Understanding the Role of Opioids in Pain Care
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Opioids are considered
Opioids are considered controlled substances, which means they are regulated by the government. Controlled substances are regulated because they can potentially have a detrimental effect on a person’s health and wellbeing when taken inappropriately, illegally or not used for a legitimate medical use.1 The Drug Enforcement Administration (DEA) organizes controlled substances into five schedules according to medical value and potential for abuse. Each schedule has a different level of restriction.
Here's an overview of these schedules and examples of drugs within each. Note: not all of the drugs listed below are opioids.2
Substances have no currently accepted medical use in the US, a lack of accepted safety for use under medical supervision and a high potential for abuse.
Heroin, LSD, marijuana, peyote, methaqualone, ecstasy
Substances have a high potential for abuse, which may lead to severe psychological or physical dependence. Substances require a signed, written prescription, and refills are prohibited.
Fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, opium oxycodone, oxymorphone
Substances have less potential for abuse than substances in Schedules I or II, and abuse may lead to moderate or low physical dependence or high psychological dependence.
Buprenorphine, buprenorphine/naloxone, acetaminophen with codeine, nalorphine
Substances have a low potential for abuse relative to substances in Schedule III.
Alprazolam, carisoprodol, clonazepam, clorazepate, diazepam, lorazepam, midazolam, temazepam, triazolam
Substances have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics.
Pregabalin, Robitussin AC, Phenergan with Codeine, ezogabine
2 million Americans
~2 million Americans had substance use disorders related to prescription pain relievers in 2015.3