Clinical meaning
The DEA controlled substance schedules classify drugs by abuse potential and accepted medical use. Schedule I (no accepted medical use, high abuse potential: heroin, LSD, marijuana federally), Schedule II (high abuse potential with accepted medical use: oxycodone, morphine, fentanyl, amphetamines, methylphenidate), Schedule III (moderate abuse potential: buprenorphine, testosterone, codeine combinations), Schedule IV (low abuse potential: benzodiazepines, zolpidem, tramadol), Schedule V (lowest abuse potential: pregabalin, cough preparations with small amounts of codeine). NPs must hold a valid DEA registration and comply with state-specific prescriptive authority regulations for controlled substances.
Diagnosis & workup
Diagnostics & workup: - Check Prescription Drug Monitoring Program (PDMP) before every controlled substance prescription - Urine drug screen (UDS) at baseline and randomly during chronic opioid therapy - Assess pain using validated tools (numeric rating scale, functional assessment) - Screen for substance use disorder (CAGE-AID, DAST-10, ORT) - Morphine milligram equivalent (MME) calculation for opioid dosing - Risk stratification tools (ORT - Opioid Risk Tool)