The Haight Ashbury Free Clinics’ Drug Detox section opened in 1969 at 529 Clayton as the speed epidemic shifted to downers like barbiturates and heroin. Led by Dr. George “Skip” Gay, it evolved from the Medical section at 558 Clayton and later inspired the Clinics’ Rock Medicine program.

At the time, detox had to occur in hospitals, but Dr David Smith and Don Wesson developed an outpatient detox method using phenobarbital at UC San Francisco. This reduced costs and increased patient capacity. Darryl Inaba and UCSF’s clinical pharmacy staff later introduced non-narcotic medications alongside counseling. Group therapy became central, serving up to 100 patients daily during the 1970 heroin epidemic.

Though the 1915 Harrison Narcotic Act made community-based addiction treatment illegal, enforcement was lax in the Haight due to the crisis. Elsewhere in California, doctors were arrested for using similar detox methods, spurring the creation of the California Society of Addiction Medicine. This led to the formation of the American Society of Addiction Medicine and the eventual recognition of Addiction Medicine as a board-certified specialty.