Expert Insights
You know a drug is dangerous when most addicted locals make a concerted effort to avoid it. But that hasn’t stopped a deadly new drug from making its way to the streets of San Francisco. Isotonitazene, known as ISO, is a synthetic opioid that’s over 20 times more potent than fentanyl. Drug dealers are adding ISO to other products that are sold around the city. In fact, according to the DEA, lab tests show ISO is mainly being added to heroin, fentanyl, and pressed into fake prescription pills. The Tenderloin and SoMa districts are now ground zero for a fatal overdose epidemic that shows no end in sight. This is why it’s so important that we provide narcan to all local residents, whether it’s someone who abuses opioids or knows someone who abuses opioids. Narcan is the one tool we have at our disposal that can quite literally save lives. Every resident in these districts should be carrying at least one dose of narcan, a medication known as the “anti-overdose drug.”
How We Rank Listings
Every facility in our San Francisco directory is independently reviewed before it appears on this page. We verify state licensing through the California Department of Health Care Services (DHCS), confirm accreditation status with The Joint Commission and the Commission on Accreditation of Rehabilitation Facilities (CARF), and cross-check details with each provider directly.
Our editorial team prioritizes accuracy and patient safety over advertising relationships. Listings are not ranked by payment. Facilities are organized to help families compare options on the factors that matter most: level of care, accepted insurance and payment types, specialty programs, and accreditation.
- State licensing verified through California DHCS
- Accreditation confirmed with The Joint Commission and CARF
- Level of care, insurance, and program details cross-checked directly with providers
- Listings updated on a recurring schedule and corrected as facilities report changes
Rehab in San Francisco: What to Know
San Francisco is a consolidated city and county, so the local treatment system, the data, and the policy response are organized at one level rather than spread across municipal and county agencies. There are 78 licensed rehab facilities operating in San Francisco, ranging from withdrawal management programs and inpatient residential treatment to outpatient clinics, sober living homes, and dual-diagnosis programs. Most of the city’s publicly funded substance use system runs through the San Francisco Department of Public Health (SFDPH) Behavioral Health Services division, with private and nonprofit providers filling out the rest of the network. For a broader view of options outside the city, the California state rehab directory covers facilities across the wider region.
The system has a single front door for people who need help navigating it. The Behavioral Health Access Center (BHAC) at 1380 Howard Street, operated by SFDPH, can assess and authorize placement into outpatient, intensive outpatient, residential, withdrawal management, medication-assisted treatment, and crisis stabilization programs. BHAC also runs a 24/7 Behavioral Health Access Line at 888-246-3333, staffed in English, Spanish, Cantonese, Mandarin, and Vietnamese, that connects San Franciscans to addiction treatment options regardless of insurance status. FindTreatmentSF.org publishes near real-time availability for residential and crisis beds across the city’s contracted providers.
Fentanyl is the defining context for San Francisco’s treatment landscape. The city recorded 810 accidental overdose deaths in 2023, the deadliest year on record, before declining to 635 deaths in 2024 as SFDPH expanded telehealth-based medication treatment, naloxone distribution through the Drug Overdose Prevention and Education (DOPE) Project, and the Bridge Clinic at Zuckerberg San Francisco General Hospital. More than 80 percent of those deaths involved fentanyl, and the city continues to see overdoses involving stimulants and emerging adulterants such as xylazine and bromazolam. The treatment infrastructure has been retooled around that reality, with low-barrier buprenorphine access, on-demand telehealth induction, and expanded residential capacity.
San Francisco is also a major regional hub for specialty programs. The city anchors a network of LGBTQ+ affirming providers, women’s-specific residential treatment, programs that serve people experiencing homelessness, and one of the largest VA health care systems in Northern California. Treatment is geographically accessible by BART and Muni for most neighborhoods, and many providers cluster in SoMa, the Mission, the Tenderloin, and the Western Addition.
Cost of Rehab in San Francisco
The cost of rehab in San Francisco depends primarily on the level of care, the length of the program, and whether health insurance is in network with the facility. California-wide averages give the clearest baseline. Because San Francisco has one of the highest costs of living in the country, list-price treatment in the city typically lands at or above the state average, particularly for residential and medical detox programs. Most San Franciscans pay far less than the sticker price by using private insurance, Medi-Cal, or sliding-scale and free city-funded programs.
These figures represent the full self-pay cost of treatment without insurance, and they include residential and medical detox programs that pull the average upward. Many factors push individual costs above or below these averages, including the program’s amenities, the length of stay, and whether the facility is in network with the patient’s health insurance plan.
