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

For Miami clients in Brickell, Coral Gables, Coconut Grove, Aventura, or Pinecrest, the 50-mile drive up I-95 to RECO's Delray Beach campus is part of the clinical value — far enough from familiar triggers to make detox stick, close enough that family therapy weekends stay realistic. RECO's detox partner facilities hand off directly into our residential and PHP programs within the same organization, so there is no waiting list, no gap, and no rebuilt chart between levels of care.

From Brickell, Coral Gables, or Coconut Grove, the drive up I-95 to RECO’s Delray Beach campus runs roughly 50 miles and about 65 minutes in light traffic — closer to 90 minutes when the afternoon I-95 crawl sets in north of Aventura. For most Miami clients, that distance is not an inconvenience to engineer around but a clinical feature to lean into. Detox is the moment in treatment when proximity to familiar dealers, the social circuit around Brickell, or the late-night Coconut Grove scene can quietly undo the work. A medically supervised withdrawal followed by a residential stay an hour up the coast puts geography itself to work — the same way clinicians put medication, therapy, and structure to work.

RECO’s detox partner facilities provide 24/7 medical supervision through the acute withdrawal phase, with direct admission into RECO’s residential program or PHP immediately afterward. There is no organizational hand-off, no waiting list between levels of care, and no clinical chart that has to be rebuilt from scratch when you arrive. That continuity is the part Miami families ask about most often, and it is the part most marketing pages do not explain clearly.

When medical detox is the right starting point

Detox is medically indicated when withdrawal risk is moderate to severe. In practical terms, that means alcohol, benzodiazepines (Xanax, Klonopin, Ativan), and opioids almost always warrant medical supervision. Alcohol withdrawal can progress to seizures and delirium tremens in heavy daily drinkers; benzodiazepine withdrawal carries a similar seizure risk and is notoriously protracted; opioid withdrawal is rarely life-threatening on its own but is severe enough that unsupervised attempts almost always end in relapse, and the post-detox tolerance drop creates a genuine overdose window.

Stimulant withdrawal — cocaine, methamphetamine, prescription amphetamines — is a different clinical picture. There is rarely an acute medical danger, so a hospital-level detox is not usually required, but the depression, anhedonia, and intense cravings of the first 72 to 96 hours are easier to navigate in a supervised setting than in a Brickell condo with the dealer’s number still in the phone. Whether detox is the right starting point follows the ASAM criteria — particularly Dimension 1 (acute intoxication and withdrawal potential) and Dimension 3 (emotional, behavioral, and cognitive conditions) — rather than a one-size-fits-all rule. Our admissions team works through that assessment by phone before anyone gets in a car.

What 24/7 medical supervision actually looks like

“Medical detox” is a term that gets used loosely. Concretely, it means: vital signs (blood pressure, pulse, temperature, oxygen saturation) monitored on a defined schedule; withdrawal symptoms scored using validated tools — the CIWA-Ar for alcohol, the COWS for opioids — so dosing decisions are anchored in objective data rather than a clinician’s guess; medications given to ease symptoms safely, typically a tapering benzodiazepine protocol for alcohol withdrawal, buprenorphine or methadone for opioid withdrawal, and adjunct medications (clonidine, ondansetron, trazodone) for blood pressure, nausea, and sleep; and an on-site medical team capable of responding immediately if a vital sign drifts the wrong direction.

It is worth saying this plainly: detox is a medical procedure, not a willpower exercise. The “white-knuckle it at home” stories that circulate among Miami friends and family usually leave out the seizure, the cardiac event, or the relapse that followed 48 hours later. Supervised withdrawal exists because the body — particularly a body that has been adapting to alcohol or benzodiazepines for years — does not respond well to abrupt change.

Direct continuity into residential or PHP

The single biggest predictor of post-detox relapse is the gap between finishing detox and starting the next level of care. Nationally, that gap can stretch into days or weeks while a separate program reviews records, runs intake paperwork, and waits for a bed. RECO clients move from the partner detox facility directly into residential or PHP within the same organization. The clinical team that will manage the rest of your treatment receives the detox handoff in person — medication list, CIWA/COWS trajectory, co-occurring concerns, family contacts.

For clients stepping down further, that continuity carries forward into IOP, the on-site sober-living network, and the alumni and aftercare program. Most Miami clients use sober-living rather than commuting back to Brickell or Aventura for the first 60 to 90 days — the drive is too long to do daily, and more importantly, the distance from old triggers is part of why the model works.

Medication-assisted induction during detox

For opioid use disorder, the evidence for medication-assisted treatment is unambiguous. Buprenorphine induction during the detox phase — typically as Suboxone — reduces craving sharply and protects against the early-relapse window that follows tolerance loss. RECO’s psychiatric team coordinates MAT initiation with the detox partner so the medication is already stable when you transition into residential or PHP. For clients who prefer a non-opioid maintenance option, extended-release naltrexone (Vivitrol) is initiated after a clean window.

For alcohol use disorder, the available medications are naltrexone (oral or monthly injection) and acamprosate — both well-studied, both underused nationally, and both available as part of the treatment plan when clinically appropriate. The deeper clinical detail for substance-specific care lives on our alcohol and opioid treatment pages. Medication is one tool among several — the therapy side of the program leans on CBT, DBT skills training, motivational interviewing, and EMDR or Trauma-Focused CBT where trauma is driving the substance use — but for opioid and alcohol use disorder, omitting medication when it is indicated is a clinical decision that needs to be justified, not the default.

Insurance, getting started, and what Miami families should expect

RECO is in-network with most major commercial carriers — Aetna, Cigna, Blue Cross Blue Shield, United/UMR, Magellan among them — and our admissions team runs a same-day benefits verification so the financial picture is clear before anyone packs a bag. For families coordinating from Pinecrest or Coral Gables, the practical sequence is usually: a phone call to confirm clinical fit and run benefits; transportation arranged from Miami to the detox partner; three to seven days of medically supervised withdrawal; and direct admission into residential or PHP on the Delray Beach campus. Family involvement — through structured family therapy sessions and our family program — is built into the treatment plan from the first week, and the drive from Miami is short enough that in-person family work is realistic for most weekends.

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