Service use and program-level impacts of a collaborative hospital-community emergency department diversion program for people experiencing alcohol and opioid intoxication.
Canadian journal of public health = Revue canadienne de sante publique · 2026-09-14 · Observational study
Abstract
OBJECTIVES: People experiencing substance use problems frequently use emergency departments (EDs). Some ED visits may be safely divertible to non-medical settings. This study evaluated the service use and program-level impacts of the Stabilization and Connection Centre (SCC), an ED diversion program for people experiencing alcohol and/or opioid intoxication in Toronto. METHODS: This retrospective cross-sectional study used administrative data from 1/1/2023 to 12/31/2024 to describe SCC visitor volumes and characteristics. Poisson and linear regression models were fitted to examine the temporal and environmental correlates of SCC visit counts, and differences in lengths of stay and paramedic transition times at the SCC compared to patients presenting to two nearby EDs for substance intoxication. RESULTS: There were 4574 SCC visits during its first two operational years, with most visitors being male, 24-54 years of age, and homeless. Lengths of stay at the SCC (M = 10.11 h, SD = 8.38) were significantly longer than in the comparison group visiting the ED (M = 4.61 h, SD = 4.22). Paramedic transfer of care times were also significantly shorter at the SCC (M = 7.20 min, SD = 3.62) than the ED (M = 34.10 min, SD = 45.22). SCC visits were significantly lower during the winter and weekdays, but higher on days when nearby EDs were busier and during the week when monthly income support payments are issued. CONCLUSION: The SCC was associated with some intended program-level outcomes in the forms of safe ED diversions of patients experiencing intoxication and reduced paramedic transfer of care times.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Alcohol · People experiencing homelessness · Implementation · Offload delay & turnaround · Poisoning & substance use
Related articles
- Can Emergency Medical Services Utilization Rates Be Used to Measure the Success of An Alcohol Amnesty Policy? (Prehosp Emerg Care, 2021)
- Validation of triage criteria for deciding which apparently inebriated persons require emergency department care. (Emerg Med J, 2011)
- Unnecessary emergency medical services transport associated with alcohol intoxication. (J Int Med Res, 2018)
- Implementation of an Alcohol Medical Amnesty Policy at an Urban University With a Collegiate-Based Emergency Medical Services Agency. (J Adolesc Health, 2019)
- Examining a Stabilization Center for Patients with Alcohol or Opioid Intoxication Transported by Paramedics: A Cohort Study of an Emergency Department Diversion Model. (Prehosp Emerg Care, 2025)
- Sobering centers, emergency medical services, and emergency departments: A review of the literature. (Am J Emerg Med, 2021)