Avina Home Detox
Medical detoxification delivered in the principal’s residence. Physician-led. Twenty-four-hour licensed nursing. Five days minimum.
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: clonidine for autonomic support, gabapentin for anxiety, ondansetron for nausea, trazodone for sleep. Vitamin and micronutrient repletion: multivitamin, folic acid, thiamine. CIWA scoring hourly through the acute window.
Eight-day Subutex taper as the standard, with microinduction variants for principals on long-acting opioids or methadone. Adjunct comfort medications. 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.
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 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 patient 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 companion arc begins or continues. Telehealth is scheduled. The Chief of Staff briefs the family 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, co-signs every nursing note, and holds kill-switch authority on any case that should not be running.
Schedules every shift. Validates every nurse against Avina’s training curriculum before a first deployment. Holds the after-hours line. The first call when a case escalates. Nurses are licensed in the jurisdiction of the engagement, vetted, NDA-bound, sized to the case.
NAD and BR+ NAD for cellular repair through the post-acute window. Glutathione for hepatic support. Methylated B-complex. Hydration with balanced electrolytes. Each session physician-prescribed and nurse-administered, in the same residence, by the same office.
LMFT-led therapy commences when the principal is ready, usually inside the post-acute window. Family work runs in parallel where indicated. The therapy travels with the principal long after the detox closes.
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, New York, and Florida in Year One, with additional jurisdictions added as licensure permits. 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.
Only the people the principal authorises in writing. The engagement letter names the family contacts who receive briefings, the rhythm of the briefings, and the boundary of clinical confidentiality between principal and family. The default is privacy.
Avina Home Detox is priced by the case, not by the day. The engagement letter sets the cost 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 through Avina’s engagement states (Intake, Active, Managed, Steady) under the same Chief of Staff. Telehealth, IV, and Companion practices are commissioned as the case requires.
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.