Senate committee substitute to the 3rd edition adds the following content.

Part X.

Amends GS 122C-3, which defines terms as they are used in GS Chapter 122C (Mental Health, Developmental Disabilities, and Substance Abuse Act of 1985), as follows. Adds and defines the terms mobile unit, opioid treatment program, opioid treatment program medication unit, and opioid treatment program mobile unit. Amends the definition of facility to include an opioid treatment program facility licensed to operate an opioid treatment program medication unit, and an opioid treatment program mobile unit.

Enacts new GS 122C-35 requiring a licensed opioid treatment program facility intending to establish, maintain, or operate an opioid treatment program medication unit or opioid treatment program mobile unit to apply to the Division of Health Service Regulation for certified services provided from an opioid treatment program medication unit or opioid treatment program mobile unit to be added to its license. Requires the Medical Care Commission (Commission) to adopt rules establishing the requirements for obtaining licensure, including requiring that each opioid treatment program medication unit and each opioid treatment program mobile unit seeking to operate in this State prove that it has obtained approval from the State Opioid Treatment Authority, and registered with the Drug Control Unit and the federal Drug Enforcement Agency. Allows for the issuance of a license to an opioid treatment program facility to provide certified services at an opioid treatment program medication unit or an opioid treatment program mobile unit if the program is in compliance with all rules adopted by the Commission regarding opioid treatment programs. Sets out issues that must be considered when approving or denying an application. Prohibits an opioid treatment program facility from establishing, maintaining, or operating an opioid treatment program medication unit or opioid treatment program mobile unit without a current license that includes and covers that specific unit and without first obtaining certification from the Substance Abuse and Mental Health Services Administration. Deems a unit that is added to an opioid treatment program facility license as part of the opioid treatment program facility license and allows it to be subject to inspections that the Department of Health and Human Services (DDHS) deems necessary, applicable rules, and all applicable federal laws and regulations. Substantial failure to comply may result in an adverse action on a license and administrative penalties. Specifies that any required services not provided in an opioid treatment program mobile unit or opioid treatment program medication unit must be conducted at the opioid treatment program facility, including medical, counseling, vocational, educational, and other assessment and treatment services. Requires licenses to provide services at an opioid treatment program mobile unit or an opioid treatment program medication unit to be renewed annually; sets out requirements for license renewal. Allows DHHS to charge a nonrefundable annual license fee plus a nonrefundable annual per-unit fee of $265 for each medication or mobile unit. Makes an opioid treatment program facility with no previous violations subject to inspection once every other year; those with medication or mobile units may be subject to annual inspections. Requires the Commission to adopt emergency, temporary, or permanent rules for the licensure, inspection, and operation of opioid treatment program medication units and opioid treatment program mobile units, including rules concerning 10 specified issues, including maintenance and location of records, emergency staffing requirements, and number of clients allowed per medication unit and mobile unit. These provisions become effective on the effective date of the emergency rules adopted by the Medical Care Commission.

Requires the Commission to adopt emergency rules for the implementation of new GS 122C-35 without prior notice or hearing or upon any abbreviated notice or hearing that the agency finds practical because adhering to the notice and hearing requirements would be contrary to the public interest and the immediate adoption of the rule is required by a serious and unforeseen threat to the public health or safety. Also authorizes the Commission to adopt temporary or permanent rules for licensure, inspection, and operation of opioid treatment medication units and opioid treatment program mobile units.

Part XI.

Amends GS 90-113.73 to also require a dispenser to report when a prescription is for gabapentin, whether the dispenser has a DEA number. Also requires for a prescriber prescribing gabapentin to report if the prescriber has a DEA number and the number is known by the dispenser. Makes additional technical and clarifying changes. Provides that a dispenser is not required to report instances in which gabapentin is provided directly to the ultimate user and the quantity does not exceed a 48-hour supply. Effective January 1, 2024.

Further amends GS 90-113.73, effective January 1, 2025, by specifying that for the purposes of the statute, a dispenser includes a person licensed to practice veterinary medicine when that person dispenses gabapentin.

Part XII.

Amends GS 90-106 to require a practitioner to electronically prescribe all controlled substances in GS 90-93(a)(1)a (not more than 200 milligrams of codeine or any of its salts per 100 milliliters or per 100 grams). Makes conforming changes. Effective January 1, 2024.

Part XIII.

Amends GS 90-12.7 to allow a governmental or nongovernmental organization to distribute an opioid antagonist obtained over the counter to a person at risk of experiencing an opiate-related overdose or to a family member, friend, or other person in a position to assist a person at risk of experiencing an opiate-related overdose. Allows a person who receives an opioid antagonist over the counter to administer the antagonist to another person if the person has a good faith belief that the other person is experiencing a drug-related overdose and the person exercises reasonable care in administering the drug.