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Background: Fueled by misinformation, fentanyl panic has harmed public health through complicating overdose rescue while rationalizing hyper-punitive criminal laws, wasteful expenditures, and proposals to curtail vital access to pain pharmacotherapy. To assess misinformation about health risk from casual contact with fentanyl, we characterize its diffusion and excess visibility in mainstream and social media., Methods: We used Media Cloud to compile and characterize mainstream and social media content published between January 2015 and September 2019 on overdose risk from casual fentanyl exposure., Results: Relevant content appeared in 551 news articles spanning 48 states. Misinformed media reports received approximately 450,000 Facebook shares, potentially reaching nearly 70,000,000 users from 2015-2019. Amplified by erroneous government statements, misinformation received excess social media visibility by a factor of 15 compared to corrective content, which garnered fewer than 30,000 shares with potential reach of 4,600,000 Facebook users., Conclusion: Health-related misinformation continues to proliferate online, hampering responses to public health crises. More evidence-informed tools are needed to effectively challenge misinformed narratives in mainstream and social media., Competing Interests: Declarations of Interests The authors have no conflicts of interests to declare., (Copyright © 2020. Published by Elsevier B.V.)