Ron Krzmarzick has celebrated 21st birthdays with more young adults than he cares to remember.

Here’s how the party often starts:

The people celebrating arrive at the Brown County Evaluation Center (or detox) in the back of a police squad car. A gate shuts and locks behind the car before they are taken out and escorted into the building and told to stand still, if they’re able. They’re “pat-searched” and anything that can be of harm to themselves or others is removed from their pockets and put away.

When that’s done, they’re brought through another door that locks behind them before entering an office with concrete block walls. That’s where the paperwork begins. It’s a process that can take 20 to 30 minutes, and “is sometimes a challenge,” depending on how drunk the person has become.

They’re asked who they are, how much they’ve had to drink and if their family has a history of alcoholism, among other things. A breath test will establish their blood-alcohol concentration before they’re led to a bunk in a room, where their blood pressure and other “vitals” are taken by a staff member. After that, if they fall asleep, someone wakes them up every two hours to take their vitals again.

“What we’re afraid of is they’re going to go into withdrawals, or fall asleep and not wake up,” said Krzmarzick, the facility’s supervisor.

Of course, it’s not always someone celebrating a birthday who gets all this attention. It can be anyone who has had too much to drink before getting in trouble with police or being brought to the hospital by a concerned friend or family member.

Coming down

Everyone brought to New Ulm’s detox, which serves an 11-county area at a cost of $225 per person per day, meets with a licensed counselor sometime after the first 24 hours. They are offered education about the dangers of high-risk drinking, a little advice and, if necessary, leads on where to get further help with alcohol or mental health problems, if they want it. Their vitals are still being taken, just not as often.

Sometimes, for experienced drinkers, it takes a day or two for that withdrawal process to start, though. If it does, they’re given medication to keep their blood pressure down while they shake and sweat. They usually don’t want to get out of bed because they’re sick, Krzmarzick said. It’s a dangerous time when seizures and strokes are a deadly possibility.

“Alcohol withdrawal is a very dangerous thing, probably more dangerous than any other drug,” said Sharon Rhoades, director of the Evaluation Center, which also includes a juvenile detention center.

She’s been working at the facility for 18 years. When she started, it was rare to see college-age drinkers brought to detox. It was usually regular customers with chronic drinking problems who came through the facility’s series of locking doors. Although the facility doesn’t keep statistics on age, she said young people are now brought in regularly, especially on weekends. And their blood-alcohol concentration levels are reaching highs that were rare for anyone a decade ago, she said.

“We used to be amazed at a .3, now we’re seeing levels as high as .5,” Rhoades said. “Those aren’t usually college kids, but the .20s and .30s are very common for them. Many of them can’t believe they’re in a place like this and they don’t ever want to come back. But, for some people, it’s just a story to tell their friends when they get home.”

Long path

The path to dangerous drinking for some starts earlier than many people realize, said Michael McGinnis of Addiction Recovery Technologies in Mankato. Part of the reason for that is young people aren’t getting the message about high-risk drinking, or straight facts about alcohol in general, when they need it most, he said.