Healthcare (Substance Abuse)

This bill asks the Alabama State Committee of Public Health to review and potentially classify a new synthetic opioid called N-Propionitrile Chlorphine as a Schedule I controlled substance. The legislation cites concerns that this drug is approximately 10 times more potent than fentanyl and poses a high risk of accidental overdose due to its extreme potency and presence in counterfeit pills. If the committee acts on this request, the substance would be added to Alabama's list of controlled substances under existing state law. The bill directs the State Health Officer and committee members to process this review immediately.

HB 453 requires all health insurance plans in Alabama - including private coverage, Medicaid, and public employee health plans - to cover breast reconstruction surgery after mastectomy or cancer treatment. It ensures patients can choose their preferred surgeon (even outside their insurance network) and defines comprehensive coverage to include all necessary procedures for physical and psychological recovery. The bill sets rules for cost-sharing in private insurance and allows patients or healthcare providers to sue insurers who fail to comply, with enforcement by the Attorney General and Insurance Commissioner. The bill is currently pending in the House Insurance Committee as of February 12, 2026.

HB 487 allocates $43,138,650 in supplemental funding from Alabama’s Opioid Treatment and Abatement Fund for the fiscal year ending September 30, 2026. The bill directs funds to specific state entities, including $26.36 million to the Department of Mental Health for opioid prevention, treatment, and recovery programs (such as Naloxone purchases, the 988 Crisis Line, and residential detox), $1 million to the Department of Corrections for medication-assisted treatment and harm-reduction services in prisons, and smaller allocations to universities, courts, child advocacy centers, and law enforcement. Key provisions include funding for opioid prevention programs in schools, expansion of treatment beds, and support for community-based recovery services. Unused funds will carry forward to the next fiscal year, as specified in Section 2.

HB 364 requires doctors and nurse practitioners to discuss specific opioid risks with patients before prescribing an initial and third prescription for Schedule II opioids or opioid pain medications. The discussion must cover addiction risks, alternatives to opioids, dangers of mixing opioids with alcohol or sedatives, and dependence risks, with providers documenting this in medical records. It does not apply to cancer patients in active treatment, hospice/palliative care patients, long-term care residents, or those prescribed opioids for substance abuse treatment. The bill affects healthcare providers and patients receiving opioid prescriptions for acute or chronic pain, aiming to improve informed decision-making.