By David Joel Miller.
How drugs are classified for legal purposes.
The Controlled Substances Act of 1970 created another way to classify drugs. In another post, I talked about some of the ways drugs can be classified, by their origin, by their medical effect, or by the experience the user has. For legal purposes, some drugs are scheduled on one of five separate schedules of controlled substances.
The criteria for placing drugs on a particular schedule include whether they have an accepted medical use, their potential to be abused, and the likelihood they will produce dependence. Many people refer to drugs with a high abuse potential as narcotics. Narcotics technically are drugs that will put you to sleep, knock you out, and may potentially cause death. Many of the scheduled drugs are stimulants or Hallucinogens. When talking about legal regulation of drugs, it is important to know that the correct term is, controlled substances.
Here’s a brief description of the five drug schedules and some examples of drugs on each schedule.
Schedule I drugs.
These drugs have an extremely high abuse potential. They are likely to cause dependence, have withdrawal effects, and produce cravings. They are not currently accepted for medical use in the United States. These drugs are not believed to be safe even when used under medical supervision.
An example of the need for scheduling some drugs on schedule one is illustrated by the drug thalidomide. This drug was approved and widely used in Europe, where it was often prescribed to women for treatment of morning sickness. There was a good deal of pressure for it to be approved in the United States. One doctor at the FDA resisted the pressure to approve the drug for use in the US because of safety concerns.
After this drug was used in Europe for some time, it was discovered that the drug would produce serious birth defects when women who were pregnant were exposed to the drug. Even handling the medication could produce birth defects. Today this drug is used for treating cancers, but it continues to carry warnings that women who may become pregnant should not come in contact with this drug.
Some examples of drugs currently on schedule I include, heroin, peyote, psilocybin, ecstasy, LSD, methcathinone, marijuana, and most other products containing THC.
Schedules II drugs.
These drugs have a high abuse potential. They must have a recognized medical use, though it may require severe restrictions. Abuse of these drugs can result in either physical or psychological dependency. To prescribe these drugs, doctors must have a DEA number and use a triplicate prescription pad. One copy of each prescription stays with the doctor; one is given to the patient who must take it to the pharmacy, the third copy is sent to the DEA.
Examples of schedule two drugs include morphine, codeine, methadone, other opiates, Ritalin, methamphetamine, cocaine, PCP, and many other similar drugs.
Schedule III drugs.
Drugs on this schedule are more widely used for medical purposes. There are less likely to be abused than drugs on schedule II. These drugs can still be abused and may produce a mild to moderate substance use disorder.
Examples of schedule III drugs include Vicodin, Tylenol with codeine, Marinol a synthetic capsule containing THC, Ketamine, anabolic steroids, and similar drugs.
Schedule IV drugs.
These drugs have wide medical application in the US. They have a low potential for abuse when compared to drugs on schedules I, II, or III. People may build up some tolerance to these drugs and experience withdrawal, resulting in physical or psychological dependence, but these drugs are less likely to produce cravings than the drugs on the earlier schedules.
Examples of schedule IV drugs are Darvon, Valium, Librium, Ativan, Xanax, and similar drugs.
Schedule V drugs.
These drugs have many accepted medical uses in the US. They have the lowest abuse potential of all the scheduled drugs. Abuse of the drug may lead to some types of dependency. Some drugs on schedule V are available in both prescription strength and an over-the-counter version. For example, some pain relievers are available over-the-counter in two hundred milligrams strengths, the stronger six hundred and eight hundred milligrams versions require a prescription.
Just because drugs are on schedule V does not mean they are totally safe. Many people abuse over-the-counter pain relievers. Taking too many of these medications can result in permanent damage to either the liver or the kidney.
Some problems with drug schedules.
Despite the movement towards legalizing marijuana for medical and recreational use, the federal government continues to keep it on schedule I. This creates conflict between the federal government and state or local governments. Doctors who prescribe medical marijuana are likely to lose their DEA numbers. Doctors who work in hospitals or chronic pain clinics are unable to prescribe marijuana without losing their ability to prescribe stronger opiate pain medications.
Heroin continues to be a schedule I drug. This has prevented doctors from prescribing heroin to people who are addicted to opiates. In other countries, addicts, can receive their drugs by prescription and can administer them in safe injection sites where the used needles are properly disposed. Because heroin stays on schedule I, addicts are prescribed methadone a drug which is even harder to withdraw from than the heroin.
Staying connected with David Joel Miller
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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.