The Controlled Substances Act is a law passed in 1970 in the United States that determines the drugs that are classified as scheduled drugs, as well as their specific classification. The drugs that are regulated by the act are those drugs that are also regulated by federal law. The drugs are placed into one of five schedules based on the medical use of the substance, its abuse potential, and the risk for dependence (addiction). In addition, the CSA discusses the method by which drugs may be added to or removed from a schedule or transferred from one schedule to another.

The Comprehensive Crime Control Act of 1984 amended the CSA, such that the drug enforcement administrator may place a substance that has no approved medical use under Schedule I (which includes only illegal drugs with addictive potential) on a temporary emergency basis for up to one year. This time frame may be extended a further six months.

Organizations that may add, delete, or change a schedule include the Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS). In addition to these organizations, a petition to change a drug schedule can be made by a drug manufacturer, a medical association, a pharmacy association, a public group, and even an individual U.S. citizen. At one point, there was an effort by some individuals to move methylphenidate (Ritalin, Concerta, Focalin, etc.) to classification as a Schedule III drug; however, this attempt was disapproved.

The CSA regulates narcotics, depressants, stimulants, hallucinogenic drugs, and anabolic steroids. It also requires strict record keeping of all controlled substances, and each substance must also be inventoried every two years. These requirements were made to help to trace the flow of drugs from the point of manufacture or importation to distribution, then to the pharmacy and hospital and finally, to the patient who received the drug. Such requirements help to prevent drug diversion. Records for Schedule I and II drugs must be kept separate and in a more secure place than for drugs that fall into Schedules III, IV, and V.

Schedule I drugs, which include marijuana, heroin, lysergic acid diethylamide (LSD), and crack cocaine, are considered highly addictive and may only be used lawfully in government-approved research. Schedule II, III, IV, and V drugs may be prescribed by or directly administered by a doctor. Some states require multiple-copy prescriptions of Schedule II drugs.

Under the CSA, refills may not be prescribed for Schedule II drugs. If the patient continues to need the drug, he or she must receive a new prescription every 30 days, which is also not refillable. The doctor may not call in the prescription over the phone to a pharmacist. In contrast, if the doctor prescribes drugs from Schedules III through V, he or she may give the patient a written prescription or call in the drug to the pharmacy. Refills of drugs in those categories may be authorized.

With Schedule V drugs, which are primarily cough medicines with codeine and some antidiarrhea drugs, the law requires that the patient be at least 18 years old and show the pharmacist personal identification, and his or her name must be entered into the pharmacist's special log.

States have the option to schedule a drug at a higher scheduled level than that which has been conferred by the federal government, but they may not schedule drugs at a lower level. Thus, states may be more punitive than the federal government but may not be less punitive.

This is one of the reasons why when states have passed laws legalizing marijuana (primarily for medical purposes for patients who have severe illnesses), the federal government has expressed its adamant opposition to these laws, since marijuana is classified as a Schedule I drug under the Controlled Substances Act. They argue that only Congress can make laws that assign a lower rating to a drug, and that this is not an act that is within the powers of any individual state. Those who wish to decriminalize the use of marijuana, for medical or recreational use, do not regard marijuana as a dangerous and addictive drug. This controversy is likely to continue, as of this writing.

Since 1970 when the Controlled Substances Act was enacted, many drugs have been added to the scheduled drugs list, such as methylenedioxymethamphetamine (MDMA/ecstasy) and anabolic steroids.

References:

Joseph, Donald E. Drugs of Abuse. Washington, D.C.: U.S. Department of Justice, 2005.

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