When Nicole Cannizzaro told Univision she’s worked “extensively” on fentanyl, she left out a second piece of her own record — not just the threshold that rose on her watch as Senate leader, but the timing of it against everything else Nevada was doing to the drug supply at the same moment.
Nevada Was Already Squeezing the Legal Side
Years before the 2019 trafficking bill passed through her chamber, Nevada lawmakers had been tightening the legal opioid supply.
SB 459, passed in 2015, required doctors to check the state’s prescription monitoring database before writing new controlled-substance prescriptions.
AB 474, passed in 2017, added further prescribing mandates on top of that.
Opioid prescriptions in Clark County fell steadily as a result. By one measure, a 20 percent drop between late 2015 and the end of 2017, and a further 22.5 percent drop after AB 474 took effect.
(Source: [Price, Fagan, Hardy “Investigating the Relationship Between Nevada’s Restrictive Opioid Prescription Laws and Deaths From Illicit Opioids,” NDA Journal, Spring 2020])
Researchers at Touro University tracked what happened to overdose deaths over that same window.
Fentanyl deaths in Clark County rose from 27 a year in 2016 to 51 a year in 2018, a 1.8-times increase, even as legal prescriptions kept falling. A follow-up study found a statistically significant rise in combined heroin and fentanyl deaths after AB 474 took effect.
“Outcomes of Nevada’s Controlled Substance Laws: CS Prescribing is Down, CS Deaths are Up”
NDA Journal Winter 20-21WEB NV Rx Law, Death
The pattern researchers flagged: as the legal pipeline narrowed, people in pain or already dependent didn’t stop needing the drug. They moved to the illicit market instead, and increasingly, what’s on that illicit market now is fentanyl.
Then the Other Hand Loosened Trafficking Rules
In 2019, the same year illicit fentanyl deaths were climbing on the back of the prescription crackdown, Cannizzaro moved a bill through her chamber that raised the low-level trafficking threshold for fentanyl from 4 grams to 100 grams on a 19-2 Senate vote.
Two milligrams is enough to kill someone. A hundred grams is enough to kill tens of thousands.
Read our prior coverage:
Nevada AG Nominee Cannizzaro’s Fentanyl Fib
Put the two policies next to each other, and the state’s position doesn’t hold together.
Nevada spent the mid-2010s making it harder for patients to get opioids from a doctor, on the theory that prescriptions were feeding the crisis. Then, just as the data started showing people were substituting fentanyl for those lost prescriptions, the Legislature made it easier for someone to carry a lethal, bulk-level supply of that same drug without facing a trafficking charge.
One hand tightened the tap on the legal supply. The other loosened the penalty on the illegal one, at the exact moment the illegal one was picking up the slack.
A Loophole Nevada Was Warned About in Writing
There’s a piece of Nevada’s prescribing law that got almost no attention when it passed, and it points straight at another way the legal-to-illicit pipeline this piece has traced can operate.
AB 474, the 2017 law that tightened prescribing rules for human patients, specifically defined its restrictions to exclude veterinarians. Animal patients weren’t covered.
Dr. Daniel L. Orr II, a UNLV School of Dental Medicine professor emeritus and oral and maxillofacial surgeon, flagged the problem in print the year the law took effect.
Writing in the Nevada Dental Association Journal in 2018, Orr noted the exemption and asked, pointedly, “what is to prevent an owner that desires CS from kicking the dog” and then booking a vet visit — before adding, sarcastically, that surely no one would ever do that.
(Source: [Orr, “A Bad Rx: AB 474, Nevada’s Star Chamber Solution to a Fake News Problem,” NDA Journal Summer18 ])
It wasn’t a rhetorical stretch.
A 2018 survey of 189 Colorado veterinarians, published in the American Journal of Public Health, found 13 percent had suspected a client of injuring or sickening a pet on purpose to obtain opioids, and 44 percent knew of a client or staff member misusing an animal’s prescription.
The FDA has warned clinics to watch for it. At least 15 states now run prescription-monitoring checks on pet owners the same way they do on human patients.
Nevada is not one of them.
Orr says he’s concerned about the lack of coverage surrounding what he calls “the explosion of animal abuse in order to get opiates from veterinarians.”
It’s a concern he flagged as a possibility in 2018, when AB 474 tightened prescribing rules for humans but left veterinarians and their patients outside the law entirely, and one he says has only grown since.
