Authorities were summoned to an apartment Saturday morning in the 3400 block of 19th and Mission streets where they found two men and a woman dead inside.
Police and fire crews briefed Supervisor Hillary Ronen who and said it appears four friends may have purchased cocaine, not knowing it was laced with fentanyl, a powerful opiate. Only one of those friends survived.
"They all passed out and three of them never woke up again and it is devastating," said Ronen. "They were in their 30s, had their whole lives in front of them, and probably didn't know there was fentanyl there."
The latest data from the city shows overdose deaths are trending downward, with 46 accidental overdoses in January of this year compared with 65 last January.
Dr. David Smith founded the Haight Ashbury Free Clinic and is the medical director for the Avery Lane treatment program. He said mixing a stimulant like cocaine with an opiate, or "speedballing," can be a dangerous mix. But he said many drug users may not even know they're mixing.
He said they've run tests which show more than 60% of the time the drugs people purchase are not what they expect.
"So, when you'd buy methamphetamine it'd contain fentanyl. When you'd buy cocaine it'd contain fentanyl," said Smith. "I don't know that they know they were speedballing, or whether it was laced with fentanyl. But it's very serious."
Smith said fentanyl is relatively cheap and available. But it can also be deadly, especially for those who have not built up a tolerance.
For her part, Ronen says she is working to overhaul how the city handles the addiction crisis, including making sure more beds are available for those seeking treatment, and that harm reduction measures are more easily obtainable.
"Handing out Narcan, handing out the test strips so that people can test drugs before they ingest them to make sure that there's no fentanyl in them," said Ronen. "Because you really don't know at this point."
Investigators have not determined for certain if fentanyl was involved. It will take a toxicology test to confirm one way or the other.
The toxicology test results have not yet been made available.