How to Pay for Rehab in San Francisco
The 78 facilities in San Francisco accept a wide mix of payment types. Self-payment, private insurance, Medi-Cal, and Medicare are the four most common, but most programs also offer sliding-scale fees, financial assistance, or financing for patients who do not qualify for public coverage and cannot afford the full self-pay price. The chart below shows how many facilities in the directory accept each payment type.
Coverage details vary widely by program and by patient eligibility, so the best first step is to call the facility directly or use the Behavioral Health Access Line at 888-246-3333 to confirm what your plan will pay for.
Medicare
26 facilities in San Francisco accept Medicare. Original Medicare (Parts A and B) covers medically necessary inpatient detox and rehab, outpatient counseling, partial hospitalization, and medication-assisted treatment through Part D prescription drug plans. Medicare Advantage (Part C) plans bundle these benefits and often add coverage for additional services. Most patients still pay a portion of the cost in the form of deductibles, copays, and coinsurance, but supplemental Medigap policies can reduce out-of-pocket expenses. Learn more about verifying your rehab benefits before admission.
Medicaid (Medi-Cal)
37 facilities in San Francisco accept Medi-Cal, California’s Medicaid program. San Francisco participates in the state’s Drug Medi-Cal Organized Delivery System (DMC-ODS), a 1115 waiver program that broadens Medi-Cal coverage for substance use disorder services to include outpatient and intensive outpatient treatment, residential treatment in facilities larger than the federal IMD exclusion would normally allow, withdrawal management, case management, and recovery support services. Medi-Cal covers FDA-approved medication-assisted treatment for opioid use disorder without prior authorization, including buprenorphine and methadone, and the state has expanded contingency management for stimulant use disorder as a Medi-Cal benefit.
Military Benefits
9 facilities in San Francisco accept TRICARE, which covers active-duty service members, retirees, and their families. The San Francisco VA Health Care System operates inpatient, outpatient, and residential substance use treatment at the San Francisco VA Medical Center on Clement Street and at community-based outpatient clinics across the region. Eligible veterans can also access the VA’s Harm Reduction and Syringe Services Program and free naloxone vending machines at multiple VA sites. The Vet Center provides confidential counseling at no cost, including for veterans not enrolled in VA health care. For more information on benefits and program eligibility, see additional rehab resources for veterans and military families.
Insurance and Private Pay
36 facilities accept private health insurance, and 65 accept self-payment. Mental health and substance use disorder care are essential health benefits under the Affordable Care Act, which means individual and group plans sold in California must cover treatment at parity with other medical care. Coverage details, in-network providers, deductibles, and prior authorization requirements vary by carrier and plan. Major insurance carriers in California include:
- Aetna
- Anthem Blue Cross
- Blue Shield of California
- Chinese Community Health Plan
- Cigna
- Health Net
- Kaiser Permanente
- San Francisco Health Plan
- UnitedHealthcare
Other Low-Cost Options
For patients who do not qualify for Medi-Cal or Medicare and do not have private insurance, 29 San Francisco facilities offer sliding-scale fees based on income, 39 offer financial assistance, and 28 offer financing arrangements. Many SFDPH-contracted programs are available at no cost to San Francisco residents who meet eligibility criteria, and the Behavioral Health Access Center can help patients understand what is available before they commit to a program.
Free Treatment Programs
8 facilities in San Francisco offer free treatment to all clients, and additional city- and county-funded programs are available at no cost to qualifying residents through SFDPH. The Salvation Army Recovery Program, faith-based residential programs, and several community organizations also offer free or low-cost beds funded by donations and grants. Rehab scholarships and grant-funded scholarship beds at private programs are another option for people without coverage. Most free programs have waitlists, so calling early and being open to multiple options shortens the time to admission.
Levels of Care Available in San Francisco
San Francisco offers a full continuum of care across the city’s 78 licensed facilities, including 23 medical detox programs, 45 inpatient and residential programs, 43 outpatient clinics, and 60 dual-diagnosis programs that treat substance use and co-occurring mental health conditions together.
Medical Detox
Medical detox is the first phase of treatment for people with physical dependence on alcohol, opioids, benzodiazepines, or other substances that produce dangerous withdrawal symptoms. Clinical staff monitor vital signs around the clock, manage withdrawal with medication when appropriate, and stabilize patients medically before they transition to ongoing rehab. Most detox programs run 5 to 10 days. In San Francisco, low-barrier withdrawal management is available through HR360, the SoMa RISE sobering center, the Alcohol Sobering Center on Mission Street, and several hospital-based programs.
