The American College on Occupational and Environmental Medicine indicates that opioids are appropriate in the treatment of acute musculoskeletal pain only on a short-term basis and for chronic pain only when other methods and medications have failed. Most pain guidelines also recommend screening or identification of high or at risk patients. Failure to prescribe and monitor these drugs in a responsible manner can result in poor outcomes for injured workers, including delayed recovery and return to work. In some instances the highly addictive drugs can have even more severe impacts including death. In fact, deaths from opioid analgesics surpassed deaths from both cocaine and heroin between 1999 and 2002. Workers’ compensation stakeholders must confront the inappropriate use of narcotics in the system; injured workers are suffering and employers are paying for the unintended consequences of these drugs.
Controlled Substance Definitions
Controlled Substances are drugs or other chemicals that have the potential to be addictive or habit forming. The Drug Enforcement Administration (DEA) has divided the Controlled Substances into 5 schedules based on their potential to be habit forming and usefulness in medicine as a drug.
Controlled Substances are drugs or other chemicals that have the potential to be addictive or habit forming. The Drug Enforcement Administration (DEA) has divided the Controlled Substances into 5 schedules based on their potential to be habit forming and usefulness in medicine as a drug.
- Schedule I
- Drugs or other substances that have a high potential for abuse; no currently accepted medical use in the United States and have a lack of accepted safety for use under medical supervision.
- Heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote
- Schedule II
- Drugs or other substances that have a high potential for abuse; currently have an accepted medical use in treatment in the United States, or have a currently accepted medical use with severe restrictions; abuse may lead to severe psychological or physical dependence.
- Cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin
- Schedule III
- Drugs or other substances that have a potential for abuse less than Schedule I or II; currently have an accepted medical use in treatment in the United States; abuse may lead to moderate or low physical and high psychological dependence.
- Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone
- Schedule IV
- Drugs or other substances that have a low potential for abuse relative to those listed in Schedule III; currently have an accepted medical use in the United States; abuse may lead to limited physical or psychological dependence those in schedule III.
- Xanax, Soma, Darvon, Darvocet, Valium, Activan, Talwin, Ambien
- Schedule V
- Drugs or other substances that have a low potential for abuse relative to Schedule IV; currently have an accepted medical use in the United States; abuse may lead to limited physical orpsychological dependence relative to those in Schedule IV.
- Cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin
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