Outpatient Alcohol Detox in Palm Beach
Medically supervised alcohol withdrawal — from home, with physician monitoring
Alcohol withdrawal is medically significant — severe cases can cause seizures and delirium tremens (DTs). Dr. Agresti's outpatient alcohol detox protocol is designed for appropriate candidates: those without prior DTs, without severe medical comorbidities, and with a stable home environment. Daily clinical assessments using the CIWA-Ar scale ensure timely escalation if symptoms become severe.
Medications & Clinical Support
- Benzodiazepines (diazepam or lorazepam) — prevent seizures and reduce withdrawal severity
- Thiamine (Vitamin B1) — prevents Wernicke encephalopathy
- Anticonvulsants — additional seizure prevention
- Beta-blockers — cardiovascular symptom control
- Naltrexone or Vivitrol — MAT to reduce relapse after detox
- Daily CIWA-Ar scoring for objective symptom monitoring
Withdrawal Timeline
Hours 6–24
Early symptoms: tremor, anxiety, elevated heart rate and blood pressure, insomnia
Hours 24–48
Peak risk window: potential for seizures in susceptible individuals; intense monitoring required
Days 2–5
Hallucinations, delirium tremens risk (in severe cases); symptoms peak then gradually improve
Days 5–10
Acute withdrawal resolves; protracted symptoms (anxiety, insomnia, cravings) may persist for weeks
Why Outpatient Detox?
Outpatient alcohol detox is clinically validated for patients without high-risk factors. The advantages over inpatient care are significant: privacy (no admission record), cost (fraction of inpatient cost), and the ability to maintain work and family obligations during treatment. Dr. Agresti continuously monitors for signs of escalation and has established ER referral protocols if needed.
The Concierge Difference
During detox, you have Dr. Agresti's direct cell number. If symptoms become concerning at 2 AM, you call — not an answering service. This level of access is what makes outpatient detox safe and what separates concierge psychiatric care from standard treatment.
24/7
Direct physician access
No ER
Avoid unnecessary hospitalizations
Private
No inpatient admission record
Frequently Asked Questions
Who is NOT a candidate for outpatient alcohol detox?
Outpatient is contraindicated for patients with: history of alcohol withdrawal seizures, history of delirium tremens, concurrent severe medical illness, significant polysubstance use, no stable support at home, or daily alcohol use exceeding 1 liter of spirits. Dr. Agresti evaluates each patient individually.
What is CIWA-Ar scoring?
The Clinical Institute Withdrawal Assessment for Alcohol - Revised (CIWA-Ar) is a validated 10-item clinical scale that objectively measures withdrawal severity. Daily CIWA-Ar scoring helps Dr. Agresti titrate medications and determine if escalation to inpatient care is needed.
Can I take Vivitrol after alcohol detox?
Yes — Vivitrol (naltrexone extended-release injection) is highly effective at reducing alcohol cravings and relapse after detox. It requires abstinence for at least 7–10 days before administration. Dr. Agresti discusses all MAT options as part of the alcohol detox plan.