About Us
ACT fills an overwhelming unmet need for addiction services at SFGH. Substance use impacts many patients and their families. We provide expertise, care, and attention to improve outcomes.

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.

Dr. Sarah Leyde, (2019-20 Addiction Medicine Fellow) presents on stimulant-induced heart failure to the SFGH Division of Cardiology. Dr. Leyde created Hearts Plus, a contingency management program that provides addiction and heart failure care.

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:


more likely to have a mental illness


more likely to experience homelessness


more likely to self-discharge prior to completing treatment


more likely to be re-hospitalized within 30 days

Patient Stories


Learn more about our services and our patients' journeys below.

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%)

ACT is one of the biggest game-changing services I have seen at ZSFG in a long time.

Surgical Provider

San Francisco General Hospital


Our patients carry so much wisdom and resilience. It's an honor and a joy to be inspired by and learn from them.

Rachel Perera, Patient Navigator

San Francisco General Hospital


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.


Some of San Francisco's addiction medicine community at the Association for Multidisciplinary Education and Research in Substance use and Addiction (AMERSA) in 2018 in San Francisco.


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.