The purpose of this needs assessment is to present available information on trends, gaps, and needs pertaining to opioid use in Washoe County to provide recommendations and propose an action plan for the allocation of opioid litigation funds to ameliorate harms of opioid use. The 2021 Nevada Legislature passed Senate Bill 390 (SB390), an act relating to behavioral health; providing for the establishment of a suicide prevention and crisis hotline; establishment of the Fund for a Resilient Nevada; and establishing guidance for state, local, or tribal governmental entities to address the impact of opioid use disorder and other substance use disorders. SB390 is one of many efforts in Nevada to address the opioid crisis which is responsible for many of the over 107,000 overdose and drug poisoning deaths in the United States in 20211 .