Begin Your Journey, Today
Gosnold is an award-winning nationally accredited non-profit leader in the prevention, treatment, and recovery of mental health and substance use disorders.
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Medical Detoxification and Stabilization Overview
GTC is a medicaI facility staffed by nursing 24 hours a day to monitor each patient’s progress in detox. Each patient will be assessed by a nurse on admission and seen by a medical provider on their first full day in treatment.
The medical team will establish what medications are most appropriate for your situation. Nursing will check in on your vital signs as well as use clinically validated tools to measure your progress in detox at specified times each day.
Length Of Stay
Each treatment plan is unique, based on substances used, progression in treatment, and co-morbidities. Patients can expect to stay a minimum of four days with some treatment plans starting at ten days. Treatment plans can be amended based on progress in treatment as needed.
Substances and Protocols
GTC treats patients who use a variety of substances including alcohol, opiates, sedatives/benzodiazepines, and stimulants. We have specific protocols (standard order set) for each substance of choice and canbe amended based on progress in treatment as needed.
Higher Level of Care
Because of the level of care we provide, we cannot manage patients experiencing symptoms outside of the usual detox spectrum. Patients with uncontrolled hypertension, diabetic complications, and other conditions requiring services beyond our scope will need to seek treatment at a higher level of care. Patients who are not able to perform their own ADL’s will also need a higher level of care. Lastly, patients who have a psychiatric diagnosis requiring support from specialize psychiatric professionals will need a higher level of psychiatric care.
Substances and Protocols
GTC treats patients who use a variety of substances including alcohol, opiates, sedatives/benzodiazepines, and stimulants. We have specific protocols (standard order set) for each substance of choice and can combine certain protocols to best manage individuals with polysubstance use disorder.
Oral Medications Only
Due to the level of care we provide, we cannot use IVs to treat patients. This means that we do have the capacity to administer IV fluids or medications. Our providers write for the oral form of medications. Some medications (e.g. insulin) which are administered via a syringe propriate for this setting and will be administered here.
Providers
The medical providers are in daily to see new patients on their first full day of treatment and then as needed after that. Providers are available to the nursing staff by phone 24 hours a day for any needs that arise.
Chronic medication management
The providers do not manage chronic medical issues or the medications used to treat them. Our providers are no responsible for your care needs.
The focus of their practice is to Release of Information:
for patients on medications with a significant potential for abuse (e.g. gabapentin, benzodiazepines, etc.) the providers at GTC may require that you sign a release of information so that they can coordinate care with your established providers.
What to Expect During Your Stay
Detoxification is a natural process that the body undertakes to rid itself of toxic substances such as alcohol, opiates, and other drugs. The organ primarily responsible for this action is the liver, and depending on the drug and the level of individual consumption, it can take anywhere from 48 to 96 hours for the liver to rid the body of the toxin. The detoxification can take longer if your liver is diseased or damaged. Patients who have other physical maladies may also experience longer detoxification times.
Our medical staff of physicians and nurses are trained to identify and treat withdrawal proactively to ensure minimum discomfort. We use medications that lessen symptoms and make it less likely that you will experience complications requiring more intensive hospital care. We use these medications until you no longer experience the withdrawal symptoms. Generally, this will range from three to seven days.
The medical treatment during detoxification is highly effective. At Gosnold, less than one-half of one percent of patients experience withdrawal complications that require transfer to a general hospital. Medical detoxification treatment alone is insufficient to produce lasting remission. A critical component of the care is your agreement to engage in further treatment. Addiction is a chronic condition and extended periods of remission require varied treatment over a long period of time. This could mean longer periods of inpatient rehabilitation care; it almost always involves outpatient treatment, twelve-step groups, or other self-help.
Persons who become dependent on alcohol or other drugs will experience a variety of symptoms when they abruptly stop using the substances. This experience is referred to as withdrawal, and its severity depends on a variety of factors including the type of drug being used, consumption levels, general physical condition, and length of time using the drug. Symptoms of withdrawal vary with the type of drug. Alcohol and benzodiazepine withdrawal are the most serious and can be life-threatening. Symptoms include tachycardia, tremors, nausea, anxiety, and—in more severe cases—seizures and delirium tremens. Opiate withdrawal symptoms include nausea, sweating, bone pain, and symptoms reminiscent of a bad case of the flu. While these are uncomfortable, they are not life threatening.
During the detoxification treatment, you are encouraged to participate in group education and therapy groups. Patients who are physically able could attend as many as five group sessions a day. You will also meet with counselors or case managers to discuss continuing care options. Because the detoxification treatment is of short duration, our staff will initiate this discussion as soon as possible.
