Urban Recovery runs a medically supervised opioid detox program in Red Hook, Brooklyn, with medication-assisted treatment (MAT) when it is clinically appropriate. We treat adults who are physically dependent on opioids such as heroin, fentanyl, or prescription painkillers. You stay in an inpatient setting with continuous medical monitoring, and the medications available include buprenorphine, Suboxone, Sublocade, and Vivitrol. Urban Recovery holds two OASAS licenses, is CARF accredited, and offers same-day admissions. More than 10,000 lives have been transformed here.
If you have tried to stop alone and could not, that is a common experience with opioid dependence. It is not a personal failing. Opioid withdrawal is rarely fatal in the way alcohol withdrawal can be, but it can be punishing. The symptoms of opioid withdrawal can peak just as resolve begins to weaken, and one dose can end the suffering within minutes. That is why unsupervised attempts to stop opioid use so often fail.
Two forces drive many people back: untreated physical pain and untreated drug cravings. A professional medical detox addresses both. Our medical team uses prescription medications to reduce them, so recovery is no longer simply a test of endurance.
How soon opioid withdrawal starts depends on which opioid you used. Short-acting opioids include heroin and oxycodone. Their opioid withdrawal symptoms usually begin 8 to 24 hours after the last dose. The acute phase then runs 4 to 10 days. Long-acting opioids like methadone start later, 12 to 48 hours after the last dose. Their acute phase can run 10 to 20 days. These ranges come from published clinical guidance on withdrawal management, not from any single program. Your own timeline may be shorter or longer.
Physical symptoms include:
The psychological symptoms tend to be what people remember. They include severe anxiety, insomnia, restlessness, and drug cravings intense enough to override everything else.
Severe withdrawal symptoms carry their own medical risk. Sustained vomiting and diarrhea cause dehydration and electrolyte loss, and a rapid heart rate can follow. Without monitoring, these complications can become dangerous, which is why this program is inpatient rather than outpatient.
Opioids bind to opioid receptors in the brain, spinal cord, and gut. There, they block pain signals to produce pain relief and trigger dopamine release. With steady use, the brain dials down its natural response. The same dose then stops working, which is tolerance.
Physical dependence comes next. The body now needs opioids present simply to function normally. If you stop abruptly, the nervous system rebounds. That rebound is opioid withdrawal, and it is a predictable biological change rather than a character flaw.
Opioid receptors also govern breathing. At high doses, opioids suppress the brainstem drive to breathe and cause respiratory depression. That is how opioid overdose kills.
Some detox programs offer supportive care and let withdrawal run its course. Ours uses medication when it is appropriate for you. MAT pairs prescribed medication with counseling and behavioral therapy, so withdrawal and cravings are managed while you build coping skills for recovery. Your urine screen and medical history help guide which medication, if any, is used.
| Medication | How it works | When it can start |
|---|---|---|
| Buprenorphine | Partially activates opioid receptors, easing withdrawal and cravings with a much weaker effect than heroin or fentanyl | Once withdrawal is measurably underway |
| Suboxone | Buprenorphine combined with naloxone, which discourages misuse | Once withdrawal is measurably underway |
| Sublocade | Extended-release buprenorphine given as a monthly injection | After a first dose of buprenorphine has been tolerated |
| Vivitrol | Extended-release naltrexone, given as a monthly injection, that blocks opioid effects | Once opioids have fully cleared your system |
Buprenorphine binds to opioid receptors more tightly than most opioids, fentanyl included. If it is given too early, it displaces the opioid already on the receptor and triggers precipitated withdrawal, a sudden and severe version of the symptoms you came in to avoid. Under standard dosing, clinicians therefore hold the first dose until withdrawal is measurably underway. Fentanyl makes that point harder to judge, which is one more reason to start buprenorphine in an inpatient setting with continuous medical monitoring.
Vivitrol works the opposite way. Naltrexone blocks opioid receptors instead of activating them, so opioids taken while it is active have little effect. Trying to override that block with larger doses is dangerous. Vivitrol suits patients who have finished withdrawal and want a relapse barrier.
Medication does not have to end when detox does. Many people stay on buprenorphine for months or longer, and addiction medicine treats that as effective long-term treatment, not as swapping one addiction for another. Others taper off or move to Vivitrol. The right route depends on your history, your goals, and how withdrawal went.
Fentanyl remains the substance most often involved in overdose deaths in New York City. Provisional 2024 data from the NYC Department of Health and Mental Hygiene show fentanyl in 73 percent of those deaths and opioids in 78 percent. Brooklyn residents accounted for 473 of the city's 2,192 overdose deaths that year. Fentanyl and similar synthetic opioids are stored in body tissue, so withdrawal timing is less predictable than with heroin alone.
