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Sponsored| Name | Address | City |
|---|---|---|
| Fort Help Methadone Program | 915 Bryant St. | San Francisco |
| San Francisco VA Medical Center | 4150 Clement Street Building 1 | San Francisco |
| Westside Community Services | 1153 Oak St | San Francisco |
| The Center for Colorectal Health, Carolyn E. Million, MD | 450 Sutter St | San Francisco |
| Friendship House Association-American | 56 Julian Avenue | San Francisco |
| Fort Help Mission Inc. | 1101 Capp Street | San Francisco |
| Westside Community Services (Methadone Maintenance & Detoxification) | 1301 Pierce Street | San Francisco |
| Harm Reduction Therapy Center | 21 Merlin St | San Francisco |
| Walden House Inc | 890 Hayes Street | San Francisco |
| Behavioral Health Access Center | 1380 Howard St | San Francisco |
| HealthRIGHT 360 | 1563 Mission Street 3rd Floor | San Francisco |
| SFGH.OTOP | 1001 Potrero Ave | San Francisco |
| MedMark Treatment Centers Vallejo | 1628 Broadway Street Suite B | Vallejo |
| Oakland Behavioral Health Clinic – VA San Francisco Health Care System | 525 21st Street | Oakland |
| HAART Oakland | 10850 MacArthur Boulevard | Oakland |
| Starlight Community Services | 1885 Lundy Avenue Suite 223 | San Jose |
| Berkeley Addiction Treatment Services | 2975 Sacramento Street | Berkeley |
| Summit Estate Recovery Center Outpatient Program | 7280 Blue Hills Drive Suite 7 | San Jose |
| BAART Programs Richmond | 1313 Cutting Blvd. | Richmond |
| BAART Programs Oakland | 1124 International Blvd | Oakland |
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Medication treatment for opioid use disorder in San Francisco
San Francisco has one of the country’s most concentrated overdose crises and, alongside it, one of the more developed networks for getting people onto medications for opioid use disorder (MOUD). Fatal overdoses in the city fell from 811 in 2023 to 635 in 2024 and 621 in 2025, with fentanyl driving most deaths (San Francisco Office of the Chief Medical Examiner, 2025). The listings on this page cover programs across the city that provide methadone, buprenorphine (including Suboxone and Sublocade), and naltrexone (including Vivitrol), in opioid treatment programs and in office-based settings. Call any listing directly, or use the helpline on this page to talk through your options.
The three medications and where you can get each one in San Francisco
Three FDA-approved medications treat opioid use disorder, and where you go depends on which one you and a clinician decide on. Methadone for opioid use disorder is provided only through a licensed opioid treatment program (OTP), not at a regular pharmacy. San Francisco has several OTPs across the city, and dosing is usually daily on-site at first, with take-home doses possible once you are stable in treatment.
Buprenorphine, including Suboxone (the buprenorphine-naloxone combination) and the monthly Sublocade injection, can be prescribed by any clinician with a standard DEA registration and filled at a pharmacy. That means a primary care doctor, a community clinic, or a telehealth provider can start you on it, in addition to an OTP. Office-based prescribing is widely available in San Francisco and is the most common route for many people. For a deeper comparison of how the two medications work day to day, see our overview of methadone treatment.
Naltrexone, including the monthly Vivitrol injection, is not a controlled substance. Any licensed prescriber can prescribe it. Treatment begins only after you have been off opioids for a set period, usually seven to fourteen days, so a clinician will time the start carefully to avoid sudden withdrawal.
Low-barrier and street-based access in the city
San Francisco invests heavily in reducing the steps between “I want help” and a first dose. The San Francisco Department of Public Health’s Street Medicine team and the Street Overdose Response Team (SORT), launched in August 2021, respond to overdoses in the field and can start buprenorphine on the street, then keep people connected to ongoing care (San Francisco Department of Public Health, 2024). The city’s Behavioral Health Access Center (BHAC) at 1380 Howard Street is the central drop-in point for substance use and mental health care for Medi-Cal and uninsured residents, with an Office-Based Buprenorphine Induction Clinic (OBIC) and a Behavioral Health Services pharmacy on the same floor. BHAC is open seven days a week. For round-the-clock information and referrals, the SFDPH Access Helpline runs 24 hours a day at 1-888-246-3333.
