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Clinical consultation room at Jintara Rehab where the governance framework is documented

Clinical Governance, Safety and Oversight Framework at Jintara

Jintara is a licensed residential addiction treatment centre in Chiang Mai, Thailand, operated by Lanna Health Care Company Limited under Thai Ministry of Public Health licence SFD 50:13-106. Psychiatric oversight runs through our partner hospitals, with 24/7 on-site nursing and a no-compromise hospital escalation pathway.

  • Thai MoPH licensed, registered 8 September 2013 under the Narcotics Code
  • Psychiatric oversight through Bangkok Hospital Chiang Mai and Chiangmai Ram Hospital
  • 24/7 awake nursing, CIWA-Ar and COWS monitoring on active detox
  • Published limits of practice covering who the facility does and does not admit
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Fully Licensed Facility

2. Medical and Psychiatric Oversight

Board-certified addiction psychiatrists are accessed through partner hospitals rather than held on staff. This structure keeps psychiatric oversight independent and continuous, with no single-physician dependency. On-site psychiatric assessment happens on admission, the detox plan and medication schedule are signed off the same day, and psychiatric input continues through detox and throughout the program as clinically indicated.

On-site clinical operations are led by Khun Khwan, Head Nurse and Operations Manager, who runs the 24/7 awake nursing rota and co-signs hospital referrals. Jintara holds formal medical care agreements with two partner hospitals in Chiang Mai, dated February 2026 and May 2025 respectively, both compliant with the Thai Personal Data Protection Act (PDPA 2562/2019). The medical-oversight approach follows NIAAA guidelines on medically supervised detoxification.

3. Screening and Assessment Tools

Standardised clinical instruments are used on admission and throughout detox to quantify withdrawal severity and mental-health acuity. Scoring thresholds drive the frequency of nursing checks and trigger escalation when required. The tools in routine use at Jintara are listed below, each with its validated scoring range and clinical purpose.

  • CIWA-Ar: Clinical Institute Withdrawal Assessment for Alcohol, Revised. Ten indicators scored 0 to 67. Scores above 14 trigger three-times-daily nursing assessment. The original validation study (Sullivan et al., British Journal of Addiction, 1989) showed CIWA-Ar scores above 15 correlate with meaningfully higher seizure risk.
  • COWS: Clinical Opiate Withdrawal Scale. Eleven items scored 0 to 48. Drives benzodiazepine or buprenorphine taper decisions during opioid detox under psychiatrist direction.
  • PHQ-9: Patient Health Questionnaire-9. Nine items scored 0 to 27. Measures depression severity at intake, through treatment, and at discharge.
  • GAD-7: Generalized Anxiety Disorder-7. Seven items scored 0 to 21. Screens for anxiety disorders alongside primary substance assessment.
  • 8Q: Thai-language suicide-risk screening questionnaire used where clinically indicated, with SAMHSA-aligned escalation protocols if any item triggers positive.
Jintara nursing team reviewing a client's CIWA-Ar score and vital signs during monitored withdrawal

4. Detox Pathways by Substance

Every detox plan is written by the hospital psychiatrist on admission, informed by the substance history, physical examination, and Day 2 hospital workup. The pathways below are the standard clinical templates. Individual plans are adjusted for polysubstance use, co-occurring medical conditions, and psychiatric risk factors. Detox never runs in isolation at Jintara: therapy begins on Day 1 and the medical detox program is integrated with psychological treatment throughout.

  • Alcohol: Benzodiazepine taper under CIWA-Ar monitoring, Day 2 hospital workup at Bangkok Hospital Chiang Mai, and nursing cadence driven by score thresholds. Full protocol detailed on the alcohol medical detox page. Clinical framework follows SAMHSA TIP 45.
  • Opioid: Psychiatrist-determined taper, typically methadone or buprenorphine where available, with COWS scoring every four to six hours during the acute window. Monitoring follows NIDA guidance on medically supervised opioid withdrawal.
  • Benzodiazepine: Slow taper over two to three months, with seizure-risk management and careful cross-tapering when long-acting benzodiazepines are substituted. Psychiatrist review weekly through the taper.
  • Polysubstance: Individualised assessment on arrival, sequence-of-detox decisions made by the psychiatrist based on withdrawal risk hierarchy (alcohol and benzodiazepines before opioids before stimulants where possible), and daily review until stabilised.

5. Emergency Escalation Protocol

Jintara holds formal medical care agreements with two partner hospitals in Chiang Mai. The agreement with Bangkok Hospital Chiang Mai, signed February 2026, covers credit-backed referral for urgent medical care. The agreement with Chiangmai Ram Hospital, signed May 2025 with a two-year term, covers outpatient, inpatient, and annual health-check services. Both agreements follow Thai Personal Data Protection Act (PDPA 2562/2019) standards.

