GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 681
Short Title: Update Opioid Abatement Treatment Prog. Rules. (Public)
Sponsors: Representatives Crawford, Reeder, and Chesser (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Health, if favorable, Regulatory Reform, if favorable, Rules, Calendar, and
Operations of the House
April 3, 2025
*H681 -v-1*
A BILL TO BE ENTITLED 1
AN ACT DIRECTING THE COMMISSION FOR MENT AL HEALTH, DEVELOPME NTAL 2
DISABILITIES, AND SUBSTANCE USE SERVICES TO AMEND THE RULES 3
REGARDING OUTPATIENT OPIOID TREATMENT PR OGRAMS FOR GREATER 4
CONSISTENCY WITH FEDERAL REGULATIONS. 5
The General Assembly of North Carolina enacts: 6
SECTION 1.(a) The Commission for Mental Health, Developmental Disabilities, 7
and Substance Use Services (Commission) shall amend the rules applicable to outpatient opioid 8
treatment programs (OTPs) in 10A NCAC 27G .3600 through 10A NCAC 27G .3605, to be more 9
consistent with 42 C.F.R. Part 8 governing medications for the treatment of opioid use disorder. 10
In amending these rules, the Commission shall make at least all of the following changes: 11
(1) Remove stability of a patient's home environment and social relationships as 12
an eligibility criterion for take-home medication. 13
(2) Explicitly prohibit administrative discharge from treatment due to continued 14
substance use, missed doses, and nonparticipation in ancillary services such 15
as counseling. 16
(3) Remove structured counseling schedules to better align with federal 17
regulations that promote individualized care that is more patient-centered and 18
flexible. 19
(4) Reduce the number of required drug tests to align with the frequency required 20
by federal regulations. 21
(5) Remove the requirement for observed urine drug testing. 22
(6) Explicitly permit OTPs to administer methadone to patients who are not 23
enrolled with the OTPs as their patients. 24
SECTION 1.(b) In determining whether to include any additional changes to the 25
rules applicable to OTPs to achieve greater consistency with 42 C.F.R. Part 8, the Commission 26
shall engage with current and former OTP clients and OTP providers for input on other changes 27
that would serve the goal of improving access to patient-centered care and achieving better 28
alignment with federal regulations. However, the Commission shall not amend the rules to 29
include any input that is inconsistent with State or federal law. 30
SECTION 1.(c) The Commission shall publish the proposed text of the amended 31
rules applicable to OTPs by July 1, 2025. 32
SECTION 2. This act is effective when it becomes law. 33