© All Rights Reserved. National Sobering Collaborative
Powered by QuestionPro Survey Software
To request additional research papers added to this page, please email admin@nationalsobering.org.
Ryan Strum, John McPhee, Jamie Burnett, Russell MacDonald. Prehospital Emergency Care. October 9, 2025
Description: This study evaluated a non-medical stabilization center in Toronto as an alternative to emergency departments for patients with acute alcohol or opioid intoxication. Findings show that most patients were safely managed without medical intervention, suggesting that paramedic diversion to stabilization centers can effectively reduce strain on emergency departments.
Matt Ferner, Safer Cities. June 21, 2025
Description: To gauge public support for Sobering Centers as part of a city’s public safety infrastructure, Safer Cities conducted a national survey of 2,503 registered voters, which demonstrated the most convincing reasons for implementing sobering centers as a public safety policy.
Rebecca Brandes, Lauran Hardin, Christine Pickering, and Jerilene Tibayan. March, 2025.
Description: This case study highlights the Butte County Sobering Center, opened in Chico, California, in August 2024. The Center provides a safe environment for individuals publicly intoxicated by alcohol or drugs to recover, diverting them from emergency departments and jails.
Matt Ferner, Safer Cities. December, 2024
Description: To gauge public support for Sobering Centers as a public safety strategy, Safer Cities recently conducted a national survey of 2,414 registered voters that demonstrates the public support for sobering centers.
International Association of Chiefs of Police. 2023
Description: This document offers information to guide police leaders in the development of collaborative partnerships with sobering centers as an alternative to arrest for charges of intoxication.
Robin S. Engel, Gabrielle T. Isaza, Jennifer Calnon Cherkauskas, Nicholas Corsaro, and Ryan Motz, National Policing Institute. April, 2023.
Description: Results from this study lend credible support to the efficacy of sobering centers in reducing police use of arrest, thereby saving valuable time and resources for police and reducing collateral consequences for those arrested solely for public intoxication. This project summary aims to tie together findings across the various phases of this research, highlighting the major findings, gaps in knowledge, directions for future research, and considerations for police and sobering center officials.
Robin S. Engel, Gabrielle T. Isaza, Jennifer Calnon Cherkauskas, Nicholas Corsaro, and Ryan Motz. National Policing Institute. April, 2023.
Description: This report documents the findings from the second and third phases of a broader research study designed to examine the utility of sobering centers as an alternative to arrest. Findings support the benefits of sobering centers as an alternative to arrest, particularly as a tool for diverting unhoused members of the public away from the criminal justice system for minor offenses.
Gabrielle Isaza, Robin S. Engel, and Jennifer Calnon Cherkauskas. National Policing Institute. December, 2022.
Description: The report details the patterns of policies and practices for police use of sobering centers as an alternative to arrest. How do police balance and overcome policy and legal inconsistencies guiding the transport to and use of sobering centers. As well as what the situational factors are that police use in practice to determine whether or not to use sobering centers as an alternative to arrest.
Bonar Menninger. California Health Care Foundation. September 20, 2021.
Description: A conversation with Shannon Smith-Bernardin about the impact and importance of sobering centers, as well as her experience with the San Francisco Sobering Center.
Shannon Smith-Bernardin, Ph.D, R.N., C.N.L. September 19, 2021.
Description: A survey was developed and distributed from June to October 2019 to leadership of sobering centers in the United States that provided short-term (<24 hour) care to adults admitted for being intoxicated in public. The findings suggest that sobering centers play a principal role in stabilizing adults who are acutely intoxicated.
Shannon Smith-Bernardin, PhD, RN. California Health Care Foundation. September, 2021.
Description: This report describes the range of sobering center models in California and documents commonalities, differences, collective challenges, and best practices. The report is intended to provide background for health care leaders and policymakers in California when planning for, developing, and enhancing the use of sobering centers for acute intoxication.
California Health Care Foundation. July, 2021.
Description: Sobering centers present an intriguing, cost-effective alternative for providing care to persons with acute intoxication whose public alcohol or drug use puts themselves or others at risk. The paper includes insights gleaned from a field report on California sobering programs.
