Amends GS 90-113.73 to require the NC Department of Health and Human Services (DHHS) to maintain an electronic reporting system that provides real-time prescription information for all Schedule II through Schedule V controlled substances (current law does not require the reporting system to be electronic or that the information be provided in real-time). Further amends this statute requiring the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services to adopt rules requiring dispensers to report information currently required under GS 90-113.73(b) within twenty-four hours after dispensing a prescription for a Schedule II through Schedule V controlled substance (current law does not require reporting within twenty-four hours). Amends Article 5E of GS Chapter 90 (the North Carolina Controlled Substances Act) to add a new GS 90-113.74A requiring that all dispensers and providers review all information in the DHHS controlled substances reporting system pertaining to a patient for the preceding 12-month period prior to prescribing or dispensing a controlled substance to that patient to determine if the prescription is medically necessary and appropriate (emergency situations in which immediate action necessary to preserve the life or health of a patient are exempt from this requirement). Effective December 1, 2011.