ClickCease Prescription Drug Classifications: What Are they? - Granite Recovery Centers

Prescription Drug Classifications: What Are they?

Authored by Granite Recovery Centers    Reviewed by James Gamache    Last Updated: September 16th, 2021


James Gamache Medical Reviewer
Jim is a Licensed Clinical Social Worker (LICSW) and Licensed Masters Level Addictions Counselor (MLADC). He has been working in the field of mental health/addiction treatment since 1995. Jim earned a Bachelor’s Degree in Human Services from Springfield College in 2000, and a Masters Degree in Social Work from Boston University in 2002. In 2002 Jim was hired by the Mental Health Center of Greater Manchester holding the position of Clinical Case Manager. From 2004-2019, Jim was employed at WestBridge Inc. During his time at WestBridge, Jim held the following positions; Clinician, Team Leader, Director, & Chief Operations Officer. In 2019 Jim transitioned employment to GateHouse Treatment Center as the Clinical Director for 10 months. In October of 2020 Jim transitioned to Granite Recovery Centers and is currently serving as the Senior VP of Clinical Services and Quality Assurance.

You may have heard about prescription and illicit drugs being given certain classifications like “Schedule I” or “Schedule II.” But you may not have been exactly sure what those terms meant. Understanding what drug classifications mean can help when dealing with people who are struggling with drug addiction. Knowing how a specific drug is classified can help you determine how difficult it will be to help that person quit that drug.

What Are Drug Classifications?

Drug scheduling and classifications have been a part of the illicit drug and prescription drug landscape in the United States since the 1970s. On October 27, 1970, President Nixon signed the Controlled Substances Act (CSA), which was developed alongside Nixon’s war on drugs. It gave the FDA (Food and Drug Administration) and the DEA (Drug Enforcement Agency) the power to determine which substances were approved for medical use, which drugs served no medical purpose, and which drugs had the propensity for abuse. The CSA was the latest in a long line of policies that the United States enacted to manage the consequences of addictive substances.

The government regulates the distribution, possession, and creation of both illicit and illegal substances based on these drug classifications. These substances are called “controlled substances,” and they can refer to anything from hard street drugs to legal prescription medications. The one thing linking all of these drugs together is that they have the potential for abuse.

The point of the CSA was to determine which substances would be considered controlled and which wouldn’t. Not only was the government able to then regulate these controlled substances, but they were also able to affect how law enforcement responds to their possession and distribution. People who possess controlled substances fall under state laws, but people who distribute controlled substances are under the authority of federal courts. This is the reason that possession of controlled substances varies state by state when it comes to punishment and penalties.

The CSA was the latest in a long line of U.S. policies that were enacted to deal with addictive substances. The very first act was the Pure Food and Drug Act of 1906. The Act required drug manufacturers and food distributors to clearly mark which foods contain dangerous substances, including morphine, cannabis, alcohol, and others.

What Are the Classifications Based On?

Drug classifications are broken down by the DEA based on a substance’s perceived level of dangerousness. There are five schedules ranging from Schedule I to Schedule V.

The DEA intends law enforcement officials and medical professionals to use these classifications to determine a drug’s legality, whether it’s okay for medical use, and the drug’s propensity for abuse. Due to classifications being straightforward, it’s easier for the legal system to make sound judgments during criminal drug cases. It’s easy for medical professionals and experts to figure out how to handle a specific substance or prescribe it.

How Does the DEA Initiate a Schedule?

When it’s time for the DEA to classify a new drug, it first determines whether the drug can be abused. The DEA generally defines abuse as a substance being taken recreationally while creating potential health risks. Substances that can be abused may also put the society as a whole at risk. If the answer to can it be abused is yes, the DEA will put it on to a schedule. If the answer is no, the drug won’t be included on any schedule.

The DEA will then determine where the drug goes on the schedule based on its medical benefits. The company that created the drug must do large-scale clinical trials to determine the drug’s medical value. The company also has to complete this process to back up any claims.

What Are the Individual Classifications?

The following covers the five drug classifications and their meanings.

Schedule I

Schedule I drugs are considered the most dangerous drugs on the market by the DEA. After the DEA and the FDA analyze them, they determine that these drugs have no medical use. These types of drugs carry an extremely high risk and potential for addiction and abuse.

Some of the drugs on the Schedule I list include bath salts, heroin, ecstasy, LSD, Quaaludes, and marijuana. The inclusion of marijuana is explained below.

Schedule II Drugs

The FDA and the DEA have determined that Schedule II drugs also have a high potential for addiction and abuse. What makes them different from Schedule I drugs is that these drugs have been accepted as being appropriate for medical use. These drugs are usually used for treating severe pain or helping people get over addiction. These are the types of drugs that you can get with a doctor’s prescription, but it’s still possible to become addicted to them. Some of the drugs on this list include codeine, morphine, OxyContin, fentanyl, Demerol, and methadone.

Some people may be surprised to find out that cocaine is a Schedule II drug. Although it is generally known as a drug taken for illicit use only, it does have licit uses. Cocaine hydrochloride 4% and 10% can be used as a topical local anesthetic for issues with the upper respiratory tract. It helps reduce bleeding of the mucous membranes located in the nose, throat, and mouth. It’s not used often, but it is an option in certain medical cases.