Nobody has published Nevada-specific numbers on how often it happens, but it’s the result of the same mechanism driving every other figure in this piece: narrow one legal channel for a drug, and the people who depended on it find another one.
The Fix Nobody Finished
The trafficking threshold came down to 28 grams in 2023, through a bill from the Attorney General’s office that Governor Joe Lombardo signed into law, though even that was a retreat from where the bill started, after opposition from harm-reduction advocates and some Democrats narrowed it.
Cannizzaro’s own bill that session, SB 343, actually proposed a lower threshold than what passed.
The clearer partisan break came in 2025, when Lombardo pushed to bring the threshold down to 4 grams, and Cannizzaro’s chamber didn’t give that bill a hearing.
- Before 2019: 4 grams
- 2019 (Judiciary Committee Bill AB 236, cleared 19-2 in Cannizzaro’s Chamber): 100 grams
- 2023 (Attorney General Bill SB 35, signed by Lombardo) 28 grams
- 2025 (Lombardo’s proposal, not heard ) would have gone back to 4 grams
So the record, in plain terms: Nevada tightened the legal opioid supply starting in 2015, illicit fentanyl deaths rose as people moved to the black market, and in 2019 the Legislature, Cannizzaro led in the Senate, made trafficking a 25-times-larger amount of that same drug before triggering a low-level charge.
It took until 2023 for the legislature to bring that number down partway, and a 2025 proposal matching her own 2023 position still hasn’t gotten a hearing in the chamber she runs.
That’s not “extensively” working the fentanyl crisis. That’s presiding over the legal and illegal sides of the same drug problem moving in opposite directions for four years, and not correcting the imbalance even when a matching fix was sitting in front of her own chamber.
Where the Numbers Stand Now
The trend lines haven’t turned around.
Nevada’s overdose deaths rose from 1,442 in 2023 to 1,492 in 2024, according to CDC provisional data — making Nevada one of only two states in the country, along with South Dakota, to see an increase that year while the rest of the nation posted the sharpest one-year decline on record.
In 2025, Nevada’s overdose deaths dropped only about 2 percent, compared to a 14 percent decline nationally. The state isn’t losing ground anymore, but it isn’t catching up either.
The fentanyl-specific numbers out of Clark County are sharper.
Fentanyl-involved deaths there rose from 371 in 2023 to 448 in 2024, according to the Southern Nevada Health District — a jump even as the state’s overall overdose count barely moved.
Methamphetamine deaths climbed at nearly the same rate over that stretch, a reminder that fentanyl rarely shows up alone anymore; it’s increasingly cut into other drugs users don’t realize they’re taking.
Why Univision, Specifically
Cannizzaro didn’t make her “extensively” claim on just any outlet. She made it on Univision, a Spanish-language network — and the timing of that choice is worth a closer look.
A federal report on Nevada specifically, published by the CDC’s Morbidity and Mortality Weekly Report, found that overdose deaths among Hispanic and Latino Nevadans jumped 119.7 percent from 2019 to 2020, more than double the 54.5 percent increase across the rest of the state that same year.
It was a large enough spike that the CDC dedicated a standalone report to Nevada by name.
That 2019-2020 window is not incidental. It’s the same year AB 236 raised the trafficking threshold to 100 grams.
Put plainly: in the same year Cannizzaro’s own Legislature loosened the trafficking penalty, the community she chose to speak to on Univision was the one the CDC found had just been hit by the sharpest, most sudden overdose spike of any group in the state.
What’s Next
Fentanyl penalties are expected back in front of lawmakers when they return to Carson City in 2027.
The next Attorney General will have real influence over whether that fix finally happens, and Republican nominee Adriana Guzmán Fralick is making the case that voters should pick the person trying to solve the problem over the one who helped create it.
In August, Republican nominee Adriana Guzmán Fralick said:
“Nicole Cannizzaro had the opportunity to fight for the public safety of Nevadans, and she did the opposite. Instead, she stood with Aaron Ford and their soft-on-crime agenda that has cost Nevada families dearly. Now that she’s running for Attorney General, she wants voters to forget that record? Nevadans know better.”
That’s the choice voters are actually being asked to make in November, not who talks about the fentanyl crisis, but who owns a piece of how it got this bad.
Read Part One of this series: The Cannizzaro Files, Part One: A Career Without Clear Lines
The opinions expressed by contributors are their own and do not necessarily represent the views of Nevada News & Views. This article was written with the assistance of AI.
