The new Nevada drug laws that took effect out of the 2023 legislative session reshape three areas at once: possessing 28 grams or more of illicitly manufactured fentanyl is now a standalone trafficking felony, cannabis DUI charges for first and second offenses require proof of actual impairment rather than a blood-test number, and the state has launched a formal study of psychedelic-assisted therapy. Older protections — overdose immunity and mandatory diversion for first-time possession — remain in place and matter more than ever given the fentanyl changes.
Fentanyl Trafficking Starts at 28 Grams
Senate Bill 35 created NRS 453.3387, a statute written specifically for illicitly manufactured fentanyl rather than pharmaceutical fentanyl prescribed by a doctor. It reaches anyone who sells, manufactures, delivers, or simply possesses street fentanyl, any fentanyl derivative, or any mixture containing illicit fentanyl once the weight hits the threshold.1Nevada Legislature. Nevada Code 453 – Controlled Substances
The penalties come in two tiers:
- 28 to 42 grams is trafficking — a Category B felony punishable by one to ten years in prison.1Nevada Legislature. Nevada Code 453 – Controlled Substances
- 42 to 100 grams is high-level trafficking — a Category B felony punishable by two to fifteen years.1Nevada Legislature. Nevada Code 453 – Controlled Substances
Mere possession at those weights is enough. Prosecutors do not have to prove you intended to sell; the quantity itself supports the trafficking charge. Above 100 grams, the general high-level trafficking provisions of chapter 453 apply with steeper penalties still.2Nevada Legislature. Senate Bill 35 – 82nd Session
Possession Below the Trafficking Threshold
Most drug cases fall under the general possession statute, NRS 453.336, which applies to all Schedule I and II substances. Penalties scale with weight and criminal history.
- Under 14 grams, first or second offense: Category E felony. The court must defer judgment if you consent, which can lead to dismissal after completion of conditions such as treatment.1Nevada Legislature. Nevada Code 453 – Controlled Substances
- Under 14 grams, third or later offense: Category D felony with a possible fine up to $20,000.1Nevada Legislature. Nevada Code 453 – Controlled Substances
- 14 to 28 grams: Category C felony, low-level possession.1Nevada Legislature. Nevada Code 453 – Controlled Substances
- 28 to 42 grams: Category B felony, one to ten years in prison and a fine up to $50,000.1Nevada Legislature. Nevada Code 453 – Controlled Substances
- 42 to 100 grams: Category B felony, two to fifteen years and a fine up to $50,000.1Nevada Legislature. Nevada Code 453 – Controlled Substances
Someone caught with 30 grams of illicit fentanyl could face charges under both the fentanyl trafficking statute and the general mid-level possession statute. The fentanyl-specific statute exists so prosecutors can emphasize the drug’s lethality in court.
Cannabis DUI Now Requires Proof of Impairment
Assembly Bill 400, in effect since July 2021, changed how Nevada handles marijuana-related DUI charges. Under the old rule, a driver was automatically guilty if a blood test showed two nanograms of THC or five nanograms of a THC metabolite per milliliter of blood. The problem: metabolites can linger for days or weeks after any psychoactive effect is gone, which produced convictions of drivers who were sober at the wheel.
Those automatic thresholds no longer apply to misdemeanor DUI. Prosecutors have to prove the substance actually affected your ability to drive safely.3Nevada Legislature. Nevada Code 484C.110 – Unlawful Acts Relating to Driving Under the Influence The evidence in these cases is typically field sobriety tests, dashcam or bodycam footage, and the arresting officer’s observations of driving behavior.
One exception matters. The per se THC limits still apply to felony DUI, which generally means a third DUI within seven years or any DUI causing death or serious injury. For those cases, two nanograms of THC per milliliter of blood is still enough for conviction on its own.3Nevada Legislature. Nevada Code 484C.110 – Unlawful Acts Relating to Driving Under the Influence The impairment-based rule covers first and second DUI offenses only.
