The sentencing of Richie West and Dr. Robert Rand brings Reno's pill-mill case to a close, but drug activity in the Biggest Little City remains consistent.  Rand faces 10 years in prison, and West could be released as early as January after Judge Miranda Du sentenced him to 24 months in prison for a drug conspiracy charge.  Attorneys say Rand prescribed 1.24 million opioid pills in 2015, and West admitted to selling 500-2,000 pills of Oxycodone.  With both men behind bars, the drug battle continues.

"Since then, we have not seen a rise in any of these responses," Adam Heinz, Director of Communications for REMSA said.

REMSA uses the data on a program called FirstWatch, which tracks drug overdoses on a daily basis, and can help predict drug trends in the future. While the arrest of Rand and West had little impact on the opioid problem in northern Nevada, officials say the case was still very important.

"It kind of kicked the door open in terms of awareness and people realize that this issue needs to be addressed," Deputy Chief Tom Robinson, Reno Police Department said.

Robinson says the case also shows that doctors will be held accountable for their actions and should prescribe pills responsibly.

"It kind of put people with authority on notice that, although you have this authority to write a drug, you're not without some type of oversight," Robinson said.

The Centers for Disease Control says 33,000 people died of opioid overdoses in 2015, which is more than died in car crashes.  Nearly half of those were a result of prescription drugs.

"That's a very extremely powerful statistic because there's a lot of cars on the road," Heinz said. "That magnitude provides us and sheds some light that we need to do something different and we need to do something better."

Officials say overdoses did not spike after the Rand and West arrests, as some feared.  Some expected some of Rand's patients and West's customers to turn to street drugs like heroin if the Oxycodone was not available.  In the past year, Fentanyl has been introduced to more of those drugs, which is much more potent than other opioids.

"It poses a risk to the co-responders because it can be transdermally or transmitted just by touching it," Heinz said.

The Reno Police Department takes the opioid crisis very seriously, changing some internal procedures like testing of drugs for that reason.  It also has a unit that is dedicated to narcotics investigations.

"It's a serious problem and I think it's compounded by the fact that these are sometimes legitimate drugs that make it to the black market," Robinson said.

Opioid abuse can happen to people of many different backgrounds, whether the drugs are used for legitimate reasons or illicit use.

"These people don't fit what you think a drug addict is," Robinson said. "They look like me and you and mom and pop, just regular old community members."

This problem is not unique to northern Nevada. Problems related to Fentanyl are picking up in northern California, and opioid addiction and overdoses are happening throughout the United States.  Tuesday, Clark County announced it will file a lawsuit against drug manufacturers and distributors, saying its number of overdose deaths is 70 percent higher than the national average.  The drug problem is not a new development, but the opioid issue is a growing issue, and Robinson says the problems will probably continue.

"I imagine we'll continue to see those peaks and valleys and drugs coming in and out of style, so to speak, but this one is different because of the legal aspect of it, of the opioids," Robinson said.