Author: Ruben Bermea, LPC

The Schedule 1 narcotics list include a group of controlled substances that the Drug Enforcement Agency (DEA) has deemed illegal to use based on their lack of medical benefit and “potential for abuse” that can lead to addiction and harm.¹

The scheduling system allows the DEA and other government agencies to determine which substances people can legally consume for medical purposes and how they can legally access them.¹

In this Article:

• What is a Schedule 1 Narcotic?
• Schedule 1 Narcotics List
• Other Schedule 1 Controlled Substances
• Treatment for Schedule 1 Narcotic Use

What is a Schedule 1 Narcotic?

Narcotics are opioids of which the DEA limits access.¹ According to the DEA, narcotics include “opium, opium derivatives, and their semi-synthetic substitutes.”¹

The Schedule 1 controlled substance list serves as the highest tier of the DEA’s scheduling system. A Schedule 1 drug has a “high potential for misuse” and “no currently accepted medical use in treatment in the United States.”¹

Opioid use can cause physiological dependence, withdrawal, and overdose.² It can also can pose legal, personal, and health risks, especially when the opioid is made illegally.^{1, 2}

The risk for developing an opioid use disorder is related to genetics, individual temperament, family and influences, and social environmental factors, according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Schedule 1 Narcotics List

Different types of opioids share similarities in their influence on a person’s mind and body when used.¹ Beyond heroin, the Schedule 1 narcotics list includes several analogs of opioids.¹ Analogs are drugs that share chemical similarities with other drugs.

Differences in potency, purity, and chemical structure can change how Schedule 1 controlled substances impact the health of those who take them.¹

Heroin

Heroin holds many risks for users and can affect their loved ones, as well as the communities where people sell it.³ Heroin influences the way your central nervous system and brain function.

The pleasure and pain relief associated with heroin use can increase a person’s desire to misuse this substance. When physically dependent on or addicted to heroin, many people continue to misuse heroin despite knowledge of the risks and of developing or existing health problems.

Some symptoms of heroin use include:³

• Extreme drowsiness
• Vomiting
• Nausea
• Itchiness
• Slow heart rate
• Impaired breathing

Heroin’s impact on breathing can lead to life-threatening changes in the body.³ The lack of oxygen that often occurs during heroin use makes people struggle to breathe and can cause permanent brain damage. Repeated use leads to comas or death.

On the streets, people may identify heroin using names such as:^{1, 4}

• H
• Horse
• Hell Dust
• Big H
• Smack
• Skunk
• Skag
• Negra
• Thunder
• Chiva
• Brown Sugar
• Dope
• White Horse

People who misuse this substance tend to inject, smoke, or snort it through their nose.⁴ Snorting this substance can cause damage to mucosal tissues in the nose. Perforations to the nasal septum can also occur when a person snorts heroin.³

People who inject heroin often experience scarring in the veins. Others experience infections in soft tissue, heart valves, and blood vessels.³ Abscesses, or swelling of body tissue filled with pus can develop.

In addition, those who inject can contract certain infections when they share used needles.³ Needle-sharing leads to the spread of HIV, hepatitis, and other blood-borne illnesses. The likelihood of bacterial infection adds another layer of risk to heroin injections.

Heroin may appear as a brown or white powder. Others may consume a type of heroin known as “black tar heroin,” which is a sticky dark-colored version of this Schedule 1 narcotic.

Opioid overdose is one of the most serious health risks when using heroin.³ Using more heroin than you can safely process depresses breathing and heart function. Without emergency medical intervention, overdose often leads to death.

Access to naloxone, an overdose antidote prescribed under brand names such as Narcan and Kloxxado, can increase the chances of surviving an overdose.³ Family members or first responders who know how to administer these life-saving medications can help those experiencing opioid overdoses. Once administered, naloxone counters the effects of opioid overdose and prevent this emergency from becoming life-threatening.³

Why Are Some Narcotics Illegal While Others Aren’t?

Prescription narcotics are legal because they are effective at treating pain, and can be safe if used as directed by a doctor. However, heroin is illegal because it is unregulated and has no known medical use.

Fentanyl Analogs

Fentanyl is an opioid available legally for medical purposes as a Schedule II narcotic, given its role in alleviating pain in cancer patients who have a high tolerance to other opioid pain relievers.

However, The DEA also recognizes the risks of illegally made fentanyl analogs, which are opioids with similar chemical structures to legal fentanyl medications. Given how analogs are illicitly manufactured and sold for misuse, the DEA classifies fentanyl analogs as Schedule 1 controlled substances.

