A Conversation with Phillip O. Coffin, MD

Issue: November 2015

In this issue, HCV Next asks five questions of Phillip O. Coffin, MD, director of substance use research at the San Francisco Department of Public Health and assistant professor in the division of HIV/AIDS at the University of California, San Francisco.

Coffin completed a graduate degree in international affairs at Columbia University before moving on to study medicine at the University of California, San Francisco. From there it was back to Columbia for a residency in internal medicine, and then to infectious diseases training at the University of Washington in Seattle.

Phillip O. Coffin

HIV and other sequelae or substance use comprise Coffin’s main areas of interest, but he has done extensive work in screening patients with HCV and linking them to care. In the clinic, he deals with HIV, viral hepatitis and other infectious diseases, as well as substance use disorders. Beyond the clinic, he has a robust research program studying pharmacotherapies for substance use and HIV risk behaviors, interventions to reduce opioid overdose and strategies for HCV elimination.

What are your hobbies outside of practicing medicine?

Kiteboarding is my favorite activity in the rare moments I can do it, but I spend most of my time with my amazing family.

Who has had the greatest influence on your career?

My mentors are too many to list. My parents would have put the planet on their shoulders to ensure I got educated, although they never anticipated decades of post-secondary education. My mentor and friend, Steve Jones, has been particularly important.

What was the defining moment that led you to your field?

The first class I walked into as an undergraduate was called “Drugs and Society.” I remember the moment so well because I had left the cafeteria with a bunch of bananas in my backpack that, by the time I walked into class, were squished into all of my course books. The professor, a Swiss sociologist, started talking about the HIV epidemic among injectors in the setting of strict needle and syringe laws and no syringe access services. That 90 minutes drove my entire career, from international development work for drug user services to epidemiology and finally to medicine.

What area of research in hepatology most interests you right now and why?

Hepatitis C, because we are moving toward elimination in our thinking. Someday I hope we speak of HCV in the same proud sentence we use when we refer to smallpox eradication.

Have you ever been fortunate enough to witness or to been part of medical history in the making? If so, please explain.

Twenty years ago opioid overdose was thought of as an inevitable consequence of opioid (mis)use. A group of us worked on this issue and now we have prevention interventions that have demonstrated real benefits and, for many communities, opioid overdose death is seen to be just as preventable as a motor vehicle accident. This took decades of commitment, but in the end is a quite radical shift in thinking.