Commercial Drivers Are Not Covered
If you hold a commercial driver’s license, Nevada’s relaxed standard does not help you. The federal Department of Transportation enforces a zero-tolerance marijuana policy for all safety-sensitive transportation employees, and a medical review officer cannot accept a state-authorized medical marijuana recommendation as a valid explanation for a positive drug test.4U.S. Department of Transportation. DOT Medical Marijuana Notice Marijuana remains Schedule I under federal law, and CDL holders who test positive face disqualification.
Overdose Immunity When You Call for Help
Nevada’s Good Samaritan Drug Overdose Act, NRS 453C.150, protects people who seek medical help during an overdose from being arrested, charged, or convicted for several offenses that responding officers might otherwise discover.5Nevada Legislature. Nevada Code 453C.150 – Immunity From Certain Offenses or Mitigation of Penalty for Certain Offenses if Medical Assistance Is Sought for Overdose
The immunity covers simple drug possession (not possession for sale), drug paraphernalia at the scene, being under the influence during the emergency, probation or parole violations based on evidence obtained because you sought help, and restraining order violations where the person overdosing was someone you were ordered to stay away from.
The protection reaches the person calling, anyone assisting with that call, and the person experiencing the overdose. You qualify whether you phone 911, contact poison control, drive the person to a hospital, or provide care while waiting for paramedics.5Nevada Legislature. Nevada Code 453C.150 – Immunity From Certain Offenses or Mitigation of Penalty for Certain Offenses if Medical Assistance Is Sought for Overdose
The limits are hard. Immunity does not reach trafficking under NRS 453.3385, possession for the purpose of sale, or high-level drug offenses. If you are holding quantities that trigger trafficking thresholds, calling in an overdose will not shield you from those charges.5Nevada Legislature. Nevada Code 453C.150 – Immunity From Certain Offenses or Mitigation of Penalty for Certain Offenses if Medical Assistance Is Sought for Overdose The statute also preserves the state’s ability to act under Nevada’s child abuse and neglect laws, so if a child is present during the incident, child protective services can still intervene.
Even where immunity does not apply, the law requires courts to treat the decision to seek help as a mitigating factor at sentencing. That will not erase charges, but it can meaningfully reduce the penalty.
First-Offense Diversion for Possession
Under NRS 453.3363, a person with no prior drug convictions in Nevada or any other jurisdiction who pleads guilty or no contest to a possession charge can have judgment deferred. The court places you under supervision with conditions that typically include a drug treatment program. If you meet those conditions, the charge can be dismissed rather than becoming a permanent felony conviction.1Nevada Legislature. Nevada Code 453 – Controlled Substances
For small-quantity, first-time possession under NRS 453.336, this diversion pathway is built directly into the statute: the court is required to defer judgment if you consent. That mandatory deferral applies to Category E felony possession — under 14 grams of a Schedule I or II substance on a first or second offense.1Nevada Legislature. Nevada Code 453 – Controlled Substances Nevada also runs specialty drug courts in multiple judicial districts that offer structured treatment and monitoring as an alternative to incarceration.
Diversion is not available for trafficking, possession for sale, or cases involving mid-level or high-level weight tiers. For a person caught with a small personal-use amount, though, the difference between a dismissed charge and a felony record reaches employment, housing, and professional licensing for years. If you are facing a first-time possession charge, raise diversion with a defense attorney at the first meeting.
Psychedelic Therapy Is Under Study, Not Legal
Senate Bill 242 from the 2023 session created the Psychedelic Medicines Working Group, housed under the Department of Health and Human Services, to evaluate whether Nevada should allow therapeutic use of certain psychedelic substances. The bill focuses on entheogens, defined to include psilocybin and psilocin.6Nevada Legislature. Senate Bill 242 – 82nd Session Exhibit This is a study framework, not legalization. Possessing psilocybin remains a crime in Nevada for the general public.
The Working Group has completed its report and submitted recommendations for the 2025 legislative session, including a regulated access program for psychedelic-assisted therapy and training programs for law enforcement and paramedics responding to psilocybin-related incidents.7Nevada Legislature. Psychedelic Medicines Working Group Report Whether the legislature acts remains open.