If you're receiving treatment for ADHD, anxiety, depression, or other mental health conditions, you may be prescribed medications that are classified as "controlled substances" under federal law. This doesn't mean these medications are dangerous or that you should be concerned about taking them as prescribed. Many safe, effective psychiatric medications, including common ADHD stimulants and anxiety medications, fall into these categories simply because they require additional safety monitoring.

This guide helps you understand how these medications are classified, what to expect from your treatment, and how we work together to ensure your care is both safe and effective. Our goal is to provide you with the information you need to feel confident and informed about your mental health treatment.

Learning how substances are classified by federal law can empower patients, families, and healthcare providers to make informed, evidence-based decisions about care and safety. These schedules reflect both whether a substance has accepted medical uses and how likely it is to cause physical or psychological dependence.

Key Takeaways for Our Patients:

✓ Safe and effective: Many ADHD and anxiety medications are controlled substances that are safe and effective when used as prescribed

✓ Supportive monitoring: We use treatment agreements and monitoring tools to keep you safe and supported throughout your care

✓ Open communication: Honest, ongoing communication with your provider is key to your treatment progress and success

Drug Schedules:

Note: "Drug schedules" is the official federal terminology used in law. In clinical practice, we often refer to these as "controlled medications" to emphasize their therapeutic value.

Drugs, substances, and certain chemicals used to manufacture medications are classified into five distinct categories, referred to as schedules, based on their accepted medical uses and the likelihood of non-medical use or unsupervised consumption, which may pose safety concerns. A key factor in federal classification is how likely a substance is to be used outside of prescribed or medically supervised contexts. For example, Schedule I substances are considered the most restricted, as they lack recognized medical use and are associated with a high risk of causing physiological dependence, which is a normal bodily adaptation, and not the same as a substance use disorder. As the schedules progress, Schedule II, III, and so forth, this risk generally decreases. Schedule V substances are understood to carry the lowest risk of use beyond medical recommendation. A comprehensive listing of drugs and their schedules can be found on the DEA website under "Controlled Substance Act (CSA) Scheduling" or "CSA Scheduling by Alphabetical Order" (available at https://www.dea.gov/drug-information/drug-scheduling).

Schedule I

Schedule I medications, substances, or chemicals are defined as substances with no currently accepted medical use in the United States and a high likelihood of non-medical use or unsupervised consumption, which may lead to severe physiological dependence (a natural biological adjustment that does not indicate addiction). These substances are not currently indicated for psychiatric treatment by the federal government. Some examples include: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote. Understand, politics and pharmacological sciences are ever-evolving, thus these substances may be reclassified in the future as science progresses.

Schedule II

Schedule II medications, substances, or chemicals have accepted medical uses but a high likelihood of non-medical use or unsupervised consumption and are associated with significant risks, including the potential for physiological dependence (a normal body response that is different from substance use disorder). Some examples of Schedule II drugs are: stimulants such as Adderall (amphetamine), Ritalin (methylphenidate), Dexedrine (dextroamphetamine), and Vyvanse (lisdexamfetamine) commonly used to treat ADHD; and certain other controlled medications including some pain relievers. In our mental health practice, this schedule primarily includes medications used to treat ADHD and attention-related disorders.

Schedule III

Schedule III medications, substances, or chemicals have accepted medical uses and a moderate likelihood of non-medical use or unsupervised consumption, with lower potential for physiological dependence (a normal bodily adaptation) compared to Schedule I and II substances. Some examples of Schedule III drugs include: ketamine (used in treatment-resistant depression and administered in clinical settings), buprenorphine (used for opioid use disorder treatment), and certain combination medications. In psychiatric care, this schedule is most relevant for specialized depression treatments.

Schedule IV

Schedule IV medications, substances, or chemicals have accepted medical uses and a low likelihood of non-medical use or unsupervised consumption, with lower potential for physiological dependence compared to Schedule III substances. Some examples of Schedule IV drugs commonly used in mental health treatment include: benzodiazepines such as Xanax (alprazolam), Valium (diazepam), Ativan (lorazepam), and Klonopin (clonazepam) for anxiety disorders; sleep medications like Ambien (zolpidem); and certain other psychiatric medications like Tramadol.

Schedule V

Schedule V medications, substances, or chemicals have accepted medical uses and the lowest likelihood of non-medical use or unsupervised consumption among all scheduled substances. These consist of preparations containing limited quantities of certain medications and are generally used for various therapeutic purposes. Examples include Lyrica (pregabalin), which may be prescribed for anxiety and nerve-related conditions, and some cough preparations with codeine. These are typically used under close supervision for short-term symptomatic relief.