Primary Care Addiction Medicine Program

DGIM PCAM Clinic

1545 Divisadero 1st and 2nd Floors
1600 Divisadero 2nd Floor

 

Who is Eligible?

• Any patient with a UCSF Health primary care clinician needing addiction consultative services (we only provide addiction support not primary care: for insurance reasons, PCAM needs a referral from UCSF Primary care clinician

  • External Referrals ok we accept PPO insurance, Straight Medicare, Medi-cal (not SFHP)

 

How to Refer

• DGIM PCAM Clinic (for video or in person assessment): "Ambulatory referral to Internal Medicine & Subspecialties aka DGIM" Px Code REF40
• eConsult for curbside questions: eConsult to Adult Addiction Medicine", Px Code ECO177 

 

Referral Snapshot

 

Indications for Referral

• For patients with a substance use disorder (opioid, benzodiazepine, alcohol, stimulant etc, just not tobacco) we confirm the diagnosis and offer relevant treatment (often primarily medications, some behavioral approaches
• For patients initiated on buprenorphine for opioid use disorder, once stabilized we transition patients back to primary care clinician to continue buprenorphine prescribing 
• For patients with primarily a tobacco use disorder, please refer to the Fontana Treatment Center

PCAM Clinics

• Monday AM/PM
• Tuesday PM
• Thursday PM

3rd Next Available Appointment

• In person – 75 days 
• Telehealth- 35 days  
   

What to expect at first visit

• During the first PCAM visit, you can expect to speak with a clinician trained in working with people who use alcohol and/or other substances such as opiates/opioids, stimulants like methamphetamine, or weed/cannabis
• This clinician will ask questions about the substances you may use, your relationship to the substances, what role they play in your life, and if you're having any trouble or difficulty managing use. With your input, we can help determine if there is a substance use disorder or addiction to that substance present, (i.e. substance use despite health or life problems)
• Based on this assessment conversation, we can discuss what changes you'd like to make and how we can support you - whether that's scheduling a follow up appointment to check back in on your goals or discuss medication treatment options if you have a substance use disorder or addiction present
• We may not have time to talk about each and every thing that is causing difficulties in your life, we would encourage you to prioritize at the first visit the two most important things (for example, alcohol and cocaine or tobacco and fentanyl) that you want to discuss with your clinician

 

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PCAM Provider Profiles

Era Kryzhanovskaya, MD	Dr. Irina (Era) Kryzhanovskaya is an Associate Professor of Clinical Medicine at UCSF in the Division of General Internal Medicine and the Associate Program Director of the UCSF Primary Care internal medicine residency track (UCPC) at Mt. Zion. As a clinician-educator in the Academy of Medical Educators at UCSF, Dr. Kryzhanovskaya is passionate about providing learning opportunities for all health professions learners and taking the best care possible of patients across the care continuum, especially those in primary care and those living with chronic medical conditions like substance use disorder (SUD). In 2018, Dr. Kryzhanovskaya founded DGIM's first addiction clinic primarily providing buprenorphine treatment for opioid use disorder and currently is the co-medical director for PCAM, the formal embedded primary care addiction medicine clinic in DGIM, with 5 full-time clinicians serving not only the 27,000 patients at DGIM but also the broader UCSF Primary Care Services patient population. She is the CSRC co-director, helping clinicians at DGIM with an educational opportunity to discuss complex management cases for patients on controlled substances and receive interprofessional care recommendations. Dr. Kryzhanovskaya also supervises trainees, NPs, patient navigators, and LCSW's as the inpatient attending on the Addiction Care Team (ACT) at the Zuckerberg San Francisco General Hospital.  She co-created and contributes to creating new content for an electronic curriculum on mental health and addiction medicine (PsychSnaps.com) with her general medicine and psychiatry colleagues which offers biweekly, free, case-based clinical nuggets via email newsletter. In addition to seeing patients for primary care and SUD, teaching learners at various developmental levels, and providing educational and clinical service to her local community, Dr. Kryzhanovskaya is the co-host for the popular podcast, Curbsiders Teach, a medical education spin-off of the parent podcast Curbsiders Internal Medicine, in its 5th season as of summer 2025. She also contributes to production of Curbsiders Addiction Medicine and Curbsiders Internal Medicine podcast episodes.
Caroline Nguyen, MD	Dr. Caroline Nguyen is an internal medicine primary care physician who also provides addiction care. She earned her medical degree from the University of Colorado School of Medicine and completed internal medicine residency at UCSF. She then completed and adolescent medicine fellowship where she focused on caring for teens and young adults with substance use disorders. Dr. Caroline Nguyen enjoys caring for adults of all ages with substance use disorders with an added focus on young adults.
Jessica Ristau, MD	Dr. Jessica (Jesse) Ristau is board certified in Internal Medicine and Addiction Medicine, and practices both primary care and addiction medicine. She serves as the co-medical director of the Primary Care Addiction Medicine (PCAM) clinic and completed her fellowship training at UCSF. Dr. Ristau is a consultant for the National Clinician Consultation Center’s Substance Use Warmline and is deeply involved in medical education as the founder and co-chair of the UCSF Addiction Medicine CME Conference and serves on the planning committee for the California Society of Addiction Medicine (CSAM). Dr. Ristau is passionate about delivering patient-centered, evidence-based care to individuals affected by substance use disorders.
Sienna Kurland, MD	Dr. Sienna Kurland is an internal medicine specialist who provides primary care and addiction medicine care to adults.   Dr. Kurland earned her medical degree and a master of public health degree at Tulane University School of Medicine. She completed a residency in internal medicine at New York University Grossman School of Medicine, where she also served as chief resident. Since joining UCSF in 2022, she has expanded her practice and expertise to caring for patients with substance use disorders. She enjoys meeting folks in different stages of change and partnering with them to meet their goals.   In addition to caring for her patients, Kurland enjoys teaching and supervising residents at UCSF.
Devin Oller, MD	Dr. Devin Oller is an Associate Professor of Clinical Medicine at UCSF in the Division of General Internal Medicine. He completed his residency in Internal Medicine at Massachusetts General Hospital, where he also served as chief resident and as fellow in Rural Health Leadership. As a primary care and addiction medicine physician, Dr Oller is dedicated to caring for patients living with complex chronic diseases and addiction. Prior to joining UCSF, Dr Oller served as the primary care residency director at the University of Kentucky, and helped establish the first inpatient addiction medicine consultation service in the state. Dr Oller was a treatment team lead and co-investigator of the large NIH-funded Healing Communities Study in Kentucky, exploring community-based interventions to address the opioid epidemic. He also directed the Kentucky Opioid Overdose Prevention and Education Network (KY-OPEN), leading trainings of clinicians and staff across the state on addiction medicine best practices. Dr Oller has led several workshops and presented his research at regional and national internal medicine and addiction medicine conferences.
Sheree Hicks	Ambulatory Unit Manager, administrative leadership liaison for PCAM
Tangie Van	Administrative coordinator, scheduling for PCAM