What is the Controlled Substances Act (CSA)?

Background

Not until the 1960s did drug abuse
become a major federal-government issue in the United States. Before this time, drug abuse was considered mostly an unacceptable behavior. The 1960s, however, saw an escalation in drug-related crime, including the smuggling of drugs into the United States.

In response, in 1970, Congress passed the Comprehensive Drug Abuse Prevention and Control Act. The Controlled Substances Act (CSA) was part F of this law. To enforce this legislation US president Richard M. Nixon created the Drug Enforcement Administration
(DEA) in 1973. Before the establishment of the DEA, the United States had several federal agencies involved in drug regulation and control. The DEA was formed to group all drug-control activities under a single federal agency.

The DEA is responsible for achieving the mission of the CSA. Also involved in activities related to the CSA are the Department of Health and Human Services (including its National Institute on Drug Abuse, part of the National Institutes of Health) and the Food and Drug Administration
(FDA), both of which help determine what substances are to be covered by the CSA.

The CSA established five schedules to classify controlled substances. Controlled substances are narcotics, hallucinogens, anabolic steroids, stimulants, and tranquilizers. Controlled substances are assigned to a schedule based on three factors: their potential for abuse, whether they have a medical use, and whether the substance can be safely used.

Schedule I drugs have no medical use, have a high potential for abuse, and have no accepted safety levels. Prescriptions cannot be written for schedule I drugs. Some examples of Schedule I drugs are cannabis, heroin, 3,4-methylenedioxymethamphetamine, lysergic acid diethylamide, mescaline, and methaqualone.

Schedule II drugs have a high potential for abuse, have either no medical use or may have a medical use in certain conditions, and have a high potential for addiction. Some examples of schedule II drugs are cocaine, opium, morphine, methamphetamine, methylphenidate, and methadone. Schedule III drugs have less potential for abuse, are used for medical treatment, and have a moderate risk for addiction. Some examples of schedule III drugs are anabolic steroids, ketamine, and dihydrocodeine.

Schedule IV drugs are much less likely to be abused, have a medical use, and are less likely to lead to addiction. Some examples of schedule IV drugs are benzodiazepines, modafinil, zolpidem, and meprobamate. Schedule V drugs are even less likely to be abused, have a medical use, and are unlikely to lead to addiction. Some examples of schedule V drugs are diphenoxylate, pregabalin, and cough suppressants with codeine.

In addition to drug schedules, the CSA has other provisions related to drug use. The CSA requires that all persons involved with drug production, distribution, possession, use, importation, and exportation be registered with the DEA. The CSA includes the specifications for storage of controlled drugs and the security for this storage. It describes the records that must be kept for the use of controlled drugs. The CSA describes how controlled drugs are to be disposed of. In addition, the CSA discusses penalties for abuse of controlled drugs, procedures for importing and exporting controlled drugs, procedures for producing controlled drugs, and the provision for the taking of the violator’s assets.

The CSA has been amended several times since 1970, to include major changes in the law and to reflect amendments of CSA rules, such as to add new drugs or substances or to change the schedule of a drug or substance based on new information. Later changes have included permitting electronic and facsimile prescriptions for schedule II drugs and limiting the amount of pseudoephedrine that may be purchased at one time. This last change requires that the purchaser present a picture identification card at the point of sale. In the 2010s, there have been several attempts to convince federal courts, Congress, or the DEA to reclassify cannabis under schedule II or III, as there is increasing acceptance of its medicinal use, and its toxicity and potential for physical dependence are lower than those of other schedule I drugs. However, the DEA maintains that its medical usefulness has not yet been sufficiently proven and documented, and that any drug without an accepted medical use must remain in schedule I regardless of abuse potential.

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