Controlled Substance Schedules
Controlled substance schedules are the DEA's five-tier classification system (Schedule I through Schedule V) that categorizes drugs based on their accepted medical use, abuse potential, and likelihood of causing dependence.
Exam Tip
Schedule II = NO refills, written/electronic Rx only, exact count for inventory. Schedules III-V = up to 5 refills in 6 months. Know DEA Forms: 222 (ordering C-II), 41 (destruction), 106 (theft/loss).
What Are Controlled Substance Schedules?
The Controlled Substances Act (CSA) of 1970 established five schedules for classifying drugs and other substances based on their potential for abuse, currently accepted medical use, and safety profile. The Drug Enforcement Administration (DEA) and FDA determine scheduling.
The Five Schedules
| Schedule | Abuse Potential | Medical Use | Dependence | Examples |
|---|---|---|---|---|
| Schedule I | Highest | No accepted medical use | Severe | Heroin, LSD, marijuana (federal), ecstasy, peyote |
| Schedule II | High | Accepted with restrictions | Severe physical/psychological | Oxycodone, fentanyl, morphine, amphetamine (Adderall), methylphenidate (Ritalin) |
| Schedule III | Moderate | Accepted | Moderate/low physical, high psychological | Testosterone, ketamine, anabolic steroids, Tylenol with codeine |
| Schedule IV | Low | Accepted | Limited | Benzodiazepines (Xanax, Valium), zolpidem (Ambien), tramadol |
| Schedule V | Lowest | Accepted | Limited | Pregabalin (Lyrica), cough syrups with small amounts of codeine, lacosamide |
Prescribing and Dispensing Rules
| Rule | Schedule II | Schedules III-V |
|---|---|---|
| Prescription type | Written/electronic only (no phone-in except emergency) | Written, oral, fax, or electronic |
| Refills | NO refills allowed | Up to 5 refills within 6 months |
| Transfer | Cannot be transferred between pharmacies | Can be transferred once (or unlimited if pharmacies share real-time database) |
| Emergency dispensing | 72-hour emergency supply; prescriber must follow up with written Rx within 7 days | Not applicable |
| Inventory | Exact count required | Estimated count allowed |
DEA Requirements for Pharmacies
- Must have a valid DEA registration number
- Must keep Schedule II records separate from III-V
- Biennial inventory required
- DEA Form 222 or CSOS for ordering Schedule II
- DEA Form 41 for destruction of controlled substances
- Report theft/loss on DEA Form 106
Exam Alert
Controlled substance schedules are a cornerstone topic in the Overview and Laws/Regulations domain (25% of ExCPT). Know the schedule classifications, refill rules (Schedule II = NO refills), and key DEA forms (222, 41, 106).
Study This Term In
Related Terms
DEA Number
A DEA number is a unique identifier assigned by the Drug Enforcement Administration to healthcare providers and pharmacies authorized to handle controlled substances, used to track prescribing and dispensing activity.
Biennial Inventory
A biennial inventory is the DEA-required physical count of all controlled substances that must be conducted by every registrant (pharmacy, hospital, practitioner) at least once every two years to account for Schedule II-V drugs on hand.
OBRA-90 (Omnibus Budget Reconciliation Act of 1990)
OBRA-90 is a federal law that mandated prospective drug utilization review (DUR), patient counseling by pharmacists, and maintenance of patient medication profiles for all Medicaid prescription recipients.
10 free AI interactions per day
Stay Updated
Get free exam tips and study guides delivered to your inbox.