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Benzodiazepines: Schedule IV Controlled Substances

What Does "Controlled Substance" Mean?

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Updated April 28, 2014

Certain medications used to treat anxiety disorders, including panic disorder, fall under the classification of “controlled substances.” Benzodiazepines are a class of medications commonly used for their tranquilizing and anti-anxiety effects and are often used in the treatment of panic disorder. Benzodiazepines are considered “Schedule IV controlled substances.” But, what exactly does that mean?

The Controlled Substance Act of 1970

For many decades, the United States has fought what is often termed a “war on drugs.” Recognizing the potential that certain medications have for abuse and dependence, Congress enacted the Controlled Substances Act (CSA) as part of the Comprehensive Drug Abuse Prevention and Control Act of 1970. Over the years, the Act has had several revisions including:

  • The Psychotropic Substances Act of 1978
  • The Controlled Substances Penalties Amendments Act of 1984
  • The Chemical Diversion and Trafficking Act of 1988
  • The Domestic Chemical Diversion and Control Act of 1993
  • The Federal Analog Act
  • The Methamphetamine Precursor Control Act

The CSA mandates that manufacturers, distributors, pharmacies and healthcare providers diligently ensure the safe and efficient delivery of controlled substances identified within five schedules under the Act.

Schedules I, II, III, IV and V

Medications controlled by the Act fall into one of five schedules. Drugs in Schedule I have a high potential for abuse, demonstrate no approved medical use and lack customary safety standards. Schedules II to V include drugs in decreasing order of potential for abuse.

Title 21, Chapter 13 of the Act is entitled “Drug Abuse Prevention and Control.” This section outlines the following findings for each schedule:

(1) Schedule I.

(A) The drug or other substance has a high potential for abuse.

(B) The drug or other substance has no currently accepted medical use in treatment in the United States.

(C) There is a lack of accepted safety for use of the drug or other substance under medical supervision.

Examples of Schedule I drugs include:

(2) Schedule II.

(A) The drug or other substance has a high potential for abuse.

(B) 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.

(C) Abuse of the drug or other substances may lead to severe psychological or physical dependence.

Examples of Schedule II drugs include:

  • morphine
  • oxycodone (Percodan)
  • methylphenidate (Ritalin)
  • dextroamphetamine (Dexedrine)

(3) Schedule III.

(A) The drug or other substance has a potential for abuse less than the drugs or other substances in schedules I and II.

(B) The drug or other substance has a currently accepted medical use in treatment in the United States.

(C) Abuse of the drug or other substance may lead to moderate or low physical dependence or high psychological dependence.

Examples of Schedule III drugs include:

(4) Schedule IV.

(A) The drug or other substance has a low potential for abuse relative to the drugs or other substances in schedule III.

(B) The drug or other substance has a currently accepted medical use in treatment in the United States.

(C) Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in schedule III.

Examples of Schedule IV drugs include:

  • alprazolom (Xanax)
  • lorazepam (Ativan)
  • clonazepam (Klonopin)
  • diazepam (Valium)

(5) Schedule V.

(A) The drug or other substance has a low potential for abuse relative to the drugs or other substances in schedule IV.

(B) The drug or other substance has a currently accepted medical use in treatment in the United States.

(C) Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in schedule IV.

Certain cough medicines with codeine are examples of Schedule V drugs.

Benzodiazepines

Benzodiazepines are included in Schedule IV of the Act. This would seem to indicate that this class of medications has a relatively low potential for abuse in comparison with many other types of controlled substances. But, benzodiazepines do have the potential for physical dependency when used for long periods of time and psychologically addictive in some individuals.

Benzodiazepines should be taken only as directed by your doctor. You should not increase your dosage without consulting you doctor. Do not stop this medication without your doctor’s advice. Doing so may cause unwanted withdrawal symptoms or worsen your condition.

Source:

US Drug Enforcement Administration. TITLE 21 - FOOD AND DRUGS - CHAPTER 13 - DRUG ABUSE PREVENTION AND CONTROL - SUBCHAPTER I - CONTROL AND ENFORCEMENT. 05 Dec 2008.

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