Inpatient and Residential Rehab
Inpatient and residential treatment programs provide 24-hour care in a structured environment, with daily individual and group therapy, medication management, recovery skill-building, and clinical supervision. Programs typically last 28 to 90 days, with longer stays for people with severe substance use disorders or co-occurring mental health conditions. Residential admissions in San Francisco grew sharply between Fiscal Year 2022-23 and Fiscal Year 2023-24 as the city expanded contracted bed capacity through SFDPH.
Partial Hospitalization Programs
San Francisco has 4 partial hospitalization programs. PHPs run during the day, typically 5 to 6 hours per day, 5 days per week, and offer a level of structure comparable to residential treatment without the overnight stay. Patients live at home or in sober living and attend treatment during the day. PHPs are often used as a step down from inpatient or detox, or as a step up from standard outpatient when symptoms intensify.
Standard Outpatient
43 outpatient clinics in San Francisco offer treatment that fits around work, school, and family responsibilities. Most programs combine weekly individual addiction therapy with group sessions, medication management, and case management. Outpatient is the most common point of entry for people with mild to moderate substance use disorders or those stepping down from a higher level of care. Methadone clinics and buprenorphine programs at the SFDPH Behavioral Health Services Pharmacy, BAART, Westside Methadone, the Bridge Clinic, and HealthRight 360 fall into this category.
Dual Diagnosis and Co-Occurring Care
60 facilities in San Francisco treat co-occurring substance use and mental health conditions in an integrated way. Co-occurring care is the standard of care for most people seeking treatment because untreated depression, anxiety, trauma, or psychosis often drives ongoing substance use. Integrated programs address both conditions in a single treatment plan, with psychiatry, medication management, and trauma-informed therapy alongside addiction treatment.
Sober Living
17 sober living homes operate in San Francisco. Sober living provides drug- and alcohol-free housing for people in early recovery, typically after residential or PHP treatment, and supports the transition back to independent living. Residents pay weekly or monthly rent and follow house rules that may include curfews, drug testing, and required attendance at recovery meetings. Sober living is often combined with outpatient treatment or 12-step participation as part of long-term rehab aftercare.
Specialty Programs in San Francisco
San Francisco has one of the most diverse specialty program networks in the country, with facilities serving women, men, LGBTQ+ adults, veterans and military families, young adults, and older adults. Programs targeting opioid and alcohol use disorder specifically are widespread, reflecting both the city’s fentanyl crisis and the long-standing burden of alcohol use disorder in the Bay Area.
Specialty programming matters because shared identity and lived experience strengthen treatment engagement and retention. People are more likely to disclose, stay in care, and complete a program when clinicians and peers understand the cultural, gender, or life-stage context they bring with them.
Free and Low-Cost Rehab Resources in San Francisco
San Francisco residents have access to a broad network of free and low-cost mental health and substance use resources funded by the city, the state, and community-based nonprofits. The list below covers the most direct points of entry. For broader navigation, dial 211 or call the SFDPH Behavioral Health Access Line at 888-246-3333.
Crisis Lines
- 988 Suicide and Crisis Lifeline — Call or text 988. Free, confidential, 24/7 support for anyone experiencing a mental health or substance use crisis. Veterans press 1. See additional suicide prevention resources.
- SF Comprehensive Crisis — 628-217-7000. Mobile crisis response for adults and youth, 24/7.
- Psychiatric Emergency Services (PES) — Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, 628-206-8125. 24/7 walk-in psychiatric emergency care.
- SAMHSA National Helpline — 1-800-662-HELP (4357). Free, confidential, 24/7, in English and Spanish. National referral for substance use and mental health services.
County Health Department and Access Points
- Behavioral Health Access Center (BHAC) — 1380 Howard Street, 1st Floor. Drop-in Monday through Friday 8 a.m. to 7 p.m., Saturday and Sunday 9 a.m. to 4 p.m. Access Line 888-246-3333, 24/7.
- SFDPH Behavioral Health Services Pharmacy — 1380 Howard Street. Free naloxone, fentanyl test strips, and medications for opioid use disorder. Weekend hours available.
- FindTreatmentSF.org — Near real-time directory of residential, withdrawal management, and crisis stabilization bed availability across SF’s contracted providers.
- 2-1-1 Bay Area — Dial 211 or text your ZIP code to 898211. Free, confidential, 24/7 referral service for health and human services in over 150 languages.
