This needs assessment provides a summary of the available information on trends, gaps, and needs pertaining to opioid use in Clark County, Nevada. In presenting the available information, this needs assessment uses both quantitative and qualitative data to determine the risk factors that contribute to opioid use, the use of substances, and the rates of opioid use disorder, other substance use disorders, and co-occurring disorders among residents of the area. Additionally, it provides recommendations and proposes action plans for the allocation of opioid litigation funds to ameliorate harms of opioid use. As this is a joint assessment, both Clark County and the Southern Nevada Health District present their own action plans.