Division of Substance Abuse and Addiction Medicine

Division Director: Stephen Dominy, MD

Division Administrator: Lois Edblad, MPA

The Division of Substance Abuse and Addiction Medicine consists of a number of programs located at SFGH and within the community:

  • Opiate Treatment Outpatient Program (OTOP)
  • Methadone Van
  • Office Based Opiate Treatment Program (OBOT)
  • Stimulant Treatment Outpatient Services (STOP)

Opiate Treatment Outpatient Program (OTOP)

The program provides methadone detoxification and maintenance to heroin dependent clients in conjunction with medical and psychiatric services. Since the onset of the AIDS epidemic, OTOP has been involved in combating HIV disease among injection drug users through research, prevention, and medical care. Clients receive as needed HIV testing, HIV risk reduction counseling (reducing transmission or progression of HIV), and HIV medication adherence coaching. 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 the combined maintenance and detoxification services.

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, the NIA/ICHO site in Bayview Hunters Point, and in Sunnydale. The van provides services at these sites Mondays through Fridays.

Office Based Opiate Treatment Program (OBOT)

Patients receive opiate maintenance through OBOT at their primary care or psychiatric or methadone clinic. 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.

Stimulant Treatment Outpatient Program (STOP)

STOP provides outpatient treatment for methamphetamine or cocaine abuse or dependence and any co-occurring substance use or psychiatric disorders. STOP provides these services within other primary care or psychiatric programs, including the SFGH Positive Health Program, and the Division of Community Services (Citywide-Community Focus). 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 individual counseling
  • Assessment and development of individualized treatment plan
  • Individual counseling once a week, including couples and family sessions as needed
  • Group counseling
  • Random urine testing as needed
  • HIV/STD risk reduction and medication adherence support
  • Psychiatric medication management
  • Referrals and service coordination


Positive Health Program

Citywide-Community Focus


Leadership in research, education, psychiatric care and public service