Medical Service Overview

All medical services provided at Villa San Miguel are overseen by Dr. Keith Garcia, Medical Director. Board certified psychiatrist with two decades of experience with mental health and substance abuse.

Dr. Garcia is a board-certified psychiatrist with over two decades of diagnosing and treating co-occurring mental health and substance use disorders. Dr. Garcia works closely with Villa San Miguel’s clinical, nursing and case management staff to ensure every individual is provided with a comprehensive treatment plan targeting their core issues, concerns and symptoms.

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Comprehensive Psychiatric Evaluations

Each individual’s needs are different. These needs are targeted with comprehensive and thorough psychiatric, medical and clinical evaluations provided to each patient during their stay at Villa San Miguel. A robust range of assessment tools are vital in identifying and treating specific problems to ensure treatment success.

Medical Assessments and Monitoring

We utilize the American Society of Addiction Medicine criteria to determine the placement, continued stay, transfer or discharge of patients with addiction and co-occurring conditions. The ASAM criteria is one of several assessment tools Villa San Miguel uses to determine medical and psychiatric acuity. Upon arrival, each patient will meet with our trained medical staff and receive a full medical evaluation to examine withdrawal symptoms, physical health, and medical history. We utilize calculated withdrawal scales to measure each withdrawal symptom’s severity. The Clinical Institute Withdrawal Assessment for Alcohol, commonly abbreviated as CIWA or CIWA-Ar (revised version), is a 10-item scale used in the assessment and management of alcohol withdrawal. In addition to the CIWA scale, Villa San Miguel references the Clinical Opiate Withdrawal Scale (COWS) to measure the severity of a patient’s opiate withdrawal symptoms. These withdrawal tools are integrated into medication management and monitoring to reduce any discomfort related to detox symptoms. Patients will meet with psychiatric staff to address underlying mental health or co-occurring conditions that may present. A licensed will meet with patients to develop effective treatment plan options. In addition to this, our case management team will work closely with each patient to assist with coordination of continuum of care and discharge planning to provide effective care post detox.

24/7 Medical and Psychiatric Care

Villa San Miguel offers medically- supervised, 24/7 care to minimize health risks and ensure the highest quality of care during substance detox and rehabilitation. Our dedicated medical staff continuously assess and monitor withdrawal symptoms, tailoring your detox treatment plan to your specific needs. These professionals are ready to intervene if you experience any medical complications. Villa San Miguel’s experienced physicians and providers are available 24 hours a day. Our addiction specialists, physicians, nurses, and psychiatrists offer the top-notch care and support you need. Villa San Miguel is with you every step of the way.

Medication Administration, Management, & Monitoring

Withdrawal symptoms are unique to each individual and are monitored frequently by nursing and medical care staff. These symptoms are monitored closely utilizing validated scales and are treated with decades of combined medical and nursing experience to ensure safety and comfort throughout the detox experience.

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Clinical & Therapeutic Service Overview

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Group & Individual Therapy

Daily group therapy is provided at Villa San Miguel to begin the healing process. Each group is designed to provide support, instill insight, and foster the motivation each client demonstrates for sobriety. Individual therapy is available for individuals needing additional support during their stay.

Dual Diagnosis Treatment

Mental health diagnosis, treatment and ongoing support is vital in achieving long-term sobriety. Mental health diagnosis, such as depression, anxiety or bi-polar, can addressed, treated, and stabilized while at Villa San Miguel. Trained medical and clinical staff focus on dual diagnosis treatment, understanding the importance of treating and stabilizing mental health symptoms while in detox.

Options For In-House Recovery Meetings

There are options for individuals to attend 12-Step meetings while at Villa San Miguel. We believe in providing many different treatment options and supports to help achieve recovery. Treatment is not a “one size fits all” approach and the staff at Villa San Miguel understand this.

Comprehensive Discharge Planning

Each individual works closely with Villa San Miguel’s case management and clinical team to establish a supportive discharge plan that promotes wellness and recovery.

