II. Types: Class I (Schedule I Controlled Substance)

  1. High abuse potential
  2. No accepted medical use
  3. Examples
    1. Heroin
    2. Gamma Hydroxybutyrate (GHB)
    3. Lysergic Acid Diethylamide (LSD)
    4. Methaqualone
    5. Peyote
    6. 3,4-Methylenedioxymethamphetamine (Ecstasy)

III. Types: Class II (Schedule II Controlled Substance)

  1. High abuse potential
  2. Severe dependence liability
  3. Examples
    1. Morphine
    2. Codeine
    3. Hydromorphone
    4. Cocaine
    5. Amphetamines (e.g. Adderall)
    6. Methylphenidate (e.g. Ritalin, Concerta)
    7. Secobarbital
    8. Oxycodone (Percocet)

IV. Types: Class III (Schedule III Controlled Substance)

  1. Moderate dependence liability
  2. Examples
    1. Tylenol with Codeine (Tylenol #3)
    2. Hydrocodone (e.g. Vicodin) - will be moved to Class II in 2014

V. Types: Class IV (Schedule IV Controlled Substance)

  1. Limited dependence liability
  2. Examples
    1. Benzodiazepines (e.g. Xanax, Ativan, Valium, Klonopin)
    2. Propoxyphene (e.g. Darvocet)
    3. Phentermine

VI. Types: Class V (Schedule V Controlled Substance)

  1. Limited abuse potential
  2. Examples
    1. Lomotil

VII. Protocol: Schedule II Narcotic Prescriptions (DEA regulations, States may have additional rules)

  1. Electronic Prescription of controlled substances
    1. Will be required in Medicare Part D by 2021, and many states are also implementing requirements
    2. E-Presciptions reduce the risk of controlled substance diversion and abuse
    3. Requires 2 factor authentication
  2. Pharmacy must receive an original signed prescription before dispensing
    1. Prescription may not be changed by pharmacist on contacting provider for clarification
  3. Exceptions in which alternative to original prescription is acceptable
    1. Fax is sufficient in long term care patients, Hospice patients, or ParenteralNarcotics
    2. Limited quantity emergency prescriptions may be phoned to pharmacy
      1. Require that pharmacy receive original signed prescription within 7 days
  4. Prescription may cover up to 90 day supply
    1. Total of 90 day supply may be split over multiple prescriptions (e.g. 1 month each)
    2. Each prescription must have the date today (not post-dated) and an earliest fill date
    3. Partial filling of prescription is allowed for terminally ill and long-term care patients
  5. References
    1. (2020) Prescr Lett 27(1): 4
    2. (2008) Prescr Letter 15(1):1
    3. FDA Rule: Issuance of Multiple Prescriptions for Schedule II Controlled Substances
      1. http://www.deadiversion.usdoj.gov/fed_regs/rules/2007/fr1119.htm

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