Fentanyl goes by several street names including:^{1, 4}

• He-Man
• China White
• Snowflake
• Blue
• Blonde
• Diamond
• Tango and Cash
• Murder 8
• Great Bear
• China Town
• China Girl
• Friend
• Dance Fever
• Apache
• Goodfellas
• King Ivory
• Jackpot
• Humid
• Cash

People can take fentanyl in several ways.¹ Some ingest fentanyl by mouth in lozenge or tablet forms. Others inject a fentanyl analog in its powder form. Snorting and smoking fentanyl are also common.

The impurities in many illegal substances like fentanyl analogs can lead to unintended drug exposure. For instance, other illicit substances, such as heroin or cocaine, may be laced with fentanyl.¹ 

Fentanyl can impact the body and mind in a similar way to other opioids, including heroin.¹

Effects of fentanyl misuse include:¹

• Confusion
• Nausea
• Euphoria
• Drowsiness
• Dizziness
• Pain reduction
• Relaxation
• Sedation
• Urinary problems
• Vomiting
• Small pupils
• Breathing problems

As with heroin and other opioid substances, this narcotic can result in overdose.¹

A sure sign of an overdose is clammy skin that feels cold to the touch and turns blue or purple. Slowed breathing and coma can indicate an increased risk of overdose becoming life-threatening. Risk of overdose can increase if you take more fentanyl than your body can process.

As with heroin overdoses, naloxone can save a life when someone overdoses on fentanyl analogs.⁵ Treat all suspected overdoses as emergencies and seek medical attention immediately.

Other Schedule 1 Controlled Substances

Schedule 1 drugs include more substances than only narcotics.¹ According to the DEA, several substances in the hallucinogen and stimulant classes of substances qualify for Schedule 1 designations.^{2, 4} People who misuse these other drugs also develop addictions that prove lethal.²

Despite the legalization of marijuana (cannabis) for medical and recreational use in some states, the DEA still currently classifies tetrahydrocannabinol (THC), which is the psychoactive ingredient in marijuana, as a Schedule 1 drug that has no federally recognized medical use.²

Use of THC outside of the legal parameters of your state for medical or recreational purposes is subject to criminal penalties similar to those of any other controlled substance.

Substances that the DEA classifies as Schedule 1 drugs include:^{1, 4}

• Marijuana or cannabis
• Synthetic cannabinoids
• MDMA or 3,4-methylenedioxymethamphetamine
• LSD or lysergic acid diethylamide
• Psilocybin
• Mescaline, derived from peyote
• PCP
• Cathinone
• Ayahuasca
• DMT
• GHB or gamma-hydroxybutyrate
• PCP or phencyclidine
• Synthetic cathinone or bath salts

Each type of controlled substance has a unique chemical structure, effects on users, and symptoms that occur due to addiction.^{1, 2, 4}

If you have concerns about the way substance use may impact you or someone you know, reach out for support. An assessment can help determine the level of care needed to begin the road to addiction recovery.⁶

Treatment for Schedule 1 Narcotic Use

Before anyone can begin treatment for opioid or narcotic use, they may benefit from completing detoxification or a withdrawal management process.⁶ Withdrawal management constitutes a set of treatment protocols that helps you safely remove substances from your system.

Sometimes withdrawal can become so severe that a person needs to visit the hospital or stay at a residential treatment facility for support.⁶ Withdrawal management for Schedule 1 narcotics for less acute symptoms can take place in an intensive outpatient or partial hospitalization treatment setting.

But if substance use and withdrawal experience become life-threatening, they can enroll in a higher level of care.

After a successful detox, patients usually step down to begin behavioral therapy in addition to medical measures.⁶ People can receive substance use treatment at inpatient hospitals, residential treatment facilities, and an array of outpatient programs.

Treatment services that can support recovery from narcotics include:⁶

• Individual psychotherapy
• Group therapy
• Peer and mutual support groups
• Holistic interventions
• Medication management
• Family therapy
• Case management
• Treatment and relapse prevention planning
• Sober living accommodations

An assessment from a qualified substance use treatment provider can help you figure out what treatment program best suit your needs.⁶

For more information on where to get an assessment or how to begin treatment, call 800-934-1582(Sponsored) or find an NA meeting to find the closest community resources near you.

References:

1. Drug Enforcement Administration Community Outreach and Prevention Support Section. (2020). Drugs of Abuse: A DEA Resource Guide, 2020 Edition.
2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
3. National Institute on Drug Abuse. (2021, April 13). Heroin Research Report.
4. S. Department of Health and Human Services. (2020, August 20). Commonly used drugs charts.
5. S. Library of Medicine. (2020, December 12). Opioid overdose. MedlinePlus.
6. Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating Addiction: A Guide for Professionals. The Guilford Press.

Narcotics.com is user supported. We receive a commission fee from purchases made through BetterHelp links. Learn More