You should bring all prescribed medication that you have been taking. All medications need to be in the original bottle with the original label that includes doctor’s name, name of medication, dosage schedule, route, and correct amount. Our physician will review the medication and make adjustments as necessary. Do not bring any supplements or over-the-counter medication, as they will be disposed upon arrival. Our physicians will not prescribe new medications or re-initiate medications that are not current.
What is detoxification?
Detoxification is a natural process that the body undertakes to rid itself of toxic substances such as alcohol, opiates, and other drugs. The organ primarily responsible for this action is the liver, and depending on the drug and the level of individual consumption, it can take anywhere from 48 to 96 hours for the liver to rid the body of the toxin. The detoxification can take longer if your liver is diseased or damaged. Patients who have other physical maladies may also experience longer detoxification times.
How does Gosnold treat withdrawal?
Our medical staff of physicians and nurses are trained to identify and treat withdrawal proactively to ensure minimum discomfort. We use medications that lessen symptoms and make it less likely that you will experience complications requiring more intensive hospital care. We use these medications until you no longer experience the withdrawal symptoms. Generally, this will range from three to seven days.
How effective is the detoxification process?
The medical treatment during detoxification is highly effective. At Gosnold, less than one-half of one percent of patients experience withdrawal complications that require transfer to a general hospital. Medical detoxification treatment alone is insufficient to produce lasting remission. A critical component of the care is your agreement to engage in further treatment. Addiction is a chronic condition and extended periods of remission require varied treatment over a long period of time. This could mean longer periods of inpatient rehabilitation care; it almost always involves outpatient treatment, twelve-step groups, or other self-help.
What is withdrawal?
Persons who become dependent on alcohol or other drugs will experience a variety of symptoms when they abruptly stop using the substances. This experience is referred to as withdrawal, and its severity depends on a variety of factors including the type of drug being used, consumption levels, general physical condition, and length of time using the drug. Symptoms of withdrawal vary with the type of drug. Alcohol and benzodiazepine withdrawal are the most serious and can be life-threatening. Symptoms include tachycardia, tremors, nausea, anxiety, and—in more severe cases—seizures and delirium tremens. Opiate withdrawal symptoms include nausea, sweating, bone pain, and symptoms reminiscent of a bad case of the flu. While these are uncomfortable, they are not life threatening.
What I do while in detoxification?
During the detoxification treatment, you are encouraged to participate in group education and therapy groups. Patients who are physically able could attend as many as five group sessions a day. You will also meet with counselors or case managers to discuss continuing care options. Because the detoxification treatment is of short duration, our staff will initiate this discussion as soon as possible.
Should I bring my medications from home?
You should bring all prescribed medication that you have been taking. All medications need to be in the original bottle with the original label that includes doctor’s name, name of medication, dosage schedule, route, and correct amount. Our physician will review the medication and make adjustments as necessary. Do not bring any supplements or over-the-counter medication, as they will be disposed upon arrival. Our physicians will not prescribe new medications or re-initiate medications that are not current.
Aftercare
An aftercare plan helps patients continue the progress made during their detoxification treatment. Patients who continue in treatment do much better in sustaining their recovery. Gosnold’s ongoing multidisciplinary team reviews each patients’ specific needs to determine the best recovery support post-discharge.
Clinical Stabilization Services (CSS)
involves high-intensity stabilization in a structured residential treatment setting. Patients will receive a holistic approach, focusing not only on addiction, but also physical health, mental health, recovery support and life skills. CSS is a typical step-down after completing ATS and for those who do not need detoxification medications, but remain a risk for relapse.
Partial Hospitalization Program (PHP)
Programming is 5 days a week Monday-Friday from 9:00am-2:30pm for adults (18 and over). PHP is a dual diagnosis program and mental health program that is a less restrictive alternative to further inpatient. Patients receive the following treatments: Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy (DBT), Psychoeducation, and expressive therapy, case management, and medication management. Programming is both in a group setting and individualized.
Intensive Outpatient Program-Substance Use Disorder (IOP-SUD)
Individualized Counseling
Each patient at Gosnold Treatment Center is assigned a primary counselor, and is additionally part of a two person clinical team. Your primary counselor will assist you in navigating your treatment, developing and meeting your treatment goals, and will work with you to develop a comprehensive continuing care plan in order to support your ongoing recovery.
Process Groups
Counselors as part of their clinical teams lead 7 small process groups each week with their patients, these process groups are center around solving and/or addressing presenting problems through clinically facilitated interventions, as well as peer support and feedback.
Barriers to Aftercare
Certain insurances are only accepted at certain facilities, which can limit the amount of referrals that can be sent out. Availability on a bed opening up on the date of discharge can be a challenge and often cannot be confirmed until the day of discharge. Signing releases for as many facilities is recommended as early as possible. Having a back-up plan is always encouraged.
For those patients interested in sober living, scholarships are limited and difficult to obtain directly from detox. Having a reliable funding source is recommended.
