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Welcome to OTOP

The Opiate Treatment Outpatient Program (OTOP) located on the San Francisco General Hospital campus offers a wide range of services for people living in San Francisco who have an addiction to opioids (opioid use disorder). Serving over 450 patients at our main location, OTOP also has a mobile van program in the Bayview neighborhood and the only office-based methadone treatment program in California.

OTOP is a partnership between the San Francisco Department of Public Health (SFDPH) and the University of California, San Francisco (UCSF).


OTOP’s primary clinical site is located on the SFGH campus (995 Potrero Avenue) in the brick buildings on the north side of 22nd street as it enters the campus. Intake services are located on the 3rd Floor of Building 90.

OTOP's Approach to Care

OTOP is committed to providing high quality, compassionate, and evidence-based care to people with opioid use disorder in San Francisco. We are a public health program. Your recovery, your life, and your journey are our focus, and we will never treat you like a number or put profit ahead of your needs. Within the limitations of federal and state law, we try to make services work for everyone who wants them, and we integrate harm reduction into all aspects of treatment. We bring the strengths of both SFDPH and UCSF to our work, and we value and respect all people. OTOP has a commitment to diversity, equity and inclusion in our clinical work, teaching and research missions, and we live that commitment on a day-to-day basis with you.

OTOP Physicians are UCSF faculty (professors) with expertise in addiction medicine. Nurse Practitioners are experienced and highly trained in both addiction and mental health. The OTOP nursing team brings many years of experience, compassion, and a commitment to excellence to our treatment services. Our excellent counseling team is dedicated to helping you on your recovery journey and utilizes evidence-based practices including motivational interviewing and cognitive-behavioral therapy in addition to their own life experiences. They can help with everything from food and housing to relapse prevention and vocational assistance.

Available Services at OTOP

  • Medications for Opioid Use Disorder (Buprenorphine and Methadone)
  • Substance Use Counseling (including limited case management)
  • Counseling, Referrals, and Care Coordination for other Substance Use Disorders
  • Alcohol Use Disorder Medical Clinic
  • Specialty HIV services
  • Prenatal and Perinatal Care Coordination
  • Harm Reduction and Overdose Prevention Services
  • Motivational Interviewing and Cognitive Behavioral Therapy
  • Limited Psychotherapy and Psychiatric Services
  • Directly Observed Therapy (giving prescribed medications on a daily basis with methadone or buprenorphine to support adherence)
  • Hepatitis C Testing and Treatment on site
  • Care Coordination with other health providers and treatment programs (with consent)
  • Linkage to primary care and mental health services
  • Specialized Transitions to Buprenorphine from Fentanyl and Methadone


OTOP provides treatment for people with Opioid Use Disorder who are 18 years of age and over and reside in San Francisco.

Patients do not need official ID as long as identity can be reasonably established. Patients must agree to enter substance use treatment—we do not accept patients for pain management.

Payment:  OTOP works with patients who have or are eligible for public insurance in the county of San Francisco.  This includes San Francisco Medi-cal, Healthy San Francisco, and Healthy Workers. Veterans are also eligible to receive care at OTOP.

We do not accept private commercial insurance or self-pay.

If you are not sure if you are eligible, please call us to discuss more at (628) 206-8412 or come to the clinic to talk with us. If we can’t provide the care you need, we will do our best to help connect you with someone who can.

How to Make a Referral

We accept patient self-referrals and referrals from clinical service providers.  Our clinic does not operate on an appointment basis, but if we know you are planning to come in, that can help.

Please call us at (415)-530-0957 to refer a patient or if you are interested in an intake for yourself.

OTOP accepts all patients needing treatment continuation upon discharge from San Francisco General Hospital following inpatient initiation of methadone or buprenorphine. Please use the eReferral system and reach out to directly to the clinic to confirm the transition plan. In some cases it may be necessary to complete the intake before a patient leaves the hospital in order to avoid gaps in care upon discharge. We are limited in our intake capacity, so please plan ahead to avoid delays in discharge.

OTOP encourages SFGH ER referrals in which ER providers initiate methadone or buprenorphine and refer to us for follow up.

Hours of Operation

Patient Clinic Hours

Monday to Friday 6:45 – 11 am and 12:30 pm – 2:00 pm

Weekends and Holidays 7:30 – 11 am and 12:30 pm – 2:00 pm

Contact Information

995 Potrero Avenue

Building 90, 3rd Floor

San Francisco, CA 94110

Ph: (628) 206-8412

OTOP Poem by Miriam McGuinness

SF General  in 1973 

Saw the birth of ward 93

I’ve heard back then that counseling was done by a nurse

Who would dispense the medication, then pull a cigarette from her purse

Patient and provider would converse over a smoke

Discussing what concerns the nicotine would invoke

Later Ken Day started and things only got better

He checked all the boxes down to the letter

26 years ago, per diem I started

The options for treatment were not great, but good-hearted

In the early days the choices were as follows, 

Weeks or months of detox, which was a little hard to swallow

But we were the cheapest spot in town,

No healthy SF to bring the cost down

Today things have changed with Covered California and Obamacare on our side 

Maintenance is the go-to, and we’ve made big strides

More clinics have opened, and free care is available

And the passion of our staff has remained unassailable

We practice harm reduction and meet people where they’re at

We listen and ask questions, useful tools for MAT

We got the Vans going, bringing care to where folks stay

Patients could get treatment without going out of their way

HIV medication sure changed the scene, 

Once a day dosing keeps the virus unseen. 

Then came March 16 2020, we are closing the city 

Two weeks, said London, that should be plenty

We had an emergency plan in just 3 days 

The clients were outside, away from Covid haze. 

We delivered our meds to a home or hotel

to a trailer a Victorian, or wherever one would dwell

In my 26 years I’ve sure learned a lot

From colleagues and clients, many lessons I’ve got.

I’ve heard people’s life stories, of their families and traumas

How would I cope with such unimaginable dramas

We give our folks MAT, and meds for some heads,

We can cure Hep C and help you get beds. 

We give of ourselves and that’s why we’re here

It’s a great place to work, and why I’ve stayed all these years

OTOP 50th Anniversary