For many people struggling with addiction, the first days of withdrawal have long meant emergency room visits and fragmented care—but McAlister Institute’s new onsite Incidental Medical Services (IMS) at its Lemon Grove Residential Treatment Campus is set to change that.
The initiative allows clients entering McAlister’s Adult Detox, Kiva Women and Children’s Learning Center, Kiva Detox, and New Connections programs to receive medically supervised withdrawal care without leaving the facility. The change is designed to stabilize clients quickly, reduce disruptions, and improve continuity during a critical point in treatment.
“Without IMS, those clients often had to be sent to emergency departments or outside urgent care settings for even basic withdrawal support,” said Michelle Zvirzin, McAlister Institute’s chief programs officer. “This created delays, increased risk, fragmented care, and, in some cases, resulted in clients leaving treatment before stabilization.”
When withdrawal support is provided onsite, clients remain in a familiar, trauma-informed environment, reducing stress and unnecessary exposure to emergency systems. “Instead of being transported to an ER—where they may wait for hours, be retraumatized, or leave before receiving help—they remain in a calm, supportive environment where they are known, safe, and engaged in care,” Zvirzin said. “This preserves dignity and keeps clients firmly connected to their treatment plan from day one.”
Those expected to benefit most include individuals withdrawing from alcohol, opioids, or stimulants; clients with co-occurring health conditions; people with limited transportation or inconsistent access to healthcare; and individuals with trauma histories who may find emergency department environments destabilizing.
The program addresses a longstanding regional gap, particularly for East County residents.
“Internal assessments, referral patterns, and client feedback showed that East County residents were disproportionately impacted by transportation barriers, long ER wait times, and difficulty accessing consistent withdrawal care,” Zvirzin said.
Medical oversight is particularly critical during the first 24 to 72 hours of treatment, when risks for complications and treatment dropout are highest. Integrated IMS allows for immediate screening, symptom monitoring, medication adjustments, and close communication between healthcare practitioners and residential staff, improving safety and continuity of care.
For more information on McAlister Institute and its programs, visit www.mcalisterinc.org.