Alcohol Medical Detox

For patients struggling with alcohol addiction or dependence, stopping alcohol consumption abruptly without medical supervision can cause serious withdrawal symptoms. The severity of these symptoms varies according to a wide range of factors such as genetics, body composition, alcohol abuse history, prescribed medications, diet, other substance abuse, sleep history, and other mental and physical health diagnosis. Some of these withdrawal symptoms include shakiness, sweating, loss of appetite, nausea, vomiting, anxiety, nervousness, agitation, restlessness, fast heart rate, tremor, disorientation, headache, insomnia, or seizures. If untreated, severe cases of alcohol withdrawal can even be life threatening. Therefore, it is imperative that patients seek professional medical attention when going through alcohol withdrawal. At Villa San Miguel, patients going through alcohol withdrawal will receive a comprehensive assessment upon admission by our medical team. An individualized treatment plan will be created to ensure that the detox process is safe and comfortable.  In addition to a medical assessment, our staff will complete a psychiatric assessment for every patient to examine co-occurring conditions which can complicate detox, trigger relapse, or even be the root cause of the addiction in the first place. After these assessments are completed, our medical and clinical staff will provide continued medical supervision over the course of the entire detox process and prescribe medications, as necessary. One of the common treatment methods utilized by our medical team to relieve the severity of alcohol withdrawal symptoms is a closely- monitored benzodiazepine taper, which has been proven to reduce withdrawal severity and incidence of both seizures and delirium tremens (DT). The process typically takes 3 to 7 days, depending on medical necessity. In addition, patients have the option to receive both group and individual therapy. Our therapists and case management team members help patients work through any mental or emotional symptoms by incorporating tangible, real- time therapeutic tools such as Cognitive Behavioral Therapy, mindfulness, breathing techniques, grounding skills, and motivational interviewing.

Opiate/Opioid Medical Detox (Heroin, Fentanyl, Oxycodone, Hydrocodone, Morphine, etc.)

One of the most common substance use disorders in the United States is opiate/opioid use disorder. Opioids are a class of drugs that may be synthetic (such as Fentanyl) or natural opiates (such as heroin, morphine, and codeine). Individuals who use these drugs for an extended period of time develop a physical dependence and can experience severe withdrawal symptoms, including diarrhea, vomiting, nausea, restlessness, sweating, anxiety, cramping, abdominal pain, fast heart rate, insomnia, tremor, dilated pupils, watery eyes, depression, and powerful cravings for more opioids. When patients attempt to quit taking opiates or opioids on their own without medical assistance, these symptoms can be powerful, it can feel impossible to resist the urge to use the substance again. Often patients will go to extreme measures to obtain more opioids/opiates to avoid these symptoms. At Villa San Miguel, our experienced medical, clinical and psychiatric staff are familiar with the symptoms of opioid/opiate withdrawal and can support you or your loved one through detoxification and treatment. We develop customized treatment plans for each patient, depending on their medical history, substance use history, co-occurring disorders, and other factors to ensure a successful and sustainable recovery. Once assessed, a patient may require medication assistance which our medical team provides. We also recognize the importance of a holistic approach to recovery from opiate and opioid addiction and provide daily group therapy and mental health treatment. 

Benzodiazepine Medical Detox

Detoxing from Benzodiazepines is an intense and sometimes lengthy process that is best approached under medical supervision. If an individual stops taking benzodiazepines abruptly and without supervision, the withdrawal symptoms can be life-threatening. Benzodiazepines are prescription drugs that are used to treat anxiety, insomnia, panic attacks and other conditions. They are a highly addictive class of drugs and even short-term use can affect the brain. This causes benzodiazepines to be one of the most widely abused drugs and extremely difficult to stop once addicted. The first step in recovering from a Benzodiazepine addiction is detoxification, which is typically accomplished by gradually prescribing lower doses. When an individual is chemically dependent on benzodiazepines, they may experience a range of withdrawal symptoms during detox, including panic attacks, heart palpitations, hallucinations, drug cravings, insomnia, tremors, seizures and psychotic episodes. The symptoms that the benzodiazepines were originally prescribed to treat may also reappear. The length of a benzodiazepines detox depends on the type and dosage as well as how long the individual was using the drug. Short-acting benzodiazepines begin to leave the body within 10-12 hours, while long-acting varieties may take days or weeks. It may take six months or longer for withdrawal symptoms to fully subside and for an individual’s cognitive function to return to normal following benzodiazepine detoxification. In a small percentage of cases, the damage may be irreversible. By undergoing a medical-assisted detoxification from benzodiazepines, patients can experience a more comfortable and sustainable recovery process. Our medical and clinical staff at Villa San Miguel will provide 24/7 supervision during your detox process, monitoring your vital signs and prescribing medication, as necessary. 