Starting treatment and what the first days look like
Intake usually starts with a clinical assessment, a medical history, and a urine screen, and many San Francisco programs can begin medication the same day if you are clinically ready. Bring a photo ID and your insurance card if you have them, but neither is required to be assessed at BHAC. If you are using fentanyl, ask the program about timing your first buprenorphine dose, because starting too soon after a recent dose can trigger sudden, severe withdrawal (precipitated withdrawal). Clinicians manage this with timing, with low-dose (“microdose”) protocols, or with a brief inpatient start. Our guide to methadone treatment for fentanyl-involved use explains the medication side, and our overview of opioid addiction treatment walks through what to expect at a first visit.
Take-home doses and telehealth: the current rules
Federal rules updated in 2024 expanded take-home methadone (up to a 28-day supply for patients who are stable in treatment, on a graduated schedule earlier on), allowed treatment to start by telehealth within OTPs, and removed older barriers to admission, including the prior requirement of a one-year history of opioid use (SAMHSA, 42 CFR Part 8, 2024). California permits and funds medication units and mobile narcotic treatment programs as extensions of licensed OTPs, which matters most for people who cannot easily travel to a clinic every day.
As of June 2026, buprenorphine can be started through telehealth, including by phone in many cases, without a prior in-person visit. A permanent buprenorphine telemedicine rule took effect December 31, 2025, and a separate temporary extension keeps the broader pandemic-era flexibilities in place through December 31, 2026 (DEA and HHS, 2025). Telehealth rules are still being finalized, so confirm what is current with a provider. Methadone for opioid use disorder is still dispensed only through an OTP, although some programs can do the initial assessment by video.
Paying for treatment in San Francisco
California’s Medicaid program, Medi-Cal, covers all three medications for opioid use disorder through Drug Medi-Cal, and a 2022 state law prohibits prior authorization for FDA-approved opioid use disorder medications under Medi-Cal and state-regulated commercial plans (California Department of Health Care Services). In San Francisco, Medi-Cal is delivered primarily through the San Francisco Health Plan and Anthem Blue Cross. Pregnant Medi-Cal members keep full benefits for 12 months postpartum (California Department of Health Care Services). Most private insurance plans and Medicare also cover MOUD; many San Francisco programs accept self-pay and offer sliding-scale fees for uninsured residents. BHAC can connect uninsured residents to county-funded treatment.
The local overdose picture
The San Francisco Office of the Chief Medical Examiner reported 635 unintentional drug overdose deaths in 2024, down from 811 in 2023 (the deadliest year on record), and a further decline to 621 in 2025 (SF.gov; KRON4 reporting on city data, 2026). Fentanyl was involved in more than three-quarters of overdose deaths through this period. Officials and outside researchers credit the recent decline to a mix of factors: expanded buprenorphine access through street-based teams, more treatment beds, broader naloxone distribution, and shifts in the unregulated drug supply (San Francisco Department of Public Health; Public Health Institute, 2024). The takeaway for someone reading this page is simpler. Treatment works, it is local, and the most dangerous moment is the gap before you start. For background on the condition the medications treat, see our overview of opioid addiction.
Overdose response and naloxone
Naloxone, the medication that reverses an opioid overdose, is available over the counter as Narcan nasal spray and free through several channels in San Francisco. The SFDPH Behavioral Health Services Pharmacy at 1380 Howard distributes free nasal naloxone kits and fentanyl test strips, and the city’s clearinghouse distributes roughly 28,000 free kits a year (San Francisco Department of Public Health). California’s statewide standing order, issued by the California Department of Public Health, lets community organizations distribute naloxone without an individual prescription, and the DHCS Naloxone Distribution Project supplies eligible organizations with free naloxone. California’s 911 Good Samaritan law protects people who call for help during an overdose from prosecution for limited drug-related offenses. If you or someone you know is using opioids, carry naloxone. A return to use after a period of abstinence carries a higher overdose risk and is treated as a manageable part of a chronic condition rather than a failure. For more on how methadone interacts with overdose risk, see our page on methadone and overdose.