Community and Nonprofit Programs
- HealthRight 360 — 1563 Mission Street, 415-967-5334. Withdrawal management, residential treatment, outpatient, and buprenorphine services.
- Glide Foundation Harm Reduction Services — 330 Ellis Street, 415-674-6000. Drop-in services, harm reduction supplies, and contingency management programs.
- Salvation Army Harbor Light Center — 42 McLea Court, 415-503-3072. Residential recovery program with daytime and evening hours.
- San Francisco AIDS Foundation Syringe Access Services — Free naloxone, fentanyl test strips, and harm reduction supplies. Multiple locations across the city.
- Dore Urgent Care — 52 Dore Street, 415-553-3100. 24/7 urgent care for people experiencing mental health and substance use challenges.
Harm Reduction
- Drug Overdose Prevention and Education (DOPE) Project — The largest single-city naloxone distribution program in the United States, operated by the National Harm Reduction Coalition with SFDPH funding. Free naloxone training and supplies through partner sites across the city.
- Soma RISE — 1076 Howard Street, 650-781-6720. 24/7 sobering and stabilization center.
- Alcohol Sobering Center — 1185 Mission Street, 415-734-4227. Drop-in alcohol sobering services.
Veterans and Military
- San Francisco VA Medical Center — 4150 Clement Street, 415-221-4810. Inpatient, outpatient, and residential substance use disorder treatment, plus a Harm Reduction and Syringe Services Program with free naloxone vending machines on site.
- San Francisco Vet Center — 415-441-5051. Confidential counseling for veterans, service members, and their families, including services for those not enrolled in VA health care.
- Veterans Crisis Line — Dial 988 and press 1, or text 838255. 24/7 confidential support.
Government and Medi-Cal
- California Department of Health Care Services (DHCS) — Administers Medi-Cal and the Drug Medi-Cal Organized Delivery System. Apply for Medi-Cal at BenefitsCal.com or in person at the San Francisco Human Services Agency, 1235 Mission Street.
- San Francisco Health Plan — 415-547-7800. Local Medi-Cal managed care plan serving San Francisco residents.
- SAMHSA Findtreatment.gov — National searchable directory of licensed and accredited treatment facilities.
Drug and Alcohol Use Statistics in San Francisco
San Francisco’s overdose crisis is the central public health story shaping the city’s treatment system. After three years of climbing fatal overdoses culminating in a record 810 deaths in 2023, the city saw a sharp reversal in 2024 as expanded medication-assisted treatment, naloxone distribution, and residential admissions began to compound.
The overdose decline tracks with parallel growth in opioid use disorder treatment engagement. SFDPH reported a 32 percent increase in methadone treatment admissions and a 48 percent increase in new clients receiving buprenorphine in the first seven months of 2024 compared to the same period in 2023. The city also became the first in California to offer on-demand telehealth buprenorphine prescriptions through its Nighttime Telehealth Program, which has facilitated more than 1,650 telehealth visits and started approximately 40 percent of clients on medication treatment since launching in March 2024. National context for these figures is available through aggregated substance use statistics.
Resources
- San Francisco Office of the Chief Medical Examiner. (2025). Accidental Overdose Death Reports. sf.gov.
- San Francisco Department of Public Health. (2024). Overdose Prevention Plan 2024. sf.gov.
- San Francisco Department of Public Health. (2024). San Francisco Has Continued Decline in Fatal Overdoses, Expands On-Demand Treatment Program for People Who Use Fentanyl. sf.gov.
- San Francisco Department of Public Health. (2024). DPH Annual Report, Fiscal Year 2023-24. sf.gov.
- San Francisco Department of Public Health. (2025). Behavioral Health Access Center. sf.gov.
- San Francisco Department of Public Health. (2025). Care and Treatment Services for Addiction to Drugs and Alcohol. sf.gov.
- California Department of Health Care Services. (2025). Drug Medi-Cal Organized Delivery System. dhcs.ca.gov.
- U.S. Department of Veterans Affairs. (2025). San Francisco VA Health Care System: Mental Health and Substance Use Services. va.gov.
- National Harm Reduction Coalition. (2025). DOPE Project. harmreduction.org.
- United Way Bay Area. (2025). 211 Bay Area. 211bayarea.org.
- Substance Abuse and Mental Health Services Administration. (2025). National Helpline and FindTreatment.gov.
- San Francisco Examiner. (2024). SF Drug-Overdose Deaths Well Off Record-Setting 2023 Pace. sfexaminer.com.
