SFFD paramedics responded to the 24th and Mission BART plaza Monday around 5:30 p.m. after four individuals simultaneously suffered from fentanyl overdoses.

Reportedly there was a bystander — or a trained crisis response team person? — who was able to administer Narcan to all four before paramedics go there, and they all survived and were taken to the hospital for treatment. Mission Local didn't identify the "fast-acting bystander," but said that the paramedics restocked the person's supply of Narcan before they left.

The overdoses apparently occurred in Osage Alley, adjacent to the BART plaza.

As the Chronicle reports, this is just the latest incident to highlight the open-air drug market that has proliferated in this part of the Mission — perhaps as a side effect of the mayor and DA's crackdown on drug users and dealers in the Tenderloin.

Supervisor Hillary Ronen points to the illegal vendor bazaar that had been occurring at the 24th Street plaza in recent months, and her efforts to tame it.

"Chaos brings more chaos,” Ronen tells the Chronicle. "[The illegal vending] on the streets created more cover and a feeling that complete and utter lawlessness was allowed."

As SFist has reported, the free-for-all marketplace is a bit quieter these days after several efforts to crack down and enforce permitting rules, but not entirely gone — and just a couple weeks ago passersby reported seeing someone selling unrefrigerated steaks for $5 each off the sidewalk.

A July attempt to fence off the entire plaza in order keep the vendors away only succeeded in overcrowding whatever unfenced sidewalk remained — and those fences were ripped down by protesters the following month.

After the overdoses, Ronen now points the finger at the city's Department of Public Health and the mayor, saying to the Chronicle, "My immediate response is that I don’t see enough presence of [the health department] in the area of the 24th and Mission Street corridor" despite the "rampant" drug use happening there.

She also mentions the city's ambassador program, which sends teams out daily on the streets of the Tenderloin to address quality-of-life issues like open drug use.

"There are of tons of [those ambassadors] in the Tenderloin, and I very much suspect that a lot of the activity has been moved to the Mission District," Ronen says.

Ronen has been ringing this alarm for a while, and longtime residents of the Mission District seem to agree that things have gotten more chaotic in the neighborhood since the Tenderloin crackdown began.

Something in the system — the availability of Narcan at least — is working to prevent overdose deaths. The city has a plan to distribute 100,000 doses of the overdose-reversing drug in 2023, in order to try to address the overdose crisis. A total of 625 people died of overdoses in San Francisco last year, largely due to fentanyl, but hundreds more were saved because of Narcan.

Related: Smattering of Illegal Vending Slowly Returning to 24th and Mission — Including $5 Steaks?

Photo: Joe Kukura/SFist