HOUDINI LINK stands for Hospital Opioid Use Disorder treatment INItiation and LINKage to care. We began as a SAMHSA funded treatment expansion project in 2018 to better serve patients with opioid use disorder who begin medication assisted treatment (MAT) while hospitalized at Zuckerberg San Francisco General Hospital. Our team is led by Alexandra Haas, LMFT and consists of physicians and patient navigators. We provide patient centered linkage and navigation services as well as contingency management for 6 months to eligible patients. In 2021, we successfully obtained funding from the San Francisco Department of Public Health to provide our comprehensive navigation services to those communities who experience high rates of overdose in San Francisco.

Our offices are located at ZSFG in Building 90 and Building 5. However, our services are mobile. We enjoy meeting patients in the hospital, in the community, and at any San Francisco based MAT provider. Intakes are offered Monday through Friday and typically occur while the patient is still hospitalized or in the ZSFG Emergency Department.

HOUDINI LINK is committed to providing high quality, compassionate and evidence-based care to patients with OUD in San Francisco. Although we don’t prescribe medications directly, we work with patients to overcome the multitude of barriers that prevent patients from continuing with MAT once they leave the hospital. We believe in the OUD Cascade of Care that advises patients to stay on medications for at least 6 months or longer to achieve recovery from OUD. However, we continue offering our navigation services to patients regardless of being on or off MAT; almost half of our patients will go off MAT during their time with us. That is OK as we assure the patients have access to harm reduction supplies and other important tools to reduce risk for overdose. We also can offer rapid access to medication services through our partnerships with various clinics once a patient decided to restart MAT. Our patients attend licensed opioid treatment programs (“methadone clinics”), office-based buprenorphine programs, residential treatment, intensive outpatient programs, and/or primary care clinics that offer buprenorphine or extended-release naltrexone.

We screen for the social determinants of health, like lack of transportation or lack of insurance, and develop treatment plans that help address these important issues. We also provide financial incentives for patients to achieve goals and for providing urine drug screens that show cessation of opioids and cessation of stimulants.

• Patient navigation to community-based MAT providers, residential treatment, primary care and specialty mental health care (if needed)
• Contingency management for OUD and stimulant use disorder
• Motivational interviewing to help reduce problematic substance use
• Harm reduction and overdose prevention services
• Transportation to and from appointments

HOUDINI LINK enrolls patients 18 years and older with OUD who elect to start on MAT (buprenorphine, methadone, or extended-released naltrexone) while hospitalized at ZSFG. Patients need to be residents of San Francisco or unhoused and not planning to leave the area for at least 6 months. We offer services in English and Spanish. We currently do not take referrals from other hospitals or self-referrals. Our services are provided free of charge and no insurance billing occurs.

We accept referrals from all inpatient units, Psychiatric Emergency Services, and the Emergency Department at ZSFG. Please page Alexandra Haas at (415) 719-0003 for potential referrals. In addition, we round with Social Medicine and the Addiction Care Team during weekdays who can also provide referrals on behalf of the treating physician/nurse practitioner.

We offer services Monday through Friday, 8:00 am to 5:00 pm. We are closed on UCSF Holidays.

Alexandra Haas, LMFT

Project Director, HOUDINI LINK

1001 Potrero Ave

Building 90, 5^th Floor

San Francisco, CA 94110

(o) (628) 206-3010

(p) (415) 719-0003

Alexandra.haas@ucsf.edu