What Are Controlled Substances?
In This Article
Millions of Americans misuse prescription drugs every year, taking them for reasons other than what they were prescribed for. This is a major concern, so the government regulates certain substances.
These are called controlled substances. In this article, we’ll discuss the five classifications of controlled substances, why people abuse them, and the different resources available for substance abuse treatment.
What Are Controlled Substances?
Controlled substances are drugs or chemicals that the government regulates because they can be easily abused and lead to addiction. They are powerful medications that need careful handling.
These substances can be illicit drugs or prescription medications. The government groups these substances into five categories based on their medical use, potential for abuse, and how addictive they are.
The most dangerous ones, with no medical use and a high risk of addiction, are in Schedule I. On the other hand, Schedule V substances have recognized medical uses and a lower potential for abuse.
Why are Substances Controlled?
Some medications are so powerful that they need careful handling to ensure everyone’s safety. The government regulates these substances for several reasons:
- Potential for abuse and addiction: Some controlled substances are highly addictive and can lead to dependence, making it difficult to stop using them.
- Public safety concerns: Misusing controlled substances can have serious consequences.
- Medical risks associated with misuse: Taking these substances in the wrong way or without proper supervision can lead to health problems, including overdose and even death.
What is the Controlled Substances Act?
The Controlled Substances Act (CSA) is a federal law that helps ensure the safe and appropriate handling of certain drugs, substances, and chemicals.
The CSA categorizes these substances into five distinct schedules based on their medical use, potential for abuse, and potential for dependence. This helps ensure that these medications are only used under the guidance of a healthcare professional when necessary.
The Five Schedules of Controlled Substances
The table below shows the five schedules of controlled substances according to the CSA, including their criteria and examples.
| Schedule | Criteria | Examples |
| Schedule I | High potential for abuse, no currently accepted medical use in the United States, and a lack of accepted safety for use under medical supervision | Heroin, LSD (lysergic acid diethylamide), marijuana (cannabis), MDMA (ecstasy), peyote, and psilocybin (magic mushrooms) |
| Schedule II | High potential for abuse, which may lead to severe psychological or physical dependence but may have some accepted medical uses, but with severe restrictions | Cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), oxycodone (OxyContin), and fentanyl |
| Schedule III | Moderate to low potential for physical and psychological dependence | Ketamine, anabolic steroids, and products containing less than 90 milligrams of codeine per dosage unit (e.g., Tylenol with codeine) |
| Schedule IV | Low potential for abuse relative to Schedule III drugs and a low risk of dependence | Xanax, Valium, Ativan, and Ambien |
| Schedule V | Lower potential for abuse than Schedule IV drugs and consist of preparations containing limited quantities of certain narcotics, generally used for antidiarrheal, antitussive, and analgesic purposes | Cough preparations with less than 200 milligrams of codeine per 100 milliliters (e.g., Robitussin AC), Lomotil, and Lyrica |
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Why Do People Abuse Substances?
Improper use of controlled substances may lead to substance abuse and addiction. Understanding the causes and effects of substance abuse or substance use disorder (SUD) is crucial for prevention and treatment. Recognizing the signs early and seeking appropriate help can prevent or minimize the adverse outcomes of SUD.
SUD can be triggered by a variety of factors, such as:
- Genetics: Studies show that genetics can play a significant role in addiction risk. If you have a family history of substance use disorder, it’s important to be aware of your own vulnerability.
- Environment: The environment we grow up in can significantly influence our choices. Peer pressure, exposure to drugs at a young age, and lack of support can all contribute to the risk of substance abuse.
- Mental health: People with mental health conditions like depression, anxiety, or ADHD may be more likely to use substances as a coping mechanism, which can lead to addiction.
- Developmental factors: Adolescents and young adults are particularly susceptible to substance abuse due to the ongoing development of their brains.
Effects of Substance Abuse
Substance abuse can have a profound and lasting impact on the person and their loved ones. Here are some of the consequences:
- Health problems: Long-term substance abuse can lead to serious health issues like heart disease, cancer, liver damage, and even death.
- Mental health issues: Substance abuse can worsen existing mental health conditions and contribute to new ones, like depression, anxiety, and paranoia.
- Social and economic consequences: Substance abuse can lead to financial strain, job loss, legal troubles, and strained relationships with family and friends.
- Behavioral changes: People struggling with substance abuse may exhibit drastic changes in behavior, such as neglecting responsibilities, engaging in risky activities, and becoming secretive or hostile.
- Impact on youth: Adolescents who abuse substances are at higher risk for academic difficulties, mental health problems, and involvement with the juvenile justice system.
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Treatment of Substance Abuse Disorders
Treatment is unique and addresses not only the substance use itself but also the underlying factors and consequences. Here’s an overview of the common approaches:
- Detox: The first phase of addiction treatment, where the body is allowed to rid itself of harmful substances under medical supervision to manage withdrawal symptoms safely.
- Inpatient rehab: Live-in treatment programs that provide 24-hour medical and therapeutic support. Depending on your needs, these programs can last from a few weeks to several months.
- Outpatient treatment: Programs that allow you to live at home while attending treatment sessions during the day. This option is suitable for those with less severe addictions or as a step-down from inpatient care.
- Medication-Assisted Treatment (MAT): Combines medications with counseling and behavioral therapies to treat substance use disorders, particularly effective for opioid and alcohol addictions.
- Counseling and therapy: Various forms of therapy, including cognitive-behavioral therapy (CBT), family counseling, and group therapy, help you address the psychological aspects of addiction and develop coping strategies to prevent relapse.
Strategies to Prevent Substance Abuse
Education and awareness is a critical prevention strategy. Programs that increase knowledge about the dangers of substance abuse, particularly those targeting young people, can significantly influence attitudes and help with early intervention.
Early intervention is also important. Identifying people at risk early and offering support can prevent the escalation of substance use into a full-blown disorder.
Community-based efforts are a great starting point for prevention. Initiatives involving families, schools, healthcare providers, law enforcement, and community groups create an environment that supports substance-free lifestyles and reduces the likelihood of substance use.
National Hotlines and Support Groups
Several national hotlines offer free, confidential support and information for those dealing with substance use disorders:
- National Drug Helpline: Available 24/7 at (844) 289-0879, this hotline provides information on recognizing drug use, treatment options, and understanding health insurance coverage for rehab.
- SAMHSA’s National Helpline: This 24/7 helpline (1-800-662-HELP) offers treatment referrals and information services in English and Spanish for people and families facing mental and substance use disorders.
- Alcoholics Anonymous (AA): A well-known support group that follows a 12-step program to help you achieve and maintain sobriety. Meetings are available both in-person and online.
- Narcotics Anonymous (NA): Similar to AA, NA provides a 12-step program specifically for those recovering from drug addiction.
SMART Recovery: This support group offers a science-based program to help you manage your addiction and maintain sobriety through group therapy and online resources.
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- “The Controlled Substances Act.” US Drug Enforcement Agency.
- “Specialized Substance Abuse Treatment Programs.” Substance Abuse and Mental Health Services Administration (US), 1997.
- “Recovery Resources.” US Drug Enforcement Agency.
- “Important Facts about Controlled Substance Prescription.” New York State Department of Health.
- “What is Drug Addiction?” National Institute on Drug Addiction.
