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  • Opioids are pain-relieving drugs widely used by healthcare providers to control moderate to severe or chronic pain, including palliative care to control cancer pain. 

    However, opioids have a high potential for abuse and addiction, potentially resulting in harmful or fatal opioid overdoses. As a result, opioids are rightly considered controlled substances, and misuse of opioid drugs is addressed with strict penalties on both state and federal levels.

    State Opioid Laws

    State laws and policies intended to regulate opioid prescriptions and prevent or penalize opioid misuse vary significantly and are subject to frequent change.

    These laws are usually based on the Federal Controlled Substances Act and often focus on regulating the actions of health care professionals, clinicians, and other narcotic prescribers. 

    Over half of all states have enacted laws that place restrictions on opioid prescriptions for acute pain, with most limiting initial opioid prescription sizes to seven day supplies or less and establishing prescription drug monitoring programs (PDMPs).

    Many of these new laws and regulations are intended to address the United States opioid epidemic by:

    • limiting the over-prescription of narcotics to keep opioids out of the black market
    • reducing the likelihood of patients developing physiological dependence on these substances
    • encouraging the use of non-opioid pain relief whenever appropriate
    • reducing harm due to opioid misuse
    • allowing individuals prescription-free access to naloxone, an opioid overdose antidote
    • promoting professional treatment for opioid use disorder
    • further penalizing distribution or use of illicit substances

    Federal Penalties For Opioid Possession

    Illicit possession, use, or distribution of any controlled substance is prohibited and penalized by federal law, with certain offenses triggering high fines, mandatory prison terms, and confiscation of personal property.

    The penalties for trafficking larger quantities of drugs or facilitating drug overdoses are especially severe.

    For example: possessing 40-400 grams of fentanyl or 100-1000 grams of heroin will incur a minimum of 5 years in prison with a minimum of 10 years of prison time for higher quantities.

    If distribution of these substances results in serious bodily injuries or overdose deaths, the penalty is increased to 20 years and a fine of less than five/ten million dollars may result.

    Opioid Schedules

    Different opioid substances and formulations are classified as Schedule I, II, or III controlled substances.

    Schedule I

    Schedule I drugs are those with: 

    • no currently accepted medical use in the United States
    • a lack of accepted safety for use under medical supervision
    • a high potential for abuse

    Certain synthetic designer drugs (new opioids) and heroin (diamorphine) are considered Schedule I drugs.

    Schedule II

    Schedule II drugs are known to have an important and often vital role in United States medical treatment, but also possess a high potential for abuse. 

    Use of these medications for pain management or illicit misuse of these medications may lead to psychological or physical dependence.

    Schedule II opioid analgesics include: 

    • hydromorphone (Dilaudid®)
    • methadone (Dolophine®)
    • meperidine (Demerol®)
    • oxycodone (OxyContin®, Percocet®)
    • fentanyl (Sublimaze®, Duragesic)
    • morphine
    • codeine
    • hydrocodone

    Schedule III

    Schedule III drugs still have a high potential for abuse leading to moderate physical dependence or high psychological dependence, but these potentials are significantly lower than those associated with Schedule II drugs.

    Schedule III drugs include products containing less than 90 milligrams of codeine (Tylenol with Codeine®) or buprenorphine (Suboxone®).

    Treating Substance Use Disorder

    The American opioid epidemic is an ongoing public health emergency that has brought tragedy to countless Americans.

    Evidence-based treatment for opioid use disorder at an inpatient rehab center can help people overcome this disease. During your inpatient or outpatient treatment, staff put you and your family’s needs first, with proven and professional services that may include:

    • medical detox
    • medication-assisted treatment (MAT)
    • cognitive-behavioral therapy
    • treatment of co-occurring mental health disorders
    • individual and group-based counseling
    • supportive aftercare services

    To learn more,  please contact Ark Behavioral Health today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    American Medical Association (AMA) Journal of Ethics - Fighting Prescription Drug Abuse with Federal and State Law
    Centers for Disease Control and Prevention (CDC) - Prescription Drug Monitoring Programs (PDMPs)
    Drug Enforcement Administration (DEA) Diversion Control Division - Controlled Substance Schedules
    Drug Enforcement Administration (DEA) Diversion Control Division - Title 21 United States Code (USC) Controlled Substances Act
    Substance Abuse and Mental Health Services Administration (SAMHSA) - Laws and Regulations

    Medically Reviewed by
    Kimberly Langdon M.D.
    on March 8, 2021
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