Pregnancy, unhoused populations, and justice-involved care
If you are pregnant and using opioids, methadone or buprenorphine is the recommended standard of care; stopping suddenly is not advised, and treatment improves outcomes for both pregnant patients and infants (American College of Obstetricians and Gynecologists; CDC). Medi-Cal covers MOUD throughout pregnancy and for 12 months postpartum, and California law protects access to confidential treatment during pregnancy. Our page on methadone and pregnancy covers what to expect, including neonatal opioid withdrawal syndrome (NOWS) and how clinical teams plan for it.
People experiencing homelessness account for a disproportionate share of San Francisco overdose deaths, and the city’s Street Medicine program and SORT are designed to reach this population where they are, including with same-day buprenorphine and warm hand-offs to ongoing care. For people leaving San Francisco County Jail or returning from state prison, California’s CalAIM Justice-Involved Reentry Initiative connects Medi-Cal coverage and care, including MOUD, in the 90 days before release so treatment does not break at the door (DHCS, 2024). If you are helping a loved one in any of these situations, the most important first step is calling a provider on this page or the helpline to talk through options together.
Common questions about MOUD in San Francisco
How fast can I start treatment?
Many San Francisco programs offer same-day or next-day starts when you are clinically ready. BHAC is a drop-in seven days a week, the SFDPH Access Helpline runs 24/7 at 1-888-246-3333, and several office-based providers and telehealth services can prescribe buprenorphine on a first visit. Methadone starts must happen at an OTP and follow the program’s intake process.
Methadone or Suboxone: which is better?
Both are evidence-based and effective, and the right choice depends on your history, what is available, your daily life, and other medical factors. Methadone is typically dispensed daily at an OTP early on, with take-homes earned over time. Buprenorphine is usually prescribed in an office and filled at a pharmacy, which fits a wider range of schedules. A clinician at intake can help you compare them, and the comparison earlier on this page gives the basics.
Do I have to go to a clinic every day?
Not necessarily. Methadone starts with daily on-site dosing at an OTP, then take-homes become available as you stabilize, up to a 28-day supply under current federal rules. Buprenorphine is usually prescribed for at-home use from the start, with follow-up visits in person or by telehealth.
Can I start Suboxone by phone or video?
In most cases, yes. As of June 2026, federal rules allow buprenorphine to be started through telehealth, including by phone, without a prior in-person visit. Methadone for opioid use disorder is started through an OTP, although some programs can do the initial assessment by video. Confirm the current pathway with the provider, because the underlying telehealth rules are still being finalized.
What if I am on methadone and moving to San Francisco?
Contact a San Francisco OTP a few weeks before the move if possible and ask about transfer or guest dosing. Programs will need a recent dosing record from your current OTP. Continuity matters, so do not stop dosing while you arrange the transfer.
Is long-term medication treatment a problem?
No. Staying on methadone or buprenorphine long term is legitimate, evidence-based care, not a sign of unfinished treatment. Many people do best on medication for years; some taper later with a clinician, and others stay on it indefinitely. The decision belongs to you and your provider. See our page on whether methadone is addictive for the clinical distinction between dependence and addiction.
Sources and disclosures
Last reviewed June 2026.
Sources used on this page:
- San Francisco Office of the Chief Medical Examiner and San Francisco Department of Public Health, overdose data and overdose prevention plan: sf.gov drug overdose and treatment data
- San Francisco Department of Public Health, Behavioral Health Access Center and Mental Health SF: sf.gov BHAC page
- Substance Abuse and Mental Health Services Administration, 42 CFR Part 8 final rule (2024): SAMHSA methadone regulations
- Drug Enforcement Administration and U.S. Department of Health and Human Services, telemedicine rules (2025-2026): DEA telemedicine extension press release
- California Department of Health Care Services, Drug Medi-Cal and Naloxone Distribution Project: DHCS Naloxone Distribution Project
- California Department of Public Health, statewide naloxone standing order: CDPH naloxone standing order
- American College of Obstetricians and Gynecologists and CDC, opioid use disorder in pregnancy: CDC OUD treatment in pregnancy
Methadone Centers is an informational directory and is not a medical provider. The information on this page is for general education and does not replace medical advice, diagnosis, or treatment from a licensed clinician. Always consult a qualified provider about your individual situation.
The helpline listed on this site is answered by a paid advertiser. Calls are routed to participating treatment providers. Methadone Centers does not receive any commission or fee that depends on which treatment provider a caller chooses, and using the helpline is not a condition of receiving care.