Schedules of Controlled Substances.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

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.

For more on this topic see – Drug Use, Abuse, and Addiction and Recovery

Staying connected with David Joel Miller

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – 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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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What are the 5 drug schedules?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

How the Federal government regulates who gets which drug.

Here in the United States, the federal government regulates the status of drugs, who gets which drugs and how based on their listing on one of five “drug schedules.” These schedules were created by the “Controlled Substance Act of 1970.”

This act separates drugs into schedules based on their potential for addiction, their acceptance for medical treatment and their safety. Prior to 1906, the U. S. had almost no laws regulating drug use or sales. Beginning with the Narcotic Control Act in 1956 laws regulating drugs have become a common topic in legislatures both federal and state.

Drugs can be moved up or down schedules as more data comes in. Clearly, some classification decisions have been based more on political sentiment than any hard research evidence. Some drugs that had little or no potential for abuse or dependence were left off the schedules. Herbal products and many over the counter medications are either regulated in a different way or not at all.

Two drugs that are the most destructive of human health, Nicotine and Alcohol are not listed on any of these drug enforcement schedules. Some other drugs, antipsychotics, and many antidepressant drugs are also not listed. Newer synthetic drugs, the methcathinone’s or bath salts, were not added until 1992.

Schedule I drugs.

These drugs have a high potential for abuse, these drugs are not commonly accepted for medical treatment in the U. S. and there is a lack of safety data to suggest these drugs would be safe for human consumption. Drugs on this schedule are considered some of the most dangerous of the abused drugs and may not be prescribed by a physician in the U. S. Unfortunately some drugs made this prohibited schedule mostly on the basis of opinions rather than evidence. Currently, Marijuana is a schedule I drug. (I know medical and recreational marijuana are “legal” in some states but the feds still have it on Schedule I. The feds do not license doctors so they can’t keep doctors with state licenses from prescribing marijuana but they can take that doctor’s DEA number. This issue probably needs another post.)

Schedule II drugs.

These drugs have a high potential for abuse. Use or abuse of this drug can lead to addiction as in physical or psychological dependency. These drugs do have a recognized medical use. The question for the doctor is, does that use justify the risks of the patient using the drug. Many of the opioids fall in this category. They work well on pain but they are very likely to produce addiction. These drugs require the prescribing doctor to have a DEA number and to write triplicate prescriptions. One copy stays with the doctor, one goes to the patient to carry to the pharmacy and one goes to the DEA. Hard to believe they miss pill mills considering they get these copies. Still, many of these meds do get diverted into illegal use and result in a significant amount of addiction and deaths.

Schedule III drugs.

Drugs on Schedule III are less likely to be abused than those on Schedules I and II. The medical value is high enough that there are fewer restrictions on prescribing these drugs including who is allowed to prescribe the drugs on this schedule. These drugs are not terribly physically addicting but may be very psychologically addicting.

Schedule IV drugs.

Drugs on this schedule are safer than those on Schedules I, II, and III. These drugs have accepted medical uses and are lower in addiction potential.

Schedule V drugs.

Lowest abuse potential and safest of the scheduled drugs.

Hope this helps explain how the Controlled Substance Act of 1970 with all its subsequent amendments is supposed to help reduce the prescription and use of dangerous pharmaceutical drugs. You may see that there are still some problems with the scheduling of specific drugs and scheduling does not keep them off the street but on balance I think things would be worse if there were no regulations of this kind.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

You might also want to check out these other counselorssoapbox posts.

Drug Use, Abuse, and Addiction

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

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.

How are drugs classified?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

How are drugs classified?
Photo courtesy of Pixabay.

What kinds of drugs are abused?

There are a whole lot of drugs that get abused and they are not all the ones you might recognize. Drugs are classified in a variety of ways. Which classification system you want to use is partially dependent on why you are classifying the drug. For our purpose in this post “drug” includes prescription medications, drugs of abuse and things people give themselves to alter their sensory perception even if they are not always considered a drug. Here are some ways drugs can be classified.

Is this drug legal?

How law enforcement classifies and regulates drug use behavior impacts how we look at drugs in other contexts. The roots of the current 5 schedule system of drug classification for legal purposes are in the 1970 Controlled Substance act. Who can buy a drug; prescribe a drug and how this needs to be done, all fall under the legal classification system. Laws do not always fit neatly with the scientific evidence.  There are other posts, past and upcoming, about drug laws and regulations. You will find more drug info posts under Drug Use, Abuse, and Addiction.

Where does this drug come from?

Drugs can be plant or animal based, synthetic as in manufactured in a lab, or semisynthetic, that is a plant-based drug that is modified in the lab.

Some people have tried to make the argument that plant-based drugs are “natural” therefore less dangerous than synthetic or man-made drugs. This is often used as an argument for the legalization of marijuana.

Some natural plant-based drugs are poisonous and can prove fatal even in very small doses. The Opioid’s come from one species of poppy plant but is very addicting and an overdose can be fatal. Other drugs like LSD-25 were originally isolated from plant material (a fungus growing on rye grain) but can easily be synthesized in the lab. Other life-saving drugs are completely synthetic. The plant vs. factory origin way of classifying drugs has not proved useful to my way of thinking.

What is this drug used for?

Is a drug an antidepressant or a blood pressure med? Many dissimilar chemicals may be used to treat the same condition. Drugs to treat ADHD can be stimulant drugs or there are non-stimulant alternatives. Pain relievers include aspirin and Opiates. Aspirin can be used to treat heart issues and Opiates can be listed as a drug of abuse. The same medication may help treat depression or be used to help you stop smoking. Classifying drugs by use is problematic at best especially when we are talking about drugs that may be abused.

What part of the body does this drug work on?

Heart med, blood med or Liver med? Not all meds used to treat the heart do the same thing. Many drugs work on multiple parts of the body.  Drugs which are helpful in some places in the body eventually get broken down to be eliminated. A drug that is great for back pain may be harmful or even toxic to the kidney or liver where it needs to be removed from the body.

What is the chemical structure?

Some chemical structures have similar effects. There are a great many Barbiturates which are all similar in action. The contrary is that there are a great many compounds that end with “hydrochloride.” These can have extremely different properties.

What is its mechanism of action?

Drugs can be studied by how they do the things they do. Reuptake inhibitors stop the breakdown and recycling of neurotransmitters. While they may have similar mechanisms of action it matters which neurotransmitter they are prolonging.

What is its name?

Street names often describe the primary effects. Drugs can also be classified by chemical name, formula or brand name.

Other possibilities for classifying drugs.

Uppers Downers and All Arounders.

Inaba in his book Uppers, Downers and All Arounders simplified drugs, particularly drugs of abuse, into three primary categories. Uppers mean drugs used for their stimulant properties. Downers are depressant drugs. All-Arounders are drugs which alter perception including hallucinogens and Deliriants.

People who abuse stimulant drugs may switch between cocaine and amphetamine depending on the price and availability but they like the stimulant feeling. Downers, those drugs used for their depressant characteristics, include Alcohol, Heroin and other Opioids, and other central nervous system depressants.

The newest edition of his book also discusses some additional drugs that have mixed effects or do not fit neatly into the three grouping system but among drugs of abuse, the use of uppers and downers continues to be the largest part of what the substance use disorder treatment field treats.

Route of administration or method of use.

Inhalants can be any number of very dissimilar chemicals. Oral medications have in common only the way they enter the body as do injectable drugs.

You might also want to check out these other counselorssoapbox posts.

Drug Use, Abuse, and Addiction

More “What is” posts will be found at “What is.”

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

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Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.