Medical assessment and detox before your programme

Clinically reviewed byNerea Encinas SánchezDirector of the centre, MSc General Health PsychologyRegistered psychologist, COPAO AO13857

Checked for accuracy on 28 July 2026. Next review due July 2027. This page is general information about our programme and is not a substitute for advice about your own situation.

A safety note first: if you are physically dependent on alcohol, benzodiazepines (such as diazepam or zopiclone) or opioids, do not stop suddenly on your own. Sudden withdrawal from these can be dangerous. In a life-threatening emergency call 999 or 112; for urgent advice that is not an emergency, call NHS 111 or speak to your GP. Part of what our assessment is for is making sure any detox you need happens safely and in the right place.

The assessment, before you travel

Before anyone is offered a place, we carry out a confidential clinical assessment by phone or video. We ask about the substance or substances involved, how much and how often, how long the pattern has been going on, your physical health, any prescribed medication, your mental health, and anything that has happened around previous attempts to stop. None of this is asked to judge you. In our approach, addiction is understood as a learned way of regulating an unbearable internal state, not a moral failing, and the assessment is carried out in that same non-shaming spirit. You can read more about that thinking on the Regulation Model.

The assessment does two things. It tells us whether a medical detox is likely to be needed before admission, and it tells us honestly whether the residential programme is the right setting for you at all. Where a mental health condition sits alongside the addiction, that is assessed at the same time, because the two are often connected. See dual diagnosis for how we work with both together.

Where detox happens, and why it comes first

Sierra does not run an on-site detox. If your assessment shows that you need a medically supervised withdrawal, that detox is arranged and completed in an appropriate medical setting before you come to us. It is a separate step, arranged and billed separately from the 28-day residential programme. This is deliberate, not a limitation. A withdrawal from alcohol or benzodiazepines in particular needs proper medical cover, and it is safer done where that cover exists.

The two routes, and which one you take

Where the detox happens depends on where you are and what the assessment finds, and there are two routes. You may be referred to a hospital in England and complete the withdrawal there before you travel, or you may come directly to Spain and complete it in a hospital in Málaga before moving to the centre.

The second route has one difference worth knowing about. Where the detox happens in Málaga and it is clinically appropriate, our clinical team comes to the hospital and the therapeutic work begins there, rather than waiting until you are discharged. It means the days spent in withdrawal are not dead time, and you arrive at the centre having already met the people who will be treating you. Whether that applies to you is a clinical decision, not a default, and it is made as part of the assessment.

In both routes the prescribing, the medical supervision and the monitoring during withdrawal are the hospital’s, not ours. Sierra’s role is the assessment that decides the level of care, the referral, and the residential treatment that follows.

Why detox alone is rarely enough

Detox clears the substance from your system. It does not, on its own, change the pattern underneath, which is why so many people relapse after a detox that was never followed by real psychological work. Completing detox first means you arrive at Sierra medically stable and clear-headed enough to engage with the therapeutic programme from day one, rather than spending your first week too unwell to take anything in. What that programme then does with the state underneath the using is set out in our programme.

Nurses on the team during your stay

Qualified nurses are part of the team while you are with us. They keep an eye on your physical wellbeing as your body settles after detox, support any prescribed medication, and are a first point of contact if something does not feel right. This is ordinary residential nursing care and continuity, not medical detox: a nurse on the team is not a substitute for the supervised withdrawal that, where needed, is completed before you arrive. You can meet the people who will care for you on the clinical team page.

How we decide whether Sierra is right for you

Not everyone who contacts us is best served by coming here, and we would rather say so than take an admission we cannot do well. If your assessment suggests you need a more intensive medical or psychiatric setting, or a hospital detox that has not yet happened, we will tell you plainly and help you understand the safer route. Where Sierra is the right fit, the assessment becomes the foundation of your care plan, so the team knows from the first day what they are working with.

If you would like to start with a confidential assessment, the next step is admissions, where we explain exactly how it works. What is included in the residential programme, and the fact that any hospital detox is costed separately, is set out in full on pricing.