Schedule III Drugs

Schedule III drugs are determined by the DEA to be drugs that have a moderate potential for abuse, meaning there is a low to moderate potential for people to become dependent. Although people can become addicted to these drugs, they are considered by these two organizations to be less dangerous than Schedule II drugs. You have to get a prescription for these drugs.

Schedule IV drugs

Schedule IV drugs have been approved for medical use, but there’s still potential for abuse. They do consider that the potential for abuse for these drugs is lower than drugs higher up on the scale, but it is still there. These types of drugs are considered easy to misuse or become addicted to. This is especially true if they’re mixed with other substances or they’re taken off-script. Some of the drugs on this list include Ativan, Klonopin, Soma, Xanax, and Valium.

Schedule V drugs

Schedule V drugs are the drugs that the DEA has considered the least dangerous on the list. However, these drugs are still considered to have some potential for abuse. These types of substances are usually manufactured by adding a tiny bit of narcotic into them. This would include medicines like cough syrup filled with codeine. In spite of these being the “least dangerous” drugs on the list, they still have the potential for abuse, and people need to be careful. If they’re not, they could become physically or psychologically dependent on the drug. Examples of Schedule V drugs include Robitussin AC, Ezogabine, and Phenergan with codeine.

Why Is Marijuana Considered a Schedule I Drug?

Many people are confused by marijuana being considered as a Schedule I drug. Schedule I drugs are considered the most dangerous drugs by the DEA, and it’s been determined that they have no medicinal value or properties. Still, states around the country are legalizing marijuana left and right. It’s a little difficult for people to understand how both things can be true.

The CSA was created at a time in history when the United States was struggling with heavy drug use among its populace. Lots of people in the 70s were freely taking drugs like psychedelics and cocaine. Much of the more conservative parts of the country were hellbent on reining in what they believed to be an out-of-control drug culture. Marijuana, used by many people at that time, was considered a dangerous drug. That perception remains today in some pockets of the country.

Another issue was that because access to marijuana was limited, it was more difficult to research the drug. This, in turn, made it difficult for researchers to prove its medical value. This is the reason that many modern day medical and advocacy groups have said that marijuana’s inclusion as a Schedule I drug is unrealistic.

Issues With How Drug Classifications Affect People Struggling With Addiction Issues

The problem that addicts face is that if they’re caught in possession of certain controlled substances, they could end up facing hard time. People who are addicted to controlled substances often have a lot of the substances on their person, so if they’re caught with what is considered a distributable amount, they could be in serious trouble.

The most important thing people struggling with addiction to controlled substances can do is seek help. The ultimate goal is to make sure that they are able to restore their lives to one that is drug-free, physically healthy, and emotionally healthy. This is where we come in.

How We Can Help

At Granite Recovery Centers, our goal is to help people overcome their addictions to controlled substances. We understand exactly how difficult it is to wean one’s body off of drugs. Part of the reason those drugs are on the drug schedules list is that they’re so easy to abuse.

We help people stop their use of everything, from Schedule I to Schedule V drugs. The schedule level of the drug being used may differ from person to person, but the effects on the body are all too real to the individual dealing with the addiction. A person suffering from an addiction to cough syrup struggles with some of the same issues as someone dealing with an addiction to heroin.

Intake

Our first goal will be to determine what drug the client needs help with. Our methods for detox and rehab will differ depending on the type of drug our clients are addicted to, as well as their physical and emotional state at the time of admission. Getting rid of an addiction is not simply clearing up a physical dependency. It’s also getting rid of the emotional baggage that created the addiction in the first place.

Detox

The next step of the process is detox. Someone withdrawing from a stimulant like cocaine will have a different detox process from someone withdrawing from an opioid like morphine.

People who are addicted to strong opioids or stimulants must go through medically assisted treatment programs, called MATs. At Granite Recovery Centers, we believe in using MATs to help our clients withdraw from drugs in as comfortable a way as possible. Many controlled substances are extremely difficult to stop using, causing people to relapse. With MATs, we’re able to provide the clients with medicines that can help the withdrawal process feel a lot less painful and more manageable. These medicines control symptoms so that our clients can focus on healing their emotional scars without being distracted by the physical ones. Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention.

We offer both inpatient and intensive outpatient programs, allowing people to choose the one that best fits their circumstances. People who are withdrawing from extremely difficult substances may benefit from being on-site during the withdrawal process so they can be monitored by medical professionals.

Many people think that the hardest part of going through rehabilitation and recovery is the withdrawal process, but sometimes the hardest work begins once the drug has left the body. People will then have to confront the issues that brought them into addiction in the first place. We offer both traditional and holistic therapies to help our clients get to the root of their issues and learn better coping mechanisms.

At Granite Recovery Centers, we want to provide accurate information about health and addiction so that our readers can make informed decisions.

We have credentialed medical doctors & clinicians who specialize in addiction treatment review the information on our website before it is published. We use credible sources such as government websites and journal articles when citing statistics or other medically related topics.