New arrivals at Connections Withdrawal Management Center in Harrington begin with the building monitor.

New arrivals at Connections Withdrawal Management Center, a detoxification facility in Harrington, begin their journey with the building monitor, where they learn about expectations and sign forms, including a privacy notice and a statement of rights and responsibilities.

The next step, intake, is where basic information is collected.

Insurance providers are called to confirm coverage for those who have insurance. For those without insurance, Douglas Spruill, site manager at the center, said staff make every effort to work something out.

“We try not to turn anybody away,” he said. “If someone has made the decision to get off drugs or alcohol, we want to help them achieve that dream.”

After the initial intake, it is back to the building monitor, where personal items will be taken and secured. Five changes of underwear, shoes and slippers are allowed, and the facility provides scrubs, but phones, electronic devices and other items are not allowed.

Next comes the triage area. A urinalysis is performed and a medical assessment is completed, then it is on to a 23-hour observation period. Everyone must be seen by a doctor or nurse practitioner within the first 23 hours.

Spruill said during this period the client will meet with the medical and clinical staff, which consists of the doctor, nurse practitioner, RN, LPN , counselor and peer counselor.

This is when a Clinical Opioid Withdrawal Scale assessment is completed. The 11-item scale helps physicians determine a person’s level of withdrawal.

“We’re looking to see if they are going through withdrawal,” Spruill said, “and if you meet the qualifications to go into in-patient treatment.”

During that 23-hour observation period, new arrivals are expected to attend a group session.

Nurses check on everyone every two hours during this time.

The aim of the observation period is to determine the best next step – whether that is inpatient treatment, outpatient or withdrawal management.

For those in need of detox, there are 28 beds available. Typically, Spruill said, people will stay in the inpatient area for three to five days. There, they will meet with counselors, create a discharge plan and attend group sessions. They are also responsible for following all the rules, for upkeep of their rooms and general housekeeping in the common areas.

“We constantly insist we have a safe environment in order for everyone to succeed,” Spruill said.

Depending on the discharge plan, people may enter the Medication Assisted Treatment program, they may go to outpatient treatment or they may be referred to another facility, such as a transition home.

Counselors and case managers work with those in treatment to determine their needs, including housing, medical followup and mental health assistance.

“We have recovery services as well,” Spruill said. “We would like to support the person in any way possible to maintain sobriety, abstinence and thrive while being in recovery.”

Many will be begin Medication Assisted Treatment, or MAT, to help reduce cravings and ease withdrawal. MAT requires daily doses that reduce withdrawal pains and block the euphoric effects of opioids.

Adam Taylor, public information officer for Connections, said MAT is considered the first line of treatment for opioid dependence, and numerous studies have shown methadone and buprenorphine treatment works.

Alex Cropper is site director for the Dover and Millsboro clinics that dispense medication to hundreds of clients every day. He said how long a person stays on the treatment is based on the individual.

NEXT - Whether entering the MAT program or going cold turkey, for most people in recovery the next step is intensive outpatient treatment.