Objective: This study examines models of sobering centers throughout the United States and identifies best practices and barriers to providing care to acutely intoxicated adults.
Method: 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.
Results: The author screened 53 programs: 37 met inclusion criteria and 26 (70%) responded. The majority of centers operated 24 hours a day, 7 days a week, averaging 5,560 visits annually (Mdn = 4,680, range: 300-22,000). Most of the staff comprised medical personnel (80%) and substance use specialists (70%). The budgets ranged from $202,000 to $4.8 million annually (Mdn = $1,165,500) and were funded by city, county, state, law enforcement, hospital systems, and grants. In addition to alcohol, common intoxicants included opioids, marijuana, and stimulants. With 4.3% of clients requiring transfer to the emergency department and 4.3% to the police or psychiatric facility, the model appears appropriate for the populations served. Best practices included offering a compassionate environment with dedicated staff, providing outreach to community members, establishing inter-organizational communication, and establishing a continuum of care for clients. Primary barriers included dependency on grant and/or static funding, a lack of community resources available to clients, and an increase in the severity of comorbid mental illness.
Conclusions: These findings suggest that sobering centers play a principal role in stabilizing adults who are acutely intoxicated. Sobering center models vary, yet share a focus on harm reduction, community collaboration, and low-barrier access to care and coordination.