Diverting Intoxicated Patients From the ER Frees Six Beds a Day

If you have ever sat in a packed emergency room at one in the morning, you have seen it. A paramedic crew brings somebody in who has been drinking but is not injured, and that person waits on a stretcher alongside everyone else. A Toronto program built a different door for exactly that situation, and researchers have now checked whether it works. Diverting intoxicated patients from the ER appears to do what it set out to do, and its clearest result is one most people would never think to measure.

What is the centre, and who runs it?

What is the centre is worth answering first, because it is not a hospital ward. The study appeared this week in the Canadian Journal of Public Health. It evaluated the first two years of the Stabilization and Connection Centre in Toronto, a non-medical facility the University Health Network opened in 2022. It redirects people intoxicated by alcohol or opioids who do not need medical attention away from the emergency department and into a 10-bed space staffed by support workers. The program is run in partnership with The Neighbourhood Group Community Services and Parkdale Queen West Community Health Centre, and their staff work the site.

Why is the ambulance number the one that matters?

Because it is the clearest result in the study and it affects people who have never heard of the centre. The ambulance number is this: paramedics dropping someone at the stabilization centre were on site for a mean of about seven minutes, against more than 34 minutes at two nearby emergency departments. Dr. Andrew Boozary, one of the centre's founders, said that means paramedics were back on the streets much faster.

When paramedics bring a patient to a crowded emergency department they often wait with that patient until the hospital can take over, which keeps the ambulance out of service. Every stretcher occupied by someone who does not need medical care is a stretcher unavailable to someone who does, in departments already under the strain that emergency physicians leaving the profession describes.

How do we know whether it is safe?

The question of whether it is safe mattered as much as the speed. Fewer than seven per cent of the centre's patients ended up transferred to hospital, which Boozary said shows the approach is catching the people who genuinely need hospital care. In his words, the status quo was not working for the way the system was responding to alcohol intoxication and opioid overdoses, especially for people experiencing homelessness.

More than half of the centre's 4,500 visits involved people who were homeless, and staff connected many of them to homeless services and substance use care. That connection piece is what an emergency department is rarely set up to do, and it is the half of diverting intoxicated patients from the ER that does not show up in a stopwatch. An emergency room can stabilize someone medically, and it is not designed to link a person to housing supports or addiction treatment at three in the morning. The same gap shows up further along the pathway, which is why psychiatric bed waits run so much longer than people expect.

So what does it mean for your wait?

Indirect but real. What it means for your wait was put plainly by Dr. Kate Hayman, medical director of the emergency department at Toronto General Hospital, who described the impact of diverting medically stable patients as transformative. Every person admitted to the centre would otherwise have been a patient in her department. That works out to roughly six fewer people a day, each of whom would have spent four or five hours there. That frees her department to focus on severe overdoses, strokes and heart attacks.

Provinces are hunting for ways to relieve emergency departments, from urgent care centres to pharmacist prescribing. Staffing recovers slowly, and American nurses moving to Canada cannot fix the wait this year. This study adds Canadian evidence that for one specific group of patients, a bed, a support worker and a warm handoff to community services does the job better than a hospital hallway. Diverting intoxicated patients from the ER is not a solution to emergency crowding on its own. It is one door, working.

What else are readers asking?

What is a stabilization and connection centre?

A non-medical, 10-bed space staffed by support workers rather than clinicians. People intoxicated by alcohol or opioids who do not need medical care recover there, and staff connect them to housing and substance use services. The Toronto site opened in 2022 through the University Health Network with two community organizations staffing it.

Does diverting patients from the ER actually work?

On the measures in this study, yes. Paramedic drop-off time fell from more than 34 minutes to about seven. Fewer than seven per cent of patients needed transfer to hospital. The nearby emergency department counted roughly six fewer patients a day. This is a two-year evaluation of one site, so treat it as evidence rather than proof.

How long do paramedics normally wait at a hospital?

In this study, more than 34 minutes on average at two Toronto emergency departments, against about seven at the stabilization centre. That waiting time keeps an ambulance and its crew out of service, which is why offload delay is tracked as a system measure rather than a hospital one.

Where should I go instead of the emergency room?

For anything severe or sudden, the emergency department remains the right choice. For everything else, a walk-in clinic, urgent care, a pharmacist for minor ailments, or your provincial health line at 8-1-1 will usually be faster. Knowing the difference between urgent care and the emergency department saves hours.

If you do not have a family doctor, every route that is still open to you is worth knowing, starting with what a walk-in clinic can actually treat.

This article is general information and not medical advice. If you are having a medical emergency, call 911. For anything non-urgent, speak with a doctor or another qualified health professional about your own situation.

If your concern is not an emergency, you do not have to default to the emergency room. You can compare walk-in clinics near you and see current wait times on Medimap, or browse the Medimap Health Hub for more on choosing the right door.