Controlled Substances Act

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The Controlled Substances Act (CSA) is a United States federal law. It controls what drugs American people and companies can have, make, import, and use. It also controls what drugs doctors can prescribe.

"Controlled substances" include illegal drugs, chemicals that are used to make illegal drugs, and some medications. If a government has rules or laws about a certain drug, then that drug is called a controlled substance.

The United States Congress passed the law as part of the Comprehensive Drug Abuse Prevention and Control Act of 1970. President Richard Nixon signed the bill into law on October 27, 1970.[1]

A U.S. Marshal seizes bags of cocaine in 1986. The Controlled Substances Act was meant to control drug trafficking, drug dealing, and abuse of drugs like cocaine

Summary

The Controlled Substances Act (CSA) sets laws about:[1]

  • Which drugs are controlled substances
  • When it is illegal to make, sell, or have controlled substances
  • What kinds of importation and exportation of controlled substances is illegal
  • The punishments for breaking these laws

The CSA does not include alcohol or tobacco as "controlled substances."[2]

Schedules

The CSA divides controlled substances up into five groups, called Schedules. Drugs are put into these categories based mostly on:[3]

  • How easily and commonly they are abused;
  • Whether they have any accepted medical uses;
  • International treaties
    • For example, the United Nations may make a treaty to control a new drug. If the United States agrees to that treaty, then the CSA has to be amended (changed) to add that drug to one of the Schedules

Amendments

The CSA was amended in 1986 to add designer drugs like Ecstasy

Since the CSA was created in 1970, many new illegal drugs and medications have been developed. Because of this, the Act has been amended many times to add on new types of drugs.

For example, since 1970, the CSA has been amended:[4]

The Schedules

There are five different Schedules of controlled substances, numbered I

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V (one through five in Roman numerals). The CSA describes the different Schedules based on three things:[6]

  1. Potential for abuse: How likely is this drug to be abused?
  2. Accepted medical use: Is this drug used as a treatment in the United States?
  3. Safety and potential for addiction: Is this drug safe? How likely is this drug to cause addiction? What kinds of addiction?

This table gives a summary of the differences between the different Schedules.[7]

Potential for Abuse Accepted Medical Use? Potential for Addiction
Schedule I High None Drug is not safe to use, even under medical supervision
Schedule II High Yes; sometimes allowed
only with "severe restrictions"
Abusing the drug can cause severe physical and mental addiction
Schedule III Medium[lower-alpha 1] Yes Abusing the drug can cause severe mental addiction, or moderate physical addiction
Schedule IV Low[lower-alpha 2] Yes Abusing the drug may lead to mild mental or physical addiction
Schedule V Lowest[lower-alpha 3] Yes Abusing the drug may lead to mild mental or physical addiction

Schedule I

The CSA says that no doctor in the United States can write a prescription for a Schedule I drug.[6] Some states have passed laws allowing doctors to prescribe marijuana for diseases like cancer and AIDS.[8] Even though those prescriptions are legal in those states, they are still illegal under the CSA.[7]

Here are some examples of Schedule I drugs:[7]

Schedule II

Schedule II drugs are the most-controlled type of drugs that a doctor can write a prescription for.[6] Some drugs that are usually illegal are on Schedule II. They are on Schedule II instead of Schedule I because sometimes, they can be used for medical reasons. For example, Schedule II includes cocaine, because it can stop bleeding and kill pain in the mouth, throat, and nose.[9] Schedule II also includes methamphetamine, because it is sometimes used to treat Attention-Deficit Hyperactivity Disorder (ADHD) and severe obesity.[10]

Even though many people use ADHD drugs like Ritalin legally, they are on Schedule II because some people abuse them

Other drugs on Schedule II include:[7]

The CSA puts limits on prescriptions for Schedule II drugs. For example, prescriptions for these drugs cannot be refilled. The patient cannot get more of the medication at the pharmacy without getting a new prescription. Also, the doctor must write the prescription

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they cannot call or fax the prescription to the pharmacy. The pharmacy needs an original copy of the prescription.[6]

Schedule III

Steroid pills that were going to be sold illegally. The CSA was amended in 1990 to include steroids

Schedule III drugs are less controlled than Schedule II drugs. Doctors can send these prescriptions to a pharmacy by fax or phone. These prescriptions can be refilled five times in six months without the patient needing a new prescription.[6]

Drugs in Schedule III include:[7]

Schedule IV

Schedule IV drugs have the same rules for prescriptions and refills that Schedule III drugs do. Examples of Schedule IV drugs include:[7]

Schedule V drugs like Lyrica are the least controlled of all the controlled substances

Schedule V

Schedule V drugs are the least strictly controlled of all the controlled substances. A doctor can call or fax the prescription to the pharmacy. There is no limit on the number of times a prescription can be refilled.[6]

Examples of Schedule V drugs include:[7]

Enforcement

The United States Drug Enforcement Administration (DEA) is in charge of enforcing the CSA. The DEA is part of the United States Department of Justice.

Usually, only two government agencies can add or remove drugs from a Schedule. These agencies are the (DEA) and the United States Food and Drug Administration (FDA). However, sometimes Congress passes special laws to add a drug to the CSA.[3]

Anyone can ask the DEA to add a drug, remove a drug, or change a drug to a different Schedule in the CSA. Even a regular person can petition the DEA for a change. After it gets a petition, the DEA starts an investigation of the drug.

During these investigations, the DEA gathers a lot of information, talks to different government agencies, gets the FDA's opinion, and does research. Because all of this takes time, a federal law allows the Attorney General of the United States to put a drug on Schedule I for a year. The law only allows this when there is "an imminent hazard" (an immediate threat) "to the public safety."[11] For example, in 2011, the Attorney General used this law to put synthetic cannabinoids on Schedule I.[12]

Notes

  1. Less than the drugs in Schedule I and Schedule II
  2. When compared with the drugs in Schedule III
  3. When compared with the drugs in Schedule IV

References

  1. 1.0 1.1 [https://www.gpo.gov/fdsys/pkg/STATUTE-84/pdf/STATUTE-84-Pg1236.pdf Pub.L. 91
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    513], 84 Stat. 1236, enacted October 27, 1970, codified at 21 U.S.C. § 801 et. seq.
  2. 21 USC § 802 – Definitions.
  3. 3.0 3.1 Yeh, Brian T. (December 13, 2012). The Controlled Substances Act: Regulatory Requirements (Report). Congressional Research Service. pp. 1–16. |access-date= requires |url= (help)
  4. [http://www.deadiversion.usdoj.gov/21cfr/21usc/841.htm 21 U.S.C. § 841
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    Prohibited acts A.]
  5. Karch, Steven B. (2007). Pathology, Toxicogenetics, and Criminalistics of Drug Abuse. CRC Press. p. 30. ISBN 978-1420054569.
  6. 6.0 6.1 6.2 6.3 6.4 6.5
  7. 7.0 7.1 7.2 7.3 7.4 7.5 7.6 [https://www.law.cornell.edu/uscode/text/21/812 21 U.S.C. § 812
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    Schedules of controlled substances].
  8. [https://www.law.cornell.edu/uscode/text/21/811#h 21 U.S.C. § 811(h)
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    Authority and criteria for classification of substances].
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