Our Story
For more than 150 years, San Francisco General Hospital has been a frontline responder to public health crises. Now, amidst a skyrocketing addiction epidemic, with 2 people dying daily of a preventable drug-related deaths and increasing alcohol-related deaths, ACT's services are vital. Fragmented care makes it difficult for our patients to access substance use services in the community. ACT links our patients to community services as part of San Francisco's treatment network while also contributing to national solutions to our addiction epidemic.
ACT answers the call
Almost half of SFGH's patients have an addiction. Before ACT, a system to address addiction care did not exist. This meant that patients were inconsistently offered addiction treatment despite it being the cause of their visit.
We obtained seed funding for ACT in January 2019. Emergency department visits and hospitalization present key touchpoints to offer substance use services, including harm reduction, evidence-based treatment, and linkage to care.
Our Patients
People identified by our city as the most marginalized are individuals ACT prioritizes during emergency department visits and hospitalizations to reduce the harms of substance use while addressing the medical and psychosocial complications of addiction. Half of the patients with SUD we see are unconnected to community care.
Compared to patients without substance use disorders, our patients with sustance use disorders face unique challenges:
2x
more likely to have a mental illness
5x
more likely to experience homelessness
5x
more likely to self-discharge prior to completing treatment
1.5x
more likely to be re-hospitalized within 30 days
Patient Stories
Learn more about our services and our patients' journeys below.
Helping Mr. J heal his heart, reconnect with purpose, and reduce methamphetamine.
Addressing the Root Cause
Mr. J was admitted with methamphetamine-induced severe heart failure. Through motivational interviewing, ACT learned he was was one of 13 siblings raised in a poor community devastated by drugs. He had had recovered from a cocaine use disorder and was happily married until a hurricaine took his home and wife. Displaced and widowed, he relocated to California to be near remaining family and began using methamphetamine to escape sleep and the traumatic nightmares.
Our Role
Mr. J aimed to heal his heart, find a sense of purpose, and stop methamphetamine. ACT educated him about the effects of methamphetamine on his heart and connected him to outpatient behavioral addiction treatment. By elucidating the root causes of his use, empowering him through knowledge, and connecting him to addiction care, he has moved towards healthier behaviors and has an improved quality of life free of methamphetamine.
Supporting Ms. M's desire to stop opioid use and connecting her to community care
Cutting the Red Tape
Ms. M had an opioid use disorder, untreated mental illness, and was experiencing homelessness. On many occasions she had attempted obtaining buprenorphine for her heroin use but was unable to find a prescriber. She was discovered unconscious after a fentanyl overdose in the street, where she had been assaulted and was admitted to ZSFG. As a result of her trauma and co-occurring stimulant use disorder in the setting of untreated mental illness, she experienced suicidal ideation and psychosis.
Our Role
Diagnosed her severe opioid use disorder for which she had been seeking treatment, counseled her on evidence-based treatment options, supported her team in initiating buprenorphine, and linked her to a community opioid treatment program for integrated SUD and psychiatric care.
Helping Mr. G stop drinking, recognize underlying trauma, and reconnect with his family
Building Connections
Mr. G was in his early 50s with a history of childhood trauma. He had been a successful chef until lost his wife, son, and career to severe alcohol use disorder. He was hospitalized ~every six weeks with complications of alcohol use.
Our Role
Built rapport over three hospitalizations and strengthened Mr. G’s connection with his primary care doctor. His goal was to stop drinking to reconnect with his son. He identified depression and trauma underlying his use and wanted a medication to reduce drinking. He started attending primary care appointments more consistently where his doctor referred him to a psychologist. His recurring admissions decreased, and on his last admission he told ACT that seeing a psychologist for the first time made him hopeful for change.
Our Impact
In 2019, ACT saw more than 400 patients. ACT more than doubled our impact in 2020. We saw 3,453 patients, started at least 600 on evidence-based medications for adiction, discharged 74 patients to residential, and expanded services to 7-days a week. ACT serves people with all substance addictions, including:
- Alcohol (31%)
- Opioid (29%)
- Methamphetamine (19%)
- Cocaine (10%)
What We Do
- Collaborate as an interprofessional team of addiction medicine physicians, nurse practitioners, patient navigators, and licensed vocational nurses to help patients navigate the system of care during and after healthcare system touchpoints in partnership with staff, clinicians, and community partners.
- Assess people with unhealthy alcohol, tobacco, and other drug use for an addiction, evaluate their goals and readiness for change, and help them move towards healthier behaviors.
- Initiate life-saving evidence-based addiction treatment.
- Ally with community partners to link patients to integrated SUD services.
- Use strength-based, patient-centered communication to reduce stigma and the harms of substance use.
- Educate hospital staff and clinicians.
- Adocate for and empower patients to self-advocate.
Learn more about the people powering our work
Explore the community, medical, and funding partners that make our impact possible. Meet the team running and evaluating the Addiction Care Team.
Want to help ACT grow?
Financial contributions directly fund and sustain our work for years to come.
ACT falls under the Division of Hospital Medicine at San Francisco General Hospital and spans the emergency department and hospital. Soon we will be expanding to inpatient psychiatry and psychiatric emergency services.