The San Francisco Sobering Center offers a refuge from the streets and a safe place for chronic public alcoholics to sober. The focus of the Sobering Center is the homeless, alcohol-dependent individual; however, anyone found intoxicated in public can use its services.

Since July 2003, our program has provided care for 14,000 individuals for a total of 48,000 encounters. Although nearly two-thirds of individuals visit the center only once, a small number of individuals are seen more frequently. A majority of our clients have a history of homelessness, and our initial work found that over 90% of clients were homeless at the time of service. Today, up to 25% of annual unduplicated clients are permanently housed.

Our impact has been substantial. Nearly 40% of our clients arrive via ambulance with another 10% from emergency department referrals. Those arriving by ambulance – over 14,000 encounters by end of year 2015 – are direct diversions from emergency departments, providing relief to overcrowding and unnecessary admissions. Of note, the percentage of clients requiring a higher level of care – with referrals to medical or psychiatric emergency departments – remains at less than 4 percent overall.

Through our targeted focus, the Sobering Center has been able to form ongoing relationships with frequent users and provide the support necessary when they are ready for positive change. The need is still great, however, and until there is a substantial solution to long-term chronic intoxication, the Sobering Center will continue to provide an alternative to jail services and emergency care.