Published online 2013 May 29. doi: 10.1310/hpj4806-473
PMID: 24421507

The Federal Comprehensive Drug Abuse Prevention and Control Act of 1970, more commonly known as the Controlled Substances Act, became effective on May 1, 1971.1,2 This federal law contains 3 different titles. Title I deals with the establishment of rehabilitation programs for drug abusers, Title II addresses the registration and distribution of controlled substances, and Title III discusses issues related to the importation and exportation of controlled substances.2 The main segment of interest to pharmacists is Title II. This RxLegal column is the first of a 4-part series that provides an overview of key components of this important federal law.

The goal of the Controlled Substances Act is to improve the manufacturing, importation and exportation, distribution, and dispensing of controlled substances.1 To achieve this goal, manufacturers, distributors, and dispensers of controlled substances must be registered with the Drug Enforcement Administration (DEA), the agency charged with enforcement of the Act on the federal level. Registration of these entities with the DEA results in the formation of a “closed system” for controlled substances distribution. This closed system allows for controlled substances to be traced from initial manufacture to final dispensing to the patient.

Controlled substances are generally defined as medications that are considered easily abusable. Under the Controlled Substances Act, these medications are categorized into 5 schedules.1 Definitions of each schedule with corresponding examples of medications are presented in Table 1. Schedule I medications have the highest abuse potential, while medications in Schedule V have a low abuse potential. In addition to the schedules, the Controlled Substances Act contains information on scheduled listed chemical products or SLCPs. These listed chemicals are products that contain ephedrine, pseudoephedrine, or phenylpropanolamine that may be marketed or distributed legally in the United States as nonprescription drugs.

Table 1.

ScheduleDefinitionsExamples
Schedule IHigh abuse potential with no accepted medical use; medications within this schedule may not be prescribed, dispensed, or administeredHeroin, marijuana, ecstasy, gamma hydroxybutyric acid (GHB)
Schedule IIHigh abuse potential with severe psychological or physical dependence; however, these medications have an accepted medical use and may be prescribed, dispensed, or administeredMorphine, codeine, hydrocodone, hydromorphone, methadone, oxycodone, fentanyl, methylphenidate, pentobarbital
Schedule IIIIntermediate abuse potential (ie, less than Schedule II but more than Schedule IV medications)Hydrocodone/acetaminophen 5 mg/500 mg or 10 mg/650 mg; codeine in combination with acetaminophen, aspirin, or ibuprofen; anabolic steroids; ketamine
Schedule IVAbuse potential less than Schedule II but more than Schedule V medicationsPropoxyphene, butorphanol, pentazocine, alprazolam, clonazepam, diazepam, midazolam, phenobarbital, pemoline, sibutramine
Schedule VMedications with the least potential for abuse among the controlled substancesRobitussin AC, Phenergan with codeine

Of note, some states have passed laws allowing for the medical or recreational use of marijuana.2 These state laws do not alter the fact that marijuana remains a Schedule I medication under federal law. In addition, medications may be removed or added to a schedule or be switched from one schedule to another. The US Attorney General has the authority to add, remove, or switch. The Attorney General generally works with the Secretary of the Department of Health and Human Services to determine a medication’s schedule.

Every pharmacy that dispenses controlled substances is required to register with the DEA.1 Prior to obtaining a DEA registration, a pharmacy must have a state license for operation. Do cheez its expire. A DEA pharmacy registration is obtained by completing the Application for New Registration (ie, DEA Form-224). Instructions for completing the form are found on the US Department of Justice DEA Office of Diversion Control Web site (http://www.deadiversion.usdoj.gov/drugreg/reg_apps/224/224_instruct.htm).3 Pharmacies can also apply electronically for a new or renewed registration (http://www.deadiversion.usdoj.gov/drugreg/reg_apps/pdf_apps.htm).4 Once approved, a pharmacy must renew registration every 3 years.

Some drug products such as pseudoephedrine, phenylpropanolamine, and ephedrine-containing medications are classified as SLCPs as described previously.1 These chemicals may be used inappropriately to compound illegal substances such as methamphetamine (ie, crystal). If a pharmacy were to engage in the wholesale distribution of these chemicals, a DEA chemical registration would be required in addition to the registration for handling controlled substances. This is rarely the case, because most pharmacies are retail distributors of these chemicals (ie, regulated sellers) and not wholesale distributors. A regulated seller legally sells the aforementioned chemicals only for personal use either directly to walk-in customers or via other face-to-face transactions.

Resident evil 4 pc cheats. Once granted, a DEA registration may be suspended or revoked by the US Attorney General.1 Reasons for suspending or revoking a registration include the following:

  • Falsifying the application for the registration

  • Having a prior conviction of a felony related to a controlled substance or a List I chemical (ie, phenylpropanolamine or pseudoephedrine)

  • Having a suspension, revocation, or denial of a state license

  • Committing an act that “renders registration inconsistent with the public interest”

  • Being excluded from Medicare or Medicaid programs

The Attorney General may also deny registration or renewal.1 In so doing, he or she determines whether issuing the registration or renewal would be inconsistent with the public interest. This decision is made by weighing factors such as state licensing board or professional disciplinary authority recommendations, compliance with laws regarding controlled substances, and a prior conviction record related to any aspect of controlled substances (ie, manufacture, distribution, or dispensing). The second article in this series will focus on requirements for controlled substances prescriptions.

