Certain medications used to treat anxiety disorders fall under the legal classification of “controlled substances.” Benzodiazepines, a class of medications commonly used for their tranquilizing and anti-anxiety effects, are considered a Schedule IV controlled substance. (Ativan and Valium are examples of benzodiazepines. Though some people mistake it for an opioid, the Xanax drug class is also benzodiazepine.) But, what exactly does it mean to be a Schedule IV controlled substance?

This article contains information on why benzodiazepines are controlled substances, what the classifications of controlled substances are, and provides a benzodiazepines list along with their common side effects.

The Controlled Substance Act of 1970

For many decades, the United States has fought what is often termed a “War on Drugs.” Recognizing the potential that certain medications have for misuse and dependence, Congress enacted the Controlled Substances Act (CSA) as part of the Comprehensive Drug Abuse Prevention and Control Act of 1970. Over the years, the Act has had several revisions including:

  • The Psychotropic Substances Act of 1978The Controlled Substances Penalties Amendments Act of 1984The Federal Analog Act of 1986The Chemical Diversion and Trafficking Act of 1987The Domestic Chemical Diversion and Control Act of 1993The Methamphetamine Precursor Control Act of 2005

The CSA mandates that manufacturers, distributors, pharmacies and healthcare providers diligently ensure the safe and efficient delivery of controlled substances identified within five schedules under the Act.

Understanding the “Schedules” of Controlled Substances

Medications controlled by the CSA fall into one of five schedules. Each schedule attempts to classify drugs in order of their potential for abuse, medical value, and safety standards. Schedule I drugs are seen as having the most serious for misuse; Schedules II through V include drugs in decreasing order of potential for misuse.

To understand what Title 21, Chapter 13 of the CSA entitled “Drug Abuse Prevention and Control” says about various controlled substances, let’s look at a brief overview of each schedule.

Schedule I

Drugs and other substances that fall into Schedule I classification are seen to have the highest potential for abuse. They are also deemed as having no accepted medical use in the United States and lack customary safety standards.

Examples of Schedule I drugs include:

  • Crack cocaine
  • Heroin
  • Lysergic acid diethylamide (LSD)
  • Marijuana
  • Phencyclidine (PCP)

Schedule II

These drugs and substances also have a high potential for abuse, but they do have a currently accepted medical use in the United States. It’s noted in the CSA that abuse of these drugs “may lead to severe psychological or physical dependence.”

Examples of Schedule II drugs include:

  • Dexedrine (dextroamphetamine)
  • Morphine
  • Percodan and OxyContin (oxycodone)
  • Ritalin (methylphenidate)

Schedule III

The potential for abuse of Schedule III drugs and substances is considered lower than the previous categories. These, too, have a medicinal use, though they can lead to “moderate or low physical dependence or high psychological dependence.”

Examples of Schedule III drugs include:

  • Anabolic steroids
  • Vicodin

Schedule IV

This is where benzodiazepines fall into the controlled substance classifications. The substances classified as Schedule IV have a lower potential for abuse compared to drugs in other schedules, but the risk does remain. Again, Schedule IV drugs do have medical uses and many are common treatments for anxiety and similar medical conditions.

According to the CSA, drugs listed in Schedule IV are classified as such because “Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in Schedule III.”

A common question people ask is: Is Xanax a controlled substance? The answer is yes, because Xanax is a benzodiazepine, and benzodiazepines are Schedule IV controlled substances.

Additional examples of Schedule IV drugs include the benzodiazepines listed below.

  • Xanax (alprazolam)
  • Ativan (lorazepam)
  • Klonopin (clonazepam)
  • Valium (diazepam)

Schedule V

In relation to other controlled substances, Schedule V drugs have a low potential for abuse and they are common medical treatments. While the risk of dependence is very low, it does still exist.

Examples of Schedule V drugs include antidiarrheals, antitussives (cough medicine), and analgesics (pain relievers).

What Are Benzodiazepines?

Benzodiazepines are prescription-only depressants that produce relaxing effects by slowing down the central nervous system (CNS). They are often prescribed to treat anxiety disorders, sleep disorders, and panic disorder. Some are also used as anticonvulsants to treat seizures.

List of Benzodiazepines

The following are drugs that fall into the class of benzodiazepines:

  • Ativan (lorazepam)
  • Centrax (prazepam)
  • Dalmane (flurazepam)
  • Doral (quazepam)
  • Halcion (triazolam)
  • Klonopin (clonazepam)
  • Librium (chlordiazepoxide)
  • Paxipam (halazepam)
  • ProSom (estazolam)
  • Restoril (temazepam)
  • Tranxene (clorazepate)
  • Serax (oxazepam)
  • Valium (diazepam)
  • Versed (midazolam)
  • Xanax (alprazolam)

Cautions Regarding Benzodiazepines

While Schedule IV indicates that benzodiazepines have less potential to be misused compared to other types of controlled substances, benzodiazepines are still commonly misused drugs.

Side effects of benzodiazepines may include:

Research has shown that benzodiazepines can cause harmful psychological and physical dependence. Some withdrawal symptoms can be fatal.

  • Blurry vision
  • Dizziness
  • Drowsiness
  • Erratic behavior
  • Euphoria
  • Fatigue
  • Hostility
  • Mood swings
  • Slurred speech
  • Tolerance
  • Vertigo

Let a doctor know if you experience these or any other side effects.

Benzodiazepines should be taken only as directed by a doctor. You should not increase your dosage without consulting a doctor. Also, do not stop taking this medication without a doctor’s advice. Doing so may cause unwanted withdrawal symptoms or worsen your condition.

Signs of Overdose

The effects of overdosing on benzodiazepines include drowsiness, confusion, impaired coordination, respiratory problems (trouble breathing), and coma. Overdose can be fatal. If you or a loved one experiences any of the signs of overdose, you should seek emergency medical attention immediately.

Frequently Asked Questions

  • What are benzodiazepines, and what is their medical use?
  • Benzodiazepines are depressant drugs that produce a tranquilizing effect. They are sometimes prescribed to treat anxiety disorders, sleep disorders, or panic disorder.
  • What does “Schedule IV drugs” mean, and are they addictive?
  • The Controlled Substances Act divides drugs into five schedules; benzodiazepines are Schedule IV drugs and they have the potential to be addictive.
  • Is Xanax considered a controlled substance?
  • Yes, Xanax is a benzodiazepine, which is a class of drugs categorized as a Schedule IV controlled substance.

Benzodiazepines are depressant drugs that produce a tranquilizing effect. They are sometimes prescribed to treat anxiety disorders, sleep disorders, or panic disorder.

The Controlled Substances Act divides drugs into five schedules; benzodiazepines are Schedule IV drugs and they have the potential to be addictive.

Yes, Xanax is a benzodiazepine, which is a class of drugs categorized as a Schedule IV controlled substance.