SAN FRANCISCOMEDICINE - California Society of Addiction ...

In Memoriam
are for stable methadone clients that operate in neighborhoods
that are not close to narcotic treatment program sites (NTP). Services
from these vans are now covered by Drug Medi-Cal.
The IBIS program, a city-wide buprenorphine treatment
program, integrates buprenorphine (Suboxone) treatment with
patients’ primary care, mental health, or “drug-free” substanceuse
treatment. More than fifteen DPH community-based sites
participate in IBIS. To support IBIS providers, the City created
the first buprenorphine induction clinic in the country. OBOT allows
physicians at COPC clinics to order methadone for selected,
stable methadone clients who can get their methadone at specially
licensed pharmacies. OBOT clients no longer need to go to their
regular NTP, allowing that treatment site to open methadone
slots to new clients who would not have been served otherwise.
Again, use of buprenorphine has allowed clients in regular COPC
and mental health outpatient programs to receive opiate replacement
care and operate their lives in ways that might be difficult
to do when tied to a traditional methadone program (given work
schedules and the need to access primary care and so on).
To better meet the needs of alcohol-dependent individuals,
DPH has collaborated with community providers to create
several innovative services, including the City’s residential
medication-assisted detoxification program and Sobering Center.
The detoxification program provides 24/7 medical coverage to
patients who are likely to develop significant alcohol withdrawal
symptoms if unmedicated. Sites and programs across the City,
including emergency departments, primary care and mental
health clinics, and BHAC, have access to these beds. The Sobering
Center provides a respite for alcohol-dependent individuals who
are acutely intoxicated and serves as a launching pad for access
to ongoing treatment.
As dual diagnosis is the rule and not the exception, the integration
of substance-use and mental health services has become
a primary DPH focus. All substance-use and mental health programs
are expected to provide dual-treatment services to their
patients. Several outpatient and residential treatment programs
are specifically set up to provide intensive dual-diagnosis treatment.
Further integration with COPC over the coming year will
expand treatment access.
CBHS monitors outcomes with data collected on all clients
through the CalOHMS state system as well as other outcomes
data. An evaluation of all the substance abuse services is currently
underway to help determine what works best for San Francisco
residents and what service needs might still need to be addressed.
Since the majority of funding for public substance-abuse programs
is dependent on City general funding, the current financial crisis
facing the City of San Francisco could impact services in the coming
years.
Dr. Robert Cabaj is director of San Francisco Community Behavioral
Health Services, and Dr. David Hersh is medical director of
CBHS Opiate Replacement Services in the San Francisco Department
of Public Health.
Nancy Thomson, MD
Byron Cone Pevehouse, MD
Byron Cone Pevehouse was born in Lubbock, Texas, on April 5,
1927. He died at age 83 on April 16 in Bellevue, Washington.
After serving for twenty-two months in the U.S. Naval Hospital
Corps during World War II, he received his MD from Baylor Medical
School in 1952. He took his neurosurgery residency at UCSF from
1954 to 1958.
Dr. Pevehouse was an honorary member of the SFMS—an honor
given to him for his contribution to the fields of neuroscience and neurosurgery.
He served as the chief of neurosurgical services for UCSF at
San Francisco General Hospital and as chief of pediatric seurosurgery
at the U.C. Medical Center for many years, being promoted to clinical
professor in 1978. In 1967, he was appointed chairman of the Department
of Neurological Surgery at University of the Pacific-Presbyterian
Medical Center, serving in this position for twenty-three years. He also
served in many professional organizations including the San Francisco
Neurological Society (president, 1973), American Association of Neurological
Surgeons (president, 1984), and the Society of Neurological
Surgeons (president, 1987), as well as the SFMS.
He retired from active practice in 1990 and was appointed by President
George Bush as a senior consultant and member of the National
Committee of Vital and Health Statistics, advisory to the Department
of Health and Human Services (1991–1995). He received the Harvey
Cushing Medal in 1994 from the American Association of Neurological
Surgeons (AANS), the Distinguished Service Award from the California
Association of Neurological Surgeons in 1991, and the same award from
the AANS in 1998. In 1997 he was elected a distinguished alumnus by
Baylor College of Medicine.
Dr. Pevehouse married Maxine Elizabeth Smith in 1951, and they
had three daughters. Maxine died in an accident in 1978. He married
Lucy Seguin Beck, a Houston attorney, in 1981.
He is survived by his sister, Nona Burgamy of Lubbock,
Texas; his second wife, Lucy Beck Pevehouse; his daughters De
Ann Freitag (Erik) of Alameda, California, Carol Palato (Paul) of
Lake Balboa, California, and Lesa Howell (Rick) of Vancouver,
Washington; nine grandchildren, and one great-granddaughter.
Beloved husband, father, and grandfather, he enjoyed photography,
fishing, skiing, and tennis. Honoring his request, only a family memorial
ceremony was held.
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38 39 San Francisco Medicine June 2010 www.sfms.org