When a client's clinical symptoms exceed what can be safely managed on site, the on-duty nursing team escalates to the appropriate partner hospital without delay. Escalation triggers include symptom severity crossing pre-agreed thresholds, vital-sign changes outside safe ranges, cardiac or neurological warning signs, and any patient-reported pain or distress that clinical judgement flags as worth hospital eyes. Transfer decisions are authorised by the psychiatrist on duty.

Darren Lockie, Jintara's founder, has described the approach in plain terms: “We have a no compromise strategy. If a client complains of headaches or pain, we go immediately to the hospital.”

6. Staff Credentials and Ratios

Jintara operates at approximately 3.2 staff to every client, with 32 staff supporting a maximum of 10 clients at any time. Awake nursing cover runs 24 hours a day, with vital-sign checks every four to six hours during active detox and every one to two hours when CIWA-Ar or COWS scores are elevated. Named clinical leads carry the credentials below.

  • Darren Lockie: Founder and CEO. Managing Director of Lanna Health Care Company Limited. Over 15 years leading Thai addiction treatment operations, previously at DARA Rehab.
  • Denise O'Leary: Clinical Director and EMDR Therapist. MA Counselling Psychology, EMDRIA-certified, Beck Institute CBT trained. The only EMDRIA-certified clinician practising in Thailand.
  • Khun Khwan: Head Nurse and Operations Manager. BSc Nursing, Registered Nurse. More than 10 years of detox care across three Thai facilities. Co-signatory on hospital referral agreements.
  • Tong: Fitness and Recovery Coach. BSc Sports Science, pursuing a Master's in Counselling. Over 8 years in fitness coaching and recovery support.

Board-certified addiction psychiatrists are supplied through the partner-hospital relationships and are not listed as in-house staff, which keeps psychiatric oversight independent of any single Jintara employee.

The clinical and operational team at Jintara Rehab Chiang Mai

7. Ethics and Consent

Informed consent is obtained on admission, covering the program structure, medication plan, data handling under Thai PDPA, confidentiality boundaries, and the client's right to leave except where clinically contraindicated under Thai law. Consent is revisited whenever the treatment plan materially changes, and any use of client stories or quotes in Jintara's content is gated on separate written consent.

Confidentiality is governed by the Thai Personal Data Protection Act 2562 (2019). Family contact during treatment is permitted only with the client's written consent, and third-party disclosures (employers, referrers, legal counsel) are routed through the Clinical Director. Co-occurring medical and psychiatric conditions are documented at admission and managed jointly with the partner-hospital teams. Where a condition falls outside Jintara's operational scope, referral out is preferred to accepting a poor clinical fit.

8. Limits of Practice

Transparency about scope is a core part of Jintara's governance posture. The facility operates within a defined clinical envelope, and admissions will refer out when a prospective client's needs fall outside it. The lists below cover the client types and clinical presentations that Jintara does not accept, together with the most common referral routes.

  • Clients under 18: Jintara is adult-only, ages 18 to 65. Younger clients are directed to appropriate adolescent services.
  • Severe acute psychiatric emergencies: Active psychosis or severe suicidality requiring psychiatric inpatient care is outside scope. Clients are directed to hospital psychiatric services.
  • Acute medical conditions requiring hospital-first care: Where a prospective client needs stabilisation in a hospital before any residential program is safe, the admissions team coordinates directly with the partner hospitals.
  • Court-mandated supervision: Programs requiring continuous legal supervision or custody conditions are outside operational scope, though case-by-case review is possible for non-custodial referrals.
  • Eating disorders as primary diagnosis: Eating disorders are addressed when co-occurring with addiction but not accepted as a standalone primary diagnosis. Clients are referred to specialist services.
  • Ibogaine-based treatment: Not offered. Jintara has published clinical reasoning on the cardiac and neurological risks and is not a suitable referral for clients seeking this modality.
  • Standalone outpatient detox: Detox at Jintara is residential only, integrated with the therapy program. Clients seeking outpatient-only detox are referred to hospital services.

Darren Lockie has framed this publicly: “We tell people what we specialise in, we tell them what we don't do, and we refer them to rehabs that might be a better fit.”

9. Regulatory and Clinical References

The references below support the clinical claims made throughout this page. Where a source applies to a specific section, the inline citation points to the same URL. This list is maintained as an inline reference block rather than a separate bibliography so that the page can be read as a single authoritative document. Return to the Jintara homepage for the full site navigation.

This page describes the clinical governance framework at Jintara Rehab and is for informational purposes. It is not medical advice. Licensed medical professionals make all clinical decisions on a per-patient basis.

Garden courtyard at Jintara Rehab in Chiang Mai

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Written by Darren LockieMedically reviewed by Denise O'Leary (MA Counselling Psychology, EMDRIA Certified, Clinical Director)Published: April 17, 2026Updated: April 17, 2026