The United States has been grappling with the effects of an “opioid crisis” that has been escalating the past 2 decades, and while several strategies have been implemented to regain control, we have witnessed an even greater unraveling in the past 5 years. A recent surge in opioid overdose rates is driven primarily by fentanyl analogues, not prescribed opioids. The media, politicians, and even professional anti-opioid advocacy groups continue to muddy the waters with propaganda and deception. These fentanyl overdoses rarely involve pharmaceutical fentanyl. It’s the illegally manufactured and chemically manipulated analogues of fentanyl that have allowed its opioid agonism potency to become unmatched, even compared to fentanyl itself. This presentation will describe this rise in the fentalogues responsible for overdoses, from both a community and celebrity perspective. We also seek to debunk common myths and mischaracterizations about pharmaceutical fentanyl’s involvement in these overdoses and will highlight the flawed motivation by advocacy groups to lobby against novel fentanyl-based FDA approvals such as sublingual sufentanil. A science-based overview of physiochemical, pharmacodynamic, and pharmacokinetic differences among common fentanyl analogues and pharmaceutical fentanyl products will be unraveled. Finally, we will detail the difficulty in reversing these types of overdoses, including the need for high-dose naloxone products.