Avina Home Detox
Medical detoxification delivered in the principal’s residence. Physician-led. Twenty-four-hour licensed nursing. Five days minimum. Without engagement with any institutional health system.
Your bed, your kitchen, your people
Medical Director on every case
Licensed nursing for the full duration
Most engagements run seven to ten
The Protocol Library
The Avina Home Detox protocol library is governed by the Medical Director. Each protocol is reviewed quarterly and audited annually. We do not improvise. We do not vary. We do not deliver detox without a physician of record on the case.
Five-day standard, with seven- and ten-day variants depending on dependence severity, prior withdrawal history, and medical comorbidity. Benzodiazepine taper as the spine. Comfort medications run alongside. CIWA-Ar scoring hourly through the acute window. Wernicke prevention via IV thiamine 500mg three times daily.
Eight-day Subutex taper as the standard, with microinduction variants for principals on long-acting opioids or methadone. COWS scoring at every shift change. Naloxone available in residence. Care continuity to outpatient buprenorphine prescribing where appropriate.
Long taper protocol, typically twenty-one days minimum, occasionally longer. Cross-titration to long-acting benzodiazepine where required. EEG monitoring referral if seizure history. The most clinically demanding of the four indications and the protocol with the strictest screening.
Sequenced protocol. The acute substance is addressed first under the relevant indication-specific scoring. Stimulant withdrawal is supportive rather than pharmacologic. Nutritional and sleep architecture work runs alongside. Telehealth therapy commences in week one of the post-acute window.
Not every case is right for in-residence detox. The Medical Director reviews each before clinical work begins, and the firm declines cases where the safest setting is a hospital. We will help the family find the right facility. The standard is the standard.
Integrated IV therapy
Avina Home Detox incorporates intravenous therapy as integrated treatment, not an add-on. Every infusion is physician-prescribed and nurse-administered. The IV library supports repletion, hepatic and neurological recovery, and travels with the principal into the post-acute window.
Wernicke prevention in alcohol withdrawal. The single most evidence-supported infusion in our library. Cochrane-reviewed. Administered from Day 1.
Balanced electrolyte solution with magnesium and folate. Targeted rehydration, not routine. Indicated by clinical assessment, not protocol default.
Hepatic antioxidant support during alcohol withdrawal. Methylated B vitamins for neurological repletion. Adjunct to oral supplementation.
BR+ NAD 250 to 500mg over 4 to 6 hours, slow administration. Mitochondrial cofactor repletion during a period when chronic substance use has depleted cellular energy substrates. Pilot data suggest reduced withdrawal-associated anxiety and craving scores; larger controlled trials are in progress. First infusion Day 5; post-acute course over weeks two and three.
Evidence grades per AHD IV Library v1.0. Every claim is defensible. Nothing is marketed as proven that is not.
The five-day standard
The arriving nurse takes consents. Drugs and alcohol in the residence are disposed of appropriately. Baseline vitals: blood pressure, heart rate, temperature, respiration, oxygen saturation. Withdrawal scoring begins (CIWA-Ar for alcohol, COWS for opioid). The first nursing report goes to the physician-attended group thread.
Medications are dispensed under physician order, documented on the paper MAR and in the electronic record. Comfort medications run alongside. Vitals taken at every administration. Withdrawal score taken hourly during peak.
Nursing handover at every shift, with a written report to the group thread. The physician of record is reachable by text and by phone. Any change in condition is escalated within minutes. If a principal declines vitals, the refusal is documented. If there is an emergency, the protocol is to call 9-1-1 and then notify the physician.
The taper closes. Withdrawal scoring tapers with it. The principal eats, sleeps, talks. The post-acute arc begins: IV course where commissioned, Telehealth therapy scheduled, family briefing on the next state.
Why home, not hospital
The standard answer to a principal in clinical crisis is to remove them from their life. Avina was built on the opposite premise: bring the clinic to the home, and let the principal stay in the life that is worth recovering for.
The principal sleeps in their own bed, eats from their own kitchen, and is seen by their own people. We bring the clinic in, and we leave when the work is done.
The clinical bench
Board-certified physician with primary specialty in Pain Medicine and Physical Medicine and Rehabilitation. Authority to prescribe across the relevant schedules. Approves every Avina Home Detox case before clinical work begins, signs every protocol in the library, and holds kill-switch authority on any case that should not be running.
Schedules every shift. Validates every nurse against the Avina Home Detox Academy curriculum before a first deployment. Holds the after-hours line. Nurses are licensed in California, vetted, NDA-bound, and employed as W-2 staff.
Licensed Marriage and Family Therapist for the principal’s aftercare and family work. Telehealth-led so the work travels with the principal long after the detox closes. Commences in week one of the post-acute window.
Outpatient detox specialists, residential placement specialists, executive medicine partners. Pain medicine, addiction medicine, psychiatry, internal medicine. Called in when the case demands expertise beyond the core bench.
Discretion architecture
Every detox is delivered under a layered confidentiality framework. Nurses arrive in plain clothes. Vehicles are unmarked. Medications are pre-pulled and discreetly couriered. The household is briefed by the Chief of Staff in advance so domestic staff are aware only to the extent necessary. NDAs cover every clinician on the case, every vendor commissioned, every conversation held under the engagement.
Records are held in a HIPAA-compliant encrypted vault. Access is granular and revoked the moment a role ends. The principal owns the file. The family sees only what the principal authorises. Nothing leaves the office without written instruction.
Questions we are asked
We have begun detoxes within twenty-four hours of first enquiry where the case warranted it. Most begin within three to seven days, after the Medical Director’s case review, the engagement letter, and the nursing schedule are in place.
California in Year One. Additional jurisdictions will be added as licensure and MD licensure permit. International engagements are considered case by case in coordination with local clinicians.
For carefully screened candidates, yes. The Medical Director declines cases where the safest setting is a hospital. The screening criteria include severity of dependence, prior withdrawal history, cardiac and seizure history, comorbid medical conditions, the residence environment, and the support around the principal.
Yes. IV is integrated into Tier 2 and Tier 3 engagements. The IV Library includes thiamine, hydration, glutathione, B-complex, and NAD+ mitochondrial cofactor repletion. Every infusion is physician-prescribed and nurse-administered. NAD+ is presented as an emerging adjunct with pilot data; it is not marketed as evidence-based.
Avina Home Detox is priced by the engagement, not by the day. The engagement letter sets the investment on review of the protocol, the geography, the staffing, and the duration. We do not publish a list. We do not discount. We will explain the basis on first conversation.
The detox closes; the engagement does not. The principal moves into the post-acute window with the IV course (where commissioned), Telehealth therapy, and continued coordination through the Avina Wellness umbrella.
The protocol is to call 9-1-1 first and notify the physician of record second. Nurses are trained to escalate within minutes of any change in condition. The Medical Director and the Director of Nursing are reachable around the clock for the duration of the engagement.
Read personally by the principal or her senior operator. Reply within forty-eight hours.