Transportation is provided to further treatment; however, is not able to facilitated if a patient is returning home. Transportation to the ferry or the bus station is able to be facilitated as well; however, Gosnold is not able to purchase tickets.
Programming
Group Programming
There are various types of group programming offered throughout a patient’s stay at Gosnold Treatment Center. Some examples of groups are:
- Spirituality
- Boundaries
- Mindfulness
- Sound Bowl Therapy
- Process Group
- Step Work
- Music Therapy
- Acupuncture
- Aftercare Needs and Resources
- Step Work
- Relapse Prevention
Patients are expected to attend groups when feeling well enough to actively participate. During group time, the courtyard is closed to all activities including smoke breaks and the televisions are turned off. If a patient decides not attend group, they should be resting in their bedroom, meeting with their case manager or participating in individual work in the acute area or in their room.
Individual Programming
Each patient will be assigned a Primary and Secondary Case Manager. On a case manager’s scheduled days off, the secondary case manager will conduct daily check-ins and follow up on aftercare planning. Patients should bring a list of questions/feedback to this check-in. Phone calls should primarily be used to follow up on aftercare options, but if time allows phone calls to family/supportive friends will be conducted as approved by their case manager.
Admissions: What to Expect
Step One
Arrive for scheduled admission.
Step Two
Complete consents with admission team.
Step Three
- Complete medical history
- Physical Assessment
- Urine screen
- Breathalyzer
- Nursing will initiate individualized medication protocol as indicated.
- Individuals acutely intoxicated will not require medication and will be monitored until appropriate to initiate protocol.
Note
If individuals are too intoxicated to cooperate with the admission assessment, they will be transported to the hospital until safe to complete admission.
Step Four
Meet with Recovery Aid
- Safety assessment of belongings
- Inappropriate or unapproved items will be secured
- Complete additional screening
- Tour of the unit/Overview of Program
Step Five
Case management will meet with patient the day after admission to discuss aftercare needs, develop a treatment plan, and complete an assessment.
Step Six
A medical provider (APRN or Physician) will meet with each individual within 24 hours of admission.
What to Bring:
- One Vape: must be in original sealed package. May not be refillable. Nicotine vape only.
- Cigarettes: must be in sealed package.
- All clothing should be comfortable and machine washable.
- Clothing must cover breast/torso/buttocks
- 5 outfits
- 1 jacket (weather dependent)
- 1 pair of shoes (may also have one pair of shower sandals)
- Socks, under garments
- One book or journal
- All prescription medication in original pharmacy packaging with original, unadulterated pharmacy label
- Necessary assistive or medical devices
Case Management Services:
As part of the clinical team at Gosnold Treatment Center we have staffed 2 full-time case managers who are responsible for the implementation of the comprehensive continuing care plan you will have developed with your counselor. The case managers will work in collaboration with you, your counselor and other providers (internal and external) in order to insure that your continuing care plan is in place prior to your completion of our program.
For patients that leave Against Medical Advice and has received protocol medication within 24 hours, will not be given access to their car keys until the next day due to the potency of the protocol medication and the possibility of impaired driving.
What Not to Bring:
- Personal Vehicles: personal vehicles will be towed within 24 hours if there are not arrangements made for removal.
- Cigarette Rolling supplies (loose tobacco, rolling tubes/papers, rolling machines). Patients may not roll their own cigarettes or smoked rolled cigarettes.
- Non-Religious Head Coverings: Hats, Bandanas, Durags
- Sunglasses
- Clothing exposing breasts, torso, or buttocks
- Any item that promotes violence, drugs, or alcohol
- Open vapes or packs of cigarettes
- Personal Toiletries unless Prescription
- Art Supplies
- Electronics (MP3 player, smart watch, tablet, laptop, etc.)
- Blankets, stuffed animals, and pillows from home
What The Data Shows
- Gosnold’ s Acute level of care services has provided at least 8 different protocols to suit patients needs during their course of treatment.
- Gosnold Acute level of care services ranked the 3rd lowest facility in the state regarding leaving Against Medical Advice.
- 91% of Gosnold’ s patients agreed that “The intake process was efficient and completed in a timely manner.”
- 94 % of Gosnold’ s patients agreed that “The intake staff was courteous and attentive to my needs.”
- 90% of Gosnold’ s patients agreed that “Staff were sensitive to my language, cultural and spiritual needs.”
- 94% of Gosnold’ s patients agreed that they were satisfied with treatment.
- 90% of Gosnold’ s patients agreed that they felt safe while at Gosnold.
- The national goal average rate for treatment completion upon discharge is 55%. Gosnold’s treatment completion is 7% above the national average. Gosnold reports an 81% treatment completion rate upon discharge when our patients engage in 5 or more days at the Acute Treatment Services level of care.