Cocaine Medical Detox

Although the cocaine high lasts only for a few minutes to an hour, many individuals experience comedown symptoms such as anxiety and depression, which often lead to prolonged use and abuse of the drug. Cocaine withdrawal can begin about 90 minutes after the last use of the drug and may continue for days or even weeks. Because cocaine withdrawal symptoms vary widely, it is important to work with an experienced team of medical professionals and addiction specialists to manage your care while detoxing from cocaine. The detox process typically takes 5-7 days and can lead to side effects such as fatigue, sweating, agitation, nausea, and insomnia. Those with severe withdrawal may experience loss of motor control, difficulty breathing, convulsions and hallucinations. At Villa San Miguel, our expert care team can help you manage symptoms of cocaine withdrawal and oversee your detox process. Because cocaine causes an artificial buildup of dopamine in the brain, breaking cocaine addiction can often cause temporary mental and emotional health issues. In the event that your detox leads to an increase in anxiety, depression, paranoia or suicidal thoughts, our mental health specialists and clinicians can provide therapeutic tools or prescribe medications to make the process more comfortable for you. 

Amphetamine/Prescription Stimulants Medical Detox

Amphetamines are synthetic drugs that stimulate the central nervous system and can either be prescribed medications (such as Adderall) or illegal drugs (such as methamphetamine). Individuals may become physically and psychologically dependent on amphetamines, leading to drug abuse and addiction. This can cause neurological changes that make it very difficult to break the pattern of using amphetamines without the assistance of a medical professional. Withdrawing from amphetamines can lead to a “crash” and symptoms such as fatigue, insomnia, nausea, vomiting, body aches, and irritability which last for several days. Some individuals also experience emotional outbursts and mental health symptoms such as depression. Our clinicians at Villa San Miguel will evaluate you or your loved one’s unique situation and develop a custom detox plan to help manage symptoms from amphetamine withdrawal. We typically use a taper method to help gradually decrease dependence on amphetamines and may prescribe certain medications to provide relief during the process. We will take your symptoms and medical history into account when developing your treatment plan. In the event that you experience lingering psychological symptoms, we can help create a long-term care plan in collaboration with your doctor and mental health provider. 

Synthetic Drug Medical Detox

Many synthetic drugs are developed for medical purposes, but others are illegal street drugs or “designer party drugs” made to mimic the chemical effect of certain substances. These drugs are often produced in homemade laboratories and are difficult to regulate. Synthetic drugs can be highly addictive and include synthetic stimulants, synthetic cannabinoids (known as Spice or K2), and synthetic hallucinogens. Often, these illicit street drugs are marketed to teenagers and young adults who may be particularly susceptible to addiction. Withdrawing from synthetic drugs can lead to a range of symptoms, depending on the type of drug, the dosage, and the length of the addiction. These symptoms can include fatigue, insomnia, headaches, difficulty concentrating, tremors, paranoia and drug cravings. If you or a loved one is considering breaking an addiction to synthetic drugs, a medically-supervised detox in a safe, professional environment is the first step.

Co-Occurring Disorder Management while in Detox

Individuals who are detoxing from alcohol or drugs often exhibit medical and psychosocial symptoms that indicate an underlying condition. In addition, the withdrawal symptoms experienced during drug or alcohol detoxification may exacerbate other mental and physical health issues. This can affect the detoxification process as well as the likelihood of successful and sustainable addiction recovery. When someone is diagnosed with a substance use disorder as well as a mental health disorder, it is known as a dual diagnosis or a co-occuring disorder. Co-occurring disorders commonly include Attention-Deficit Hyperactive Disorder (ADHD), Bipolar Disorder, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder, depression and anxiety. Mental health diagnosis, treatment and ongoing support is crucial to achieving long-term sobriety. Our trained medical and clinical staff at Villa San Miguel understand the importance of treating and stabilizing mental health symptoms while in detox. We will work with you or your loved one to approach mental and physical health medically, clinically, and holistically, so that a foundation for a healthier future can be created.

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