"Illicit fentanyl and its analogs are the most substantial synthetic opioid threat that North America faces, and there is no indication that the threat will decrease in the near future. Illicit fentanyl is a synthetic opioid that is, at a minimum, 50 to 100 times stronger than morphine and responsible for the exponential increase in overdoses and overdose deaths in recent years. Illicit fentanyl and its analogs are being mixed with drugs such as cocaine and heroin and have been found disguised in counterfeit prescription pills. Data suggest that many drug users are unaware of the illicit fentanyl in the drugs they consume. The illicit fentanyl threat affects communities nationwide by depleting public health, public safety, and financial resources. This thesis seeks to present the illicit fentanyl crisis by providing its history and describing the manufacturing, trafficking, and distribution of illicit fentanyl and the effects it has on communities and community resources. Illicit fentanyl and its analogs have become an epidemic in North America that continues to spread like an infection. Policy must be implemented and success measured to prevent the infection from becoming a terminal illness."