Every client gets a full hospital workup on day two of detox.

The day two medical workup is a hospital assessment covering liver, kidney, cardiac, blood, and chest health, run at Jintara's expense on day two of detox.

Most people entering detox have not seen a hospital in years. Years of heavy alcohol or substance use affect the liver, kidneys, heart, and blood in ways that can be invisible from the outside but clinically significant during withdrawal, as the NIAAA overview of how alcohol affects the body describes. At Jintara, the view is simple: you cannot build a safe treatment plan without knowing the client's full medical picture. The workup gives the clinical team that picture on day two, while the protocol can still be adjusted to account for what is found.

Other facilities schedule hospital visits based on group transport convenience, which can push testing to day five or six. By then, the most acute withdrawal phase may already be over, and any findings that should have changed the medication plan were not available when the decisions were made.

The five components of the day two workup are: a full blood panel covering haemoglobin, haematocrit, and white and red blood cell counts; liver function tests measuring AST, ALT, GGT, and bilirubin; kidney function tests measuring creatinine and blood urea nitrogen; an EKG to screen cardiac rhythm and baseline electrical function; and a chest X-ray to assess lung health and check for cardiac enlargement or pulmonary complications.

Each test serves a purpose. Liver function results determine how medications are metabolised, because a compromised liver processes benzodiazepines and other withdrawal-support medications more slowly than a healthy one. Kidney results affect medication safety thresholds. Cardiac results flag contraindications. Blood panel results reveal nutritional deficiencies that commonly accompany heavy substance use and that, left unaddressed, can complicate the physical recovery process. The chest X-ray catches issues that have no obvious external signs, particularly in clients who smoke or use cannabis regularly.

Darren Lockie, who founded Jintara after 15 years building addiction treatment centres in Thailand, describes the workup philosophy as ensuring the client is safe to be in the program, not just safe to have arrived.

The day two hospital workup is covered by Jintara, not charged separately to the client.

At many facilities, diagnostic testing, psychiatric assessments, and specialist consultations are billed on top of the quoted program fee. Some competitors charge separately for the psychiatric assessment alone. At Jintara, the workup and the initial psychiatric assessment are both included. The only additional cost a client may encounter is the cost of prescription medication if the treating psychiatrist determines that medication is needed as part of the detox protocol, which is a cost determined by the treating psychiatrist rather than the facility's pricing.

This matters for two reasons. The first is financial clarity: families and clients making a decision about where to go for treatment should be able to compare costs without hidden variables. The second is clinical: when specialist referrals are an extra charge, some clients decline them. Jintara removes that barrier.

Alcohol and benzodiazepine use affect liver function in the majority of people who arrive at Jintara for detox. Raised AST, ALT, GGT, and bilirubin levels indicate how well the liver is processing substances, as the NIH MedlinePlus guide to liver function tests describes. When liver function is significantly compromised, the metabolism of benzodiazepines used in withdrawal management slows, which means standard dosing carries a higher risk of accumulation and over-sedation. According to NIAAA's review of alcohol-related medical complications, liver disease is among the most common consequences of alcohol use disorder, with direct implications for medication safety. The clinical team adjusts dosing accordingly, which requires knowing the liver function baseline.

Kidney function results affect a different but equally important set of decisions. Creatinine and blood urea nitrogen levels reflect how effectively the kidneys are clearing metabolic waste. Impaired kidney function changes safety thresholds for a range of medications and may indicate the need for hydration support or specialist involvement during detox.

Both findings are common. Many clients have been told their liver or kidneys are under stress before admission. The workup establishes exactly where that stress sits, so the treatment plan is built around the actual biology, not an assumption of average organ function.

Withdrawal from alcohol, benzodiazepines, and stimulants places physiological stress on the heart. As the NIH MedlinePlus guide to electrocardiograms describes, an EKG records the electrical activity of the heart and can identify arrhythmias, evidence of prior cardiac damage, and electrolyte abnormalities that affect heart rhythm. The EKG performed on day two establishes this cardiac baseline before any withdrawal-phase medications are introduced.

Jintara has identified cardiac findings through the day two workup that required follow-up with a cardiologist. These include arrhythmias that would have become more pronounced under the stress of active withdrawal, and baseline abnormalities that changed which medications could be used safely. Without the EKG, these conditions would have remained undetected until symptoms appeared, at which point the clinical response becomes reactive rather than planned.

Some medications used in withdrawal management carry their own cardiac considerations. Knowing the client's baseline rhythm before those medications are used is the difference between a protocol that is calibrated for the individual and one that is calibrated for an assumed average. Jintara's position, in Darren's words, is "no risk, no compromise." The EKG is one of the tools that makes that position operationally real.

The complete blood count measures haemoglobin, haematocrit, and white and red blood cell counts. Anaemia is common in people with long-term alcohol dependence, both because alcohol interferes with red blood cell production and because nutritional intake during active addiction is often significantly below clinical norms. A StatPearls review of alcoholic liver disease and blood markers confirms that haematological complications including anaemia are frequent in alcohol-dependent individuals. Anaemia affects detox symptoms by intensifying fatigue, dizziness, and breathlessness, which can make early withdrawal feel more severe and slow the physical recovery timeline.

Abnormal white blood cell counts can indicate infection or inflammatory conditions that need attention alongside the withdrawal protocol. Blood markers also provide a baseline for tracking nutritional recovery during the treatment program.

For alcohol-dependent clients, the blood panel informs whether nutritional supplementation is appropriate during the detox phase. This includes considerations for B-vitamin status and other markers that affect neurological stability during withdrawal. Any supplementation is determined by the treating psychiatrist based on the actual test results, not a standard protocol applied to everyone.

A chest X-ray identifies pulmonary complications, including lung changes from long-term cannabis or tobacco use, and can reveal cardiac enlargement that is not apparent from an EKG alone. It also screens for aspiration-related damage, which occurs in clients whose level of intoxication or loss of consciousness has led to inhalation of substances.

Many clients who arrive at Jintara for detox have been managing respiratory or cardiac symptoms for some time without seeking medical assessment. When someone has been drinking heavily or using cannabis daily for years, routine health check-ups tend not to happen. The chest X-ray is, in Darren's words, "sometimes the first time serious issues are seen and addressed."

This is not presented to the client as alarming. The clinical team explains that the hospital visit is a baseline check, that the results will be reviewed the same day, and that if anything requires follow-up, the plan will include that referral. The goal is clarity, not anxiety.