References

1. Pharamacist’s manual. An informational outline of the Controlled Substances Act. Revised 2010. http://www.deadiversion.usdoj.gov/pubs/manuals/pharm2/pharm_manual.pdf. Accessed April 8, 2013.
2. Abood R, Brushwood DB.Pharmacy Practice and the Law. 1st ed.Gaithersburg, MD: Aspen Publishers; 2001 [Google Scholar]
3. DEA form 224. New application for registration instructions. US Department of Justice. Drug Enforcement Administration. Office of Diversion Control. http://www.deadiversion.usdoj.gov/drugreg/reg_apps/224/224_instruct.htm. Accessed April 8, 2013.
4. Registration applications. US Department of Justice. Drug Enforcement Administration. Office of Diversion Control. http://www.deadiversion.usdoj.gov/drugreg/reg_apps/pdf_apps.htm. Accessed April 8, 2013.
Articles from Hospital Pharmacy are provided here courtesy of SAGE Publications

This is the list of Schedule II drugs as defined by the United StatesControlled Substances Act.[1]The following findings are required for drugs to be placed in this schedule:[2]

  1. The drug or other substance has a high potential for abuse.
  2. The drug or other substance has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions.
  3. Abuse of the drug or other substances may lead to severe psychological or physical dependence.

The complete list of Schedule II drugs follows.[1] The Administrative Controlled Substances Code Number for each drug is included.

ACSCNClassDrug
9050opiateCodeine
9334opiateDihydroetorphine
9190opiateEthylmorphine
9059opiateEtorphine hydrochloride
9640opiateGranulated opium
9193opiateHydrocodone
9150opiateHydromorphone
9260opiateMetopon
9300opiateMorphine
9610opiateOpium extracts
9620opiateOpium fluid
9330opiateOripavine
9143opiateOxycodone
9652opiateOxymorphone
9639opiatePowdered opium
9600opiateRaw opium
9333opiateThebaine
9630opiateTincture of opium
opiateOpium poppy and poppy straw
9040stimulantCoca, leaves and any salt, compound, derivative or preparation of coca leaves
9041stimulantCocaine, and its salts, isomers, derivatives and salts of isomers and derivatives
9180stimulantEcgonine, and its salts, isomers, derivatives and salts of isomers and derivatives
9670opiateConcentrate of poppy straw (the crude extract of poppy straw in either liquid, solid or powder form which contains the phenanthrene alkaloids of the opium poppy)
9737opioidAlfentanil
9010opiateAlphaprodine
9020opioidAnileridine
9800opiateBezitramide
9273opioidBulk dextropropoxyphene (non-dosage forms)
9743opioidCarfentanil
9120opiateDihydrocodeine
9170opioidDiphenoxylate
9801opioidFentanyl
9226opioidIsomethadone
9648opiateLevo-alphacetylmethadol
9210opiateLevomethorphan
9220opiateLevorphanol
9240opioidMetazocine
9250opioidMethadone
9254opiate intermediateMethadone intermediate: 4-cyano-2-dimethylamino-4,4-diphenyl butane
9802opiate intermediateMoramide intermediate: 2-methyl-3-morpholino-1,1-diphenylpropane-carboxylic acid
9230opioidPethidine (meperidine)
9232opiate intermediatePethidine intermediate A: 4-cyano-1-methyl-4-phenylpiperidine
9233opiate intermediatePethidine intermediate B, ethyl-4-phenylpiperidine-4-carboxylate
9234opiate intermediatePethidine intermediate C, 1-methyl-4-phenylpiperidine-4-carboxylic acid
9715opiatePhenazocine
9730opiatePiminodine
9732opiateRacemethorphan
9733opiateRacemorphan
9739opiateRemifentanil
9740opiateSufentanil
9780opiateTapentadol
1100stimulantAmphetamine, its salts, optical isomers, and salts of its optical isomers (Adderall)
1105stimulantMethamphetamine, its salts, isomers, and salts of its isomers
1631stimulantPhenmetrazine and its salts
1724stimulantMethylphenidate (Ritalin, Concerta, etc.)
1205stimulantLisdexamfetamine (Vyvanse), its salts, isomers, and salts of its isomers
2125depressantAmobarbital
2550depressantGlutethimide
2270depressantPentobarbital
7471depressantPhencyclidine
2315depressantSecobarbital
7379hallucinogenNabilone
8501precursorPhenylacetone
7460precursor1-phenylcyclohexylamine
8603precursor1-piperidinocyclohexanecarbonitrile (PCC)
8333precursor4-anilino-N-phenethyl-4-piperidine (ANPP)

References[edit]

  1. ^ ab21 CFR1308.12 (CSA Sched II) with changes through 77 FR64032 (Oct 18, 2012). Retrieved September 6, 2013.
  2. ^21 U.S.C.§ 812(b)(4) retrieved October 7, 2007
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