Division of Substance Abuse and Addiction Medicine
Division Director: Stephen Dominy, MD
Division Administrator: Lorel Hiramoto
The Division of Substance Abuse and Addiction Medicine consists of a number of programs located at SFGH and within the community:
- HIV Prevention and Intervention Program
- Methadone Van
- Office Based Opiate Treatment Program (OBOT)
- Opiate Treatment Outpatient Program (OTOP)
- Stimulant Treatment Outpatient Services (STOP)
- Stonewall Project
HIV Prevention and Intervention Program
Clients in OTOP methadone detox, OTOP methadone maintenance, OTOP van, or Stonewall receive, as needed, HIV testing, HIV risk reduction counseling (reducing transmission or progression of HIV), and HIV medication adherence coaching. Services are provided at SFGH Ward 93, the OTOP van sites, and Stonewall, 1380 18th St. Suite 202.
Methadone Van
The Methadone Van provides methadone dosing and counseling services available at Ward 93 at San Francisco General Hospital (OTOP), at the Walden House site in the Mission and NIA/ICHO site in Bayview Hunters Point. The van provides services at these sites Mondays through Fridays.
Office Based Opiate Treatment Program (OBOT)
Office Based Opiate Treatment Program (OBOT) Patients receive opiate maintenance through OBOT at their primary care or psychiatric or methadone clinic. DSAAM counselors provide the counseling at the CHN sites, currently Tom Waddell Health Center and Potrero Hill Health Center. DSAAM provides clinical coordination and quality monitoring at all sites, currently the 2 CHN health centers as well as the Bay Area Addiction Research and Treatment (BAART, 10 methadone slots) and the Harm Reduction Center (HR, 5 methadone slots). Roughly half of the patients receive methadone and half receive buprenorphine.
Opiate Treatment Outpatient Program (OTOP)
Opiate Treatment Outpatient Program (OTOP) Ward 93 at San Francisco General Hospital provides methadone maintenance dosing and counseling to heroin dependent clients in conjunction with medical and psychiatric services. Since the onset of the AIDS epidemic, the Division of Substance Abuse and Addiction Medicine (DSAAM) has been involved in combating HIV disease among injection drug users through research, prevention, treatment and medical care. We have been designated as the County methadone treatment provider for the most medically and psychiatrically compromised opiate addicts. OTOP is licensed to provide methadone to 750 clients daily in their combined maintenance and detoxification services.
The Stimulant Treatment Outpatient Program (STOP) (415 502-5777) provides outpatient treatment for methamphetamine or cocaine abuse or dependence and any co-occurring substance use or psychiatric disorders. STOP staff helps participants clarify their needs and goals using motivational interventions, and guides them in behavior change, i.e. harm reduction, cessation of use, or relapse prevention. Participants receive one or more of the following array of services:
- Drop-in group and individual counseling
- Assessment using the Addiction Severity Index (ASI) and development of individualized treatment plan
- Individual counseling once a week, including couples and family sessions as needed
- Group counseling 1-5 days a week
- Random urine testing as needed
- HIV/STD risk reduction and medication adherence support
- Psychiatric medication management
- Referrals and service coordination
Visit STOP website.