Emergency department (ED) overcrowding can contribute to long wait times and delays in care. It can also affect paramedic services when teams have to wait longer at hospitals to transfer patients, limiting their ability to respond to other emergencies. New research from The Institute for Education Research (TIER) at UHN suggests that community-based programs could help alleviate pressures on emergency services by providing an alternative care setting for people experiencing alcohol or opioid intoxication.  

People experiencing substance use problems frequently access EDs, but some cases of intoxication can be safely managed outside of a hospital setting. Diversion programs like sobering centres provide short-term care for individuals recovering from intoxication, offering an alternative for those who do not require emergency medical treatment. Despite their potential to reduce pressures on EDs, little is known about the impact of these programs in Canada.  

To address this gap, TIER researchers evaluated service use and impact of the Stabilization and Connection Centre (SCC) in Toronto—a 10-bed ED diversion program that provides short-term stabilization, monitoring, and connections to community supports for people experiencing alcohol or opioid intoxication.  The research team analyzed administrative data from the SCC’s first two years of operation, comparing lengths of stay and paramedic transfer-of-care times at the SCC with similar visits at two nearby EDs.  

Analyzing 4,574 visits between January 2023 and December 2024, the researchers found that average length of stay at the SCC was over two times longer in comparison to the ED. Paramedics also transferred care significantly faster at the SCC. Longer stays at the SCC may provide more time for support and care outside a busy ED, while shorter transfer times could allow paramedics to return to service sooner and respond to other emergency calls.  The SCC also saw more visits on days when the EDs were busier, supporting its potential role as an alternative care destination during periods of higher demand.  

Together, the findings highlight how diversion programs may help reduce pressures on EDs and paramedic services while providing an alternative setting for care. Further research is needed to examine patients’ experiences and the program’s effects on long-term outcomes.  

Dr. Nick Kerman, first author of the study, is a Research Associate in the lab of Dr. Andrew Boozary. 

Dr. Andrew Boozary, senior author of the study, is a Clinician Investigator at The Institute for Education Research at UHN. Dr. Boozary is also the founding Executive Director of UHN’s Gattuso Centre for Social Medicine and an Assistant Professor at the Institute of Health Policy, Management and Evaluation at the University of Toronto. 

This work was supported by the Gattuso Centre for Social Medicine at UHN and UHN Foundation. 

Kerman N, Hayman K, Vitkin N, Strum RP, Leston F, Luchsinger D, Steer L, Coyle S, O'Connor E, Anderson M, Boozary A. Service use and program-level impacts of a collaborative hospital-community emergency department diversion program for people experiencing alcohol and opioid intoxication. Can J Public Health. 2026 Sep 14. doi: 10.17269/s41997-026-01255-1.