Xylazine has complicated detox further. The same department recorded it in 27 percent of overdose deaths involving opioids in 2024, down from 31 percent in 2023. Xylazine is a sedative, not an opioid, so buprenorphine does not relieve it. Anyone detoxing from a contaminated supply may have symptoms that opioid medication alone will not cover. That is a specific reason to detox under medical oversight rather than at home.
Admission starts with an intake coordinator and paperwork. A nurse then takes your vitals and reviews your medical history and current medications. A urine screen identifies the opioids present in your system, along with anything else, and that result helps guide your detox and treatment. Every patient receives a psychiatric evaluation within the first 24 hours, so staff can catch co-occurring conditions early.
From there, your treatment plan is built around your use history and medical needs, with continuous medical monitoring. The clinical goal of this stage is physical stabilization. Your body leaves acute withdrawal, and you can engage with what comes next.
The facility is electronics-free, so staff store phones and computers safely and return them at discharge. From the rooftop, you can see the Statue of Liberty.
Opioid use disorder is a diagnosable medical condition. If you are reading this for someone else, these are common signs of opioid abuse:
Opioid use often starts with a prescription. Many people who use heroin first misused prescription opioids, although only a small share of people who misuse prescription opioids move on to heroin. Opioid addiction may begin with pain management or with recreational drug use. Either way, the resulting dependence responds to the same treatment.
Opioid addiction rarely arrives alone. Anxiety, depression, and unresolved trauma either precede the substance use or grow out of it. Treating one while ignoring the other often fails. That is why the psychiatric evaluation happens within the first 24 hours, and why mental health care runs through the whole stay.
Our clinicians treat behavioral health conditions and substance use disorder together, including in patients whose history involves alcohol or other drugs as well as opioids. The program includes group therapy and individual counseling. This matters because untreated mental health conditions raise the risk of relapse.
Opioid detoxification is the first stage of the treatment process, not the whole of it. Relapse rates are high when people stop at detox and go no further. Tolerance falls during withdrawal while cravings persist, and returning to a former dose in that state is a well-documented cause of fatal opioid overdose. Staying on buprenorphine after detox is linked to a lower risk of overdose death, which is why medication is worth discussing well before discharge.
Urban Recovery holds two separate OASAS licenses. One covers medically supervised withdrawal and the other covers inpatient rehabilitation, and both are provided at our Red Hook facility. We are primarily a 21- to 28-day program. After detox, care can continue in our Short-Term Residential Program, which includes group and individual counseling. Discharge planning starts on day one, and you leave with a customized discharge plan.
Opioid detox is one of four detox programs Urban Recovery provides. The others are drug detoxification, alcohol detoxification, and benzodiazepine detox, all offered at our licensed drug rehab in Brooklyn, NY.
Our facility is at 411 Van Brunt Street in the Red Hook waterfront section of Brooklyn, Kings County, near Carroll Gardens, Cobble Hill, and the Columbia Street Waterfront District.
We accept some commercial plans and most Medicaid plans. A full-time staff member helps with insurance approval to make the process as seamless as possible. Call (646) 347-1892 to ask about your coverage.
Acute withdrawal usually runs 4 to 10 days, and longer for methadone. Your own opioid detox process depends on your use history and the opioid involved. Detox is only the first phase. Our program usually runs 21 to 28 days.
You will not be comfortable, but medical opioid detox is a long way from unmedicated withdrawal. Our clinicians manage withdrawal symptoms with medication. The intent is to keep symptoms tolerable rather than to have you endure them.
Yes, when it suits your situation. We offer Suboxone, buprenorphine, Sublocade, and Vivitrol. The medical team decides based on your urine screen, the opioid involved, and your medical history. If Suboxone is right for you, the first dose waits until withdrawal is measurably underway.
Possibly. Vivitrol can only begin once opioids have fully cleared your system, because starting earlier triggers sudden withdrawal. For some patients, that point falls within a 21- to 28-day stay. After methadone or heavy fentanyl use, it can take longer. Timing depends on your use history and screening results.
Some people do opioid detox as outpatients with a prescriber, which is a legitimate route. Inpatient care is safer when dependence is severe or earlier attempts have not held, because inpatient staff can watch for dehydration and heart strain that an unsupervised attempt would miss.
Same-day admissions are available, though admission depends on your paperwork and medical team approval. Call, and our admissions staff will guide you through the first steps.
Yes. Urban Recovery complies with HIPAA and all applicable privacy laws. Our confidentiality notice explains how we handle your records.
If you are counting hours until withdrawal starts, that is the moment to call. Urban Recovery is OASAS-licensed and CARF-accredited, and we offer inpatient opioid detox in Brooklyn with medication-assisted treatment and same-day admission.
Call our intake line at (646) 347-1892 to ask about medication-assisted treatment and your coverage. You can also email admissions@urbanrecovery.com.
This page is for general information and is not a substitute for professional medical advice. If you or someone near you may be experiencing an opioid overdose, call 911 immediately.
