hours often warrant a supervised setting even when “medical” detox isn’t strictly required. The ASAM criteria’s Dimension 3 (emotional, behavioral, and cognitive conditions) frequently push stimulant cases into a higher level of care than the withdrawal physiology alone would suggest.

What 24/7 medical supervision actually looks like

Medical detox is a clinical procedure, not a test of willpower. At the partner detox facilities RECO admits Wellington clients into, the standard of care includes scheduled vital signs — blood pressure, heart rate, temperature, respiratory rate — on a frequency matched to acuity, often every two to four hours during the active withdrawal window. Withdrawal severity is tracked using validated instruments: the CIWA-Ar scale for alcohol, which scores ten symptom domains including tremor, anxiety, and tactile disturbances; and the COWS scale for opioids, which captures pulse rate, sweating, restlessness, pupil size, and GI distress.

Medication management follows the scores. For alcohol, that typically means a benzodiazepine taper protocol — symptom-triggered or fixed-schedule depending on the protocol — with thiamine, folate, and electrolyte correction. For opioids, buprenorphine or, in some settings, methadone, with adjunctive medications for nausea, muscle cramping, and insomnia. The nursing team is present continuously; the medical director or attending physician is on call and reviews every patient daily. If a complication develops — a seizure, a cardiac arrhythmia, an unexpected psychiatric presentation — the response is immediate.

Direct continuity into residential or PHP

This is where RECO’s structure differs from the more common pattern of “detox at facility A, then call around looking for a residential bed at facility B.” When a Wellington client completes detox at a RECO partner facility, the transition into RECO’s residential program or directly into PHP happens within a coordinated clinical network. The discharge summary from the detox medical team — medications administered, withdrawal trajectory, lab results, any complications — arrives directly to the RECO clinical team who will manage the next phase. The therapist assigned at intake reads it before the first session.

What this looks like in practice: no two-week gap on a waitlist, no client sitting at home in Wellington View with a freshly detoxed nervous system trying to stay sober until a bed opens up, no re-telling of the substance use history to a new intake coordinator who doesn’t have the records. The momentum of treatment carries forward.

Medication-assisted induction during detox

For opioid use disorder, the most consequential clinical decision during detox is whether to induct on buprenorphine before discharge. The evidence here is strong: buprenorphine maintenance during the post-detox window dramatically reduces craving, blocks the reinforcing effects of subsequent opioid use, and substantially lowers overdose mortality. RECO’s psychiatry team coordinates with the detox partner to time induction appropriately — usually when the COWS score crosses into moderate withdrawal — so that the medication is established and stable by the time the client transitions to residential or PHP.

Naltrexone, including the extended-release injection (Vivitrol), is the alternative for clients who prefer an antagonist approach and can tolerate a longer opioid-free washout before induction. For alcohol use disorder, acamprosate and oral naltrexone are both routinely available and discussed during the detox-to-residential transition. None of these medications are a substitute for therapy — CBT, DBT skills work, motivational interviewing, and trauma-focused modalities including EMDR and TF-CBT remain the core of clinical treatment — but they meaningfully change the early-recovery survival curve.

Local proof, insurance, and how Wellington families start

Most major commercial PPO plans — Aetna, Cigna, UnitedHealthcare, Blue Cross Blue Shield, Magellan — cover detox at in-network or out-of-network benefit levels, and RECO’s admissions team verifies benefits before any clinical recommendation is made. You can submit insurance information through the insurance verification page or call directly. For Wellington families, the practical path usually looks like this: a benefits check the same day, a clinical screening to confirm detox is the appropriate level of care, transport coordination from Wellington (most families drive in; for higher-acuity cases the detox partner can arrange transport), and a documented continuum that extends through residential or PHP and into IOP and aftercare. Substance-specific resources — the alcohol treatment overview and the opioid treatment overview — cover what each pathway looks like in more detail.

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