Withdrawal: The First Step

Staff and clients at The Bridge know the importance of withdrawal services that are provided here at The Bridge as a first step for those on their journey from addiction to sober living. The second floor at The Bridge tends to be one of the busiest areas, as our staff help people taking this first step. This floor consists of the Social Withdrawal Unit which is located within the Civil Protective Custody area, along with the Medical Withdrawal Unit. Civil Protective Custody (CPC) is where law enforcement admits intoxicated individuals who they believe might be a danger to themselves or to others. One of the biggest differences between CPC and the Social Withdrawal Unit is that social withdrawal is completely voluntary. It is common for individuals to leave the Social Withdrawal Unit and move into to the Medical Withdrawal Unit, which is also voluntary.

Over the past two years, The Bridge has seen a 25% increase in individuals voluntarily seeking services in our withdrawal programs. Those coming to us for help often have greater medical needs and we have seen an increase in the variety and unpredictability of the drug being used.

Those working on the second floor tend to see individuals admit themselves into the Social Withdrawal Unit when they know they are intoxicated and know they need a safe place to be while they begin to withdraw from the substance they have been using. Those that are in Social Withdrawal are typically intoxicated but beginning active withdrawal while those in the medical withdrawal unit are no longer actively intoxicated. The Medical Withdrawal Unit is also voluntary and individuals may stay 3-5 days.

Dave, a Registered Nurse, has worked in the Medical Withdrawal Unit for about a year and a half while also working at the Independence Center at Bryan Hospital. Dave and another nurse Lari are withdrawal specialists and have a daily routine consisting of providing care for the individuals that are in the Medical Withdrawal Unit. They monitor and record CIWA scores every four hours. CIWA, the Clinical Institute Withdrawal Assessment, is a ten question scale used to assess and manage substance withdrawal. If the individual meets criteria— a score of five or more— nurses can start to administer medications to manage withdrawal symptoms. Individuals in withdrawal are susceptible to hallucinations, tremors, and seizures.

Overall, the withdrawal programs here at The Bridge are special. Not only are their medical needs met, but clients are able to focus on their attitude and behavior, not only towards themselves but to those around them, while reflecting on their experiences. The Bridge counselors also work with clients and help them consider treatment and provide information in order to create a plan for the next steps they should take. The passage to sober living might not be the easiest but it is a journey that is worth taking.