Heroin is a Schedule I controlled substance. Oxycodone is a Schedule II controlled substance. Some cough medicines are classified as Schedule V. But what does all this mean, exactly?
What’s a “scheduled drug,” and what determines the class of each drug?
Let’s dig into how this system works.
How It Started: The Controlled Substances Act
In 1970, Congress passed the Controlled Substances Act (CSA). This was one part of the overall Comprehensive Drug Abuse Prevention Control Act. The CSA established regulations for placing drugs into “schedules.” Five classifications, or schedules, were created.
The Drug Enforcement Administration (DEA), a federal agency, is charged with placing each drug in a schedule based on three qualities: its potential for abuse, its potential for dependency, and its medical use.
But not all drugs are scheduled. Only substances that the DEA determines can be abused are put on a schedule. Once the DEA decides a drug should be scheduled, DEA officials evaluate the drug for its potential for abuse and medical use, to place it in the appropriate class.
The tricky part is clearly defining “potential for abuse” and “medical value.” These terms are not precisely outlined in the CSA. However, federal agencies have developed standards to use for these qualifications.
- “Abuse” is defined as taking a substance recreationally in a way that leads to personal health risks and risks to society.
- “Medical value” is determined by large-scale clinical trials that can prove the drug offers medicinal properties.
Once these qualities have been evaluated, the drug is classified as Schedule I, II, III, IV or V.
How Our Drug Scheduling System Works: The 5 Schedules
A drug’s classification, or schedule, determines how easy or hard a drug is to access. The higher the schedule (I being the highest), the more limits the DEA can place on accessing the drug. Schedules I and II are highly regulated, and Schedule V drugs have the fewest restrictions.
Here’s a breakdown of each schedule and examples of substances that fall into each class.
These drugs have high potential for abuse and no accepted medical use in the United States. Basically, they are illegal for any type of use outside of research.
Substances in this classification “have a high potential for abuse which may lead to severe psychological or physical dependence.” With the DEA’s approval, these drugs may be used for medical purposes.
Schedule II drugs include methadone, oxycodone, morphine, methamphetamine, hydrocodone, and Ritalin.
These first two Schedules are the most highly regulated drugs. The difference between the two classes is not necessarily the danger level of the substance. Instead, it is whether or not the government finds that a drug has value in medical treatment.
These substances have potential for abuse, but less so than those in Schedules I and II. Abuse of Schedule III substances “may lead to moderate or low physical dependence or high psychological dependence.”
Substances in this schedule include buprenorphine (Suboxone), ketamine, anabolic steroids, and any product that contains no more than 90 mg of codeine per dose (such as Tylenol with Codeine).
The DEA places substances in Schedule IV if they have a low potential for abuse (compared to drugs in Schedule III).
Schedule IV substances include many commonly prescribed medications. Examples are Xanax, Valium, Ativan, and Klonopin.
Drugs in this category are mostly substances that contain small amounts of narcotics. They have a low potential for abuse.
Examples of substances that are classified as Schedule V include cough medicines that contain less than 200 mg of codeine per 100 mL or 100 g (such as Robitussin AC).
How It Evolves: Changes to Drug Scheduling System
The law was created in 1970, and many new drugs have been introduced since then. And research is conducted to reveal new information about drugs and their potential for abuse or medical value.
So a drug’s schedule is not set in stone. There are ways to change the schedule of a substance.
One way is for Congress to pass a law that changes a drug’s schedule. However, this is not very common. Typically, Congress leaves scheduling up to the DEA.
The second way is for the U.S. attorney general to review a drug and consider a change. This involves looking at the evidence available regarding the drug’s potential for abuse and medical use.
The Department of Health and Human Services and the DEA each conduct a review of the medical and scientific evidence. After this review, the DEA can reschedule based on the findings.
Because schedules can change over time, an updated list of drug schedules is published each year. This list can be found in the Title 21 Code of Federal Regulations.
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