Medical detox. Physician-led, 24/7 nursing, dignity intact.
Medical detox is the medical stabilization of withdrawal under continuous physician oversight. At Pines Recovery Life, it is supervised by board-certified psychiatrist Sergey Litvinov, MD, and delivered by a credentialed clinical team inside our 18,000 sq ft private campus in Pembroke Pines, Florida.
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A clinical process, not a detox cleanse.
Medical detox is the supervised management of physical withdrawal from alcohol, opioids, benzodiazepines, or other substances under continuous physician oversight. It is a short, intensive phase — usually 3 to 7 days — and it is the foundation of everything that follows.
The American Society of Addiction Medicine defines detoxification as the set of interventions required to manage acute intoxication and withdrawal, prevent medical complications, and facilitate entry into continued treatment (ASAM National Practice Guideline). It is not the same as “getting clean” — detox is about making withdrawal safe so recovery work can begin.
When stopping cold turkey is dangerous.
Unsupervised alcohol or benzodiazepine withdrawal can cause seizures, delirium tremens, and death. Roughly 5% of untreated alcohol withdrawal cases progress to DTs, which carry a historical mortality rate above 5% without treatment (NCBI Bookshelf — Alcohol Withdrawal Syndrome). Opioid withdrawal is rarely fatal but carries exceptionally high relapse risk and, because tolerance drops rapidly, a dramatically increased overdose risk during that relapse. If you are using daily, stopping alone is not the answer. Calling is.
The physician who leads this program.
Sergey Litvinov, MD
Medical Director · Board-Certified Psychiatrist
Dr. Litvinov is a board-certified psychiatrist who leads the medical detox program at Pines. He personally directs withdrawal management protocols for every patient, titrates MAT when indicated, and coordinates psychiatric care for co-occurring mood, anxiety, and trauma disorders. His specialization — the intersection of addiction and psychiatry — is precisely what most patients arriving in detox actually need.
Every withdrawal is different. Every protocol matches it.
Pines follows evidence-based, substance-specific protocols aligned with ASAM and SAMHSA practice guidelines. What follows is a summary; individual plans are determined by clinical assessment.
CIWA-Ar scored q4h; symptom-triggered or fixed-dose benzodiazepine (lorazepam or diazepam); thiamine, folate, B-complex vitamins; seizure precautions; delirium tremens monitoring. Most alcohol detox runs 3–5 days. Related: alcohol treatment.
COWS scored frequently; buprenorphine induction when the window is ready; adjuncts for sleep, nausea, GI. Fentanyl patients often require micro-dosing induction due to prolonged tissue half-life. Related: opioids, fentanyl, heroin.
Switch to a long-acting agent (diazepam, chlordiazepoxide) and taper over 7–14+ days. Because benzodiazepine withdrawal is one of only two classes that can kill, this is done cautiously, with seizure monitoring throughout. Related: benzodiazepines.
No pharmacologic detox protocol — withdrawal is psychological, not physical. Primary focus: sleep restoration, hydration, nutrition, management of post-use depression, and screening for suicidal ideation. Related: cocaine, meth.
Methadone’s long half-life makes detox uniquely protracted. We coordinate with licensed OTPs for gradual taper where indicated. Related: methadone.
Oxycodone, hydrocodone, Xanax, Adderall, others. Assessment determines which protocol applies based on the substance class, dose, and duration. Related: Rx drugs.
What to expect from the moment you arrive.
Intake & full medical assessment
A thorough, unhurried intake — roughly an hour — completed with a clinician. Medical history, substance use history, psychiatric history, medications, allergies, prior treatment. Vitals, labs drawn, imaging if indicated.
Physician evaluation
Dr. Litvinov or covering physician reviews your intake, confirms the detox plan, and prescribes initial orders. Medications begin.
Room & supplies
Escorted to your private or semi-private room. Hydration, nutrition, comfort items provided. Orientation to nursing station.
First monitoring cycle
CIWA-Ar or COWS scoring begins. Vitals rechecked on schedule. Symptom-triggered medication dosing through the first night.
Therapist meet
When medically appropriate (often day 2), a brief introduction with your assigned therapist. No deep clinical work while acutely withdrawing — that begins after stabilization.
Family update (with consent)
With signed release, a concierge update to the listed family contact. No clinical detail without patient consent.
The rhythm, once withdrawal softens.
The first 48 hours are medical. Beyond that, the rhythm of care begins to widen — the body starts to settle, and the clinical work begins. Below: a representative day by the third or fourth morning of detox.
Nothing is rushed. Deep clinical work doesn’t begin in acute withdrawal. What happens in detox is stabilization — body, nervous system, sleep, appetite — so residential can start from solid ground.
The instruments behind every clinical decision.
Clinical Institute Withdrawal Assessment for Alcohol, Revised. The validated tool for scoring alcohol withdrawal severity. We score q4h in acute detox and dose benzodiazepines symptom-triggered off the CIWA score. Standard of care nationwide.
Clinical Opiate Withdrawal Scale. Validated scoring tool for opioid withdrawal across 11 symptom domains. Determines readiness for buprenorphine induction and guides comfort medication dosing.
Buprenorphine induction on-site, naltrexone transition, methadone coordination through OTPs. FDA-approved MOUD reduces overdose mortality by approximately half.
Continuous monitoring, bedside airway equipment, rapid-response protocols, long-acting benzodiazepine tapers to blunt withdrawal seizures before they start.
Depression, anxiety, trauma, bipolar, psychosis screening during detox. Psychiatric medication management begins immediately when clinically indicated — not after some arbitrary sober period.
Licensed nursing coverage continuously. LPN/RN scope of practice includes vitals, medication administration, withdrawal scoring, emergent intervention.
Most plans cover medical detox. Verify in under a minute.
Medical detox is covered by every major insurance carrier we accept under Mental Health Parity. Authorization is based on ASAM medical necessity criteria.
Verify CoverageEight questions, answered clearly.
What is medical detox?+
Is detox dangerous to do on your own?+
How long does detox take?+
What medications are used in detox?+
Do you treat fentanyl detox?+
Will insurance cover detox?+
What happens after detox?+
Can I bring my own medications?+
Reviewed by Sergey Litvinov, MD — Medical Director, board-certified psychiatrist. Updated April 2026.
Citations: ASAM National Practice Guideline · SAMHSA MOUD · NCBI — Alcohol Withdrawal · NIDA Medications for OUD · FDA MAT