Brandon Marshall, Erin McGlynn, and Andrew King. The American Journal of Emergency Medicine. February, 2021.
Description: Literature around sobering centers reveals that sobering centers are a cost-effective alternative to emergency department visits for acute alcohol intoxication and further research is required to identify safe, effective protocols for EMS to triage patients to appropriate treatment destinations.
Marlee Fischer, Michele Plorde, Hendrika Meischke, and Sofia Husain. Journal of Substance Abuse. September 10, 2019.
Description: King County Emergency Medical Services (EMS) collected client utilization data, performed interviews, and conducted interviews to find areas for improvement and identify possible barriers. Results showed a need for culture change among the community and further integration of harm reduction services.
Claudia Scheuter, Danielle H. Rochlin, Chuan-Mei Lee, Arnold Milstein, and Robert M. Kaplan. Translational Behavioral Medicine. May 22, 2019.
Description: The report estimated the impact on US health care spending if individuals with uncomplicated, acute alcohol intoxication were treated in sobering centers instead of the emergency department. It was found that implementing sobering centers as a treatment alternative for individuals with uncomplicated acute alcohol intoxication could yield substantial savings for the US healthcare system.
Suzanne V. Jarvis, Leonard Kincaid, Arlo F. Weltge, Mike Lee, and Scott F. Basinger. American Public Health Association. April, 2019.
Description: To address jail overcrowding, Houston created a jail diversion policy that allowed law enforcement to admit publicly intoxicated individuals into a new sobering center. By 2017, public intoxication jail admissions had decreased by 95%, freeing valuable resources. A promising public health intervention, sobering centers offer an alternative to incarceration and relieve overuse of emergency services while assisting individuals with substance use issues.
Shannon Smith-Bernadin, Megan Kennel, and Clement Yeh. Annals of Emergency Medicine. March 27, 2019.
Description: Evaluation of sobering centers as an alternate destination for acute intoxication. A case review was performed on all visitors during 3 years who were secondarily transferred from the sobering center. Results show that the San Francisco Sobering Center is a safe EMS destination.
Otis Warren, Rhode Island Medical Journal. October, 2018.
Description: Despite safely serving approximately 1,200 visits over 18 months with no adverse medical outcomes, the RNP struggled with inconsistent EMS utilization, barriers to detox placement, and unsustainable Medicaid funding—particularly due to a high proportion of uninsured and undocumented clients—and ultimately closed after a shift from block funding to per-visit billing.
Shannon Smith-Bernardin, Adam Carrico, Wendy Max, Susan Chapman, Academic Emergency Medicine. May 11, 2017.
Description: This study aimed to characterize adults using a sobering center for public alcohol intoxication. The authors conducted a secondary analysis of 1,271 adults seen at a sobering center between July 2014 and June 2015. Repeat and high users were older, more likely to be homeless, had higher rates of chronic medical and psychiatric conditions, and incurred significantly greater ambulance and ED utilization and costs than single-visit users.
Stefan G. Kertesz, Travis P. Baggett, James J. O’Connell, and David S. Buck. The New England Journal of Medicine. December 1, 2016.
Description: The best way to serve homeless populations is not by focusing on costs. The popular recommendation that providing permanent supportive housing to chronically homeless people will deliver net savings by reducing the use of jails, shelters, and hospitals is not the best argument. The best thing to do is instead to consider the best way to meet the population’s needs.
Otis Warren, Shannon Smith-Bernardin, Katherine Jamieson, Nickolas Zaller, and Aisha Liferidge. Journal of Health Care for the Poor and Underserved. November, 2016.
Description: The study is a cross-sectional analysis and survey of sobering centers with a review of current practices. Twenty-seven potential sobering centers were identified, where nine centers met the definition of a sobering center. The sobering centers had a wide range of missions and medical oversight. Significant heterogeneity was found in regards to size, practice patterns, and funding mechanisms.
Otis Warren. Health Affairs Volume 35, Issue 11: Culture of Health. November, 2016.
Description: The story of a patient with alcoholism and how he cycles in and out of an emergency department. His providers grapple with an outdated system of care that, instead of helping him, hurts the patient.
