Drugs on the Schedule 3 Narcotics List are all prescription medications that carry a certain level of abuse potential.
Schedule 3 Narcotics List
Schedule 3 narcotics tend to have a lower potential for misuse than Schedule 1 and 2 controlled substances. They are generally safe and effective when used in clinical applications. For example, buprenorphine is helpful in treating opioid addiction and dependence, but because it is an opioid itself, it does have potential for misuse. Misusing schedule 3 narcotics can lead to physical or psychological dependence, as well as harmful effects on your mental and physical health.1
What are Schedule III Narcotics?
The Drug Enforcement Administration (DEA) enforces the Controlled Substance Act (CSA). Drugs and chemicals are in five categories or schedules, based on their medical application, the potential for misuse and dependence, and safety. The goal is to regulate how a drug is made, distributed, used, imported, exported, possessed, and distributed. The classification system does not include tobacco and alcohol in its list of Schedule III narcotics or any other schedule, despite both being the most commonly used substances in the United States.2
The list of Schedule 3 narcotics classification has two parts: Schedule III narcotics and Schedule IIIN non-narcotics. These drugs, which have accepted medical uses, may have the potential for psychological dependence but are less likely to lead to physical dependence. Schedule 3 narcotics are often used for anesthesia, pain management, or appetite suppression.3
Examples include:1,2,3
- Ketamine
- Anabolic steroids
- Suboxone (buprenorphine/naloxone)
- Tylenol with less than 90 milligrams of codeine per dose
List of Schedule 3 Narcotics
The various drugs on the list of Schedule III narcotics are beneficial for specific medical applications. Unfortunately, it’s possible to misuse all Schedule III narcotics. Drug misuse can lead to negative personal, professional, and social consequences. Misuse also leads to harmful effects on physical and psychological health, including the development of a narcotics addiction.
Ketamine
Ketamine is used as a form of general anesthesia, either by itself or in combination with other medications, and for procedural sedation. The FDA has approved a derivative of ketamine, known as esketamine, for use in treatment-resistant depression.7
Ketamine is usually found in a white powder form, and people who misuse it tend to snort it, smoke it by sprinkling it over tobacco or marijuana, or melt it down and inject it. They misuse ketamine to achieve sensory experiences, like hallucinations and color distortions. People often mix ketamine with alcohol or other drugs. Alone or combined with other medications, misusