Substance use is a serious concern in Nevada, one of the few states where overdose deaths are still rising even as the national rate falls. Key figures:

• Nevada was one of only six states where overdose deaths rose in 2023, according to the CDC.
• Overdose deaths increased 26-29% in 2023, even as the national rate fell, per NPR Nevada.
• Fentanyl plus meth or cocaine combination deaths rose 97% from 2020 to 2023.
• Fentanyl deaths increased 20-fold since 1999.
• Methamphetamine deaths increased 18-fold since 1999.
• Fentanyl is increasingly cut into other drugs in the local supply.

Nevada is an outlier. While overdose deaths fell nationally in 2023, Nevada’s rose sharply, driven by fentanyl and its combination with methamphetamine and cocaine, a polysubstance trend that has made the crisis harder to reverse.

Nevada expanded Medicaid in 2014 under the Affordable Care Act, and Medicaid enrollment nearly doubled as a result. The state’s Division of Public and Behavioral Health oversees substance use treatment. Of the 83 facilities listed below, 69 accept Medicaid.