James Brewster-Liddle, Wayne Parsons, and Simon Moore. Journal of Emergency Nursing. July 29, 2013.
Description: The article describes the solution that the emergency unit at University Hospital Wales, Cardiff, created when they were running out of the clinical space available for patients. The staff launched a three-month pilot project which revealed that diverting intoxicated patients with low to moderate risk improved the clinical care in the unit.
Andrew H. Swain, Amanda Weaver, Alasdair J. Gray, Mark Bailey, and Stephen G. Palmer. New Zealand Medical Journal. April 5, 2013.
Description: An analysis of the workload of prehospital triage and treatment facilities established in Wellington for the 2011 and 2023 International Rugby Sevens, and the Rugby World Cup 2011. Results show that with minimal supervision, event medics and paramedics can safely care for the majority of patients attending large rugby events in New Zealand, easing the pressure on ambulances and the ED.
Barbara M. Holzer, Christoph E. Minder, Nina Rosset, Gabriela Schaetti, and Edouard Battegay. Journal of Studies on Alcohol and Drugs. 2013.
Description: Investigation of the utilization of ambulance services that resulted from alcohol and drug intoxication over a period of 1 year in a metropolitan. Results showed that sobering centers might relieve hospital emergency departments of patients not requiring acute emergency care and, in addition, could provide intervention services to prevent relapses.
Davis W. Ross, John R. Schullek, and Mark B. Homan. Annals of Emergency Medicine. November 7, 2012.
Description: Evaluation of the effectiveness and safety of emergency medical services (EMS) provider use of a checklist to triage alcohol-inebriated patients directly to a detoxification facility, instead of an emergency department (ED). The results show that field triage criteria can be used effectively to safely divert patients to detoxification facilities. *Correction about ethanol concentration
Shannon Smith-Bernardin and Michelle Schneidermann. Journal of Health Care for the Poor and Underserved. August, 2012.
Description: The San Francisco Sobering Center cares for intoxicated clients historically treated via emergency services. At the time this was written, the Sobering Center has had 29,000 encounters and 8,100 unduplicated clients. The Sobering Center safely and efficiently provides sobering and health care services to some of the City’s most vulnerable people.
Keith Flower, Anneke Post, Jeremy Sussman, Niels Tangherlini, John Mendelson, and Mark J. Pletcher. Emergency Medicine Journal. 2011.
Description: Investigation of the sensitivity and specificity of consensus triage criteria for identifying which inebriated patients could be triaged to care in a sobering center. The results showed that most inebriated individuals in the study did not require ED care, but the prospective identification of these persons was difficult.
Alexandra H. Cornwall, Nickolas Zaller, Otis Warren, Kenneth Williams, Nina Karlsen-Ayala, and Brian Zink. The American Journal of Emergency Medicine. November 4, 2011.
Description: The pilot study examined intermediate-level emergency medical technician (EMT) ability to identify intoxicated individuals who may be eligible for diversion to an alternative sobering facility. The results showed that intermediate-level EMTs may be able to play an important role in facilitating triage of intoxicated patients to alternate sobering facilities.
Jan Greene. Annals News and Perspective. May, 2007.
Description: San Diego’s Serial Inebriate Program officials were getting frequent visits from all over the country, viewing it as a long-term solution to chronic homeless populations. Emergency Departments should be used as a last resort in order to ensure that people get the best care they can for their specific needs.
James V. Dunford, Edward M. Castillo, Theodore C. Chan, Gary M. Vilke, Peter Jenson, and Suzanne P. Lindsay. Annals of Emergency Medicine. January, 2006.
Description: The study determined the impact of the San Diego Serial Inebriate Program. The results show that the community-supported treatment strategy reduced the use of EMS, ED, and inpatient resources by individuals repeatedly intoxicated in public.
NSC provides support to 80+ sobering centers reaching an estimated 175,827 clients annually representing approximately 483,720 visits. The organization offers a forum for national dialogue and provides a platform for providers and stakeholders to engage regarding best practices, policy and programmatic issues.
© All Rights Reserved. National Sobering Collaborative
Powered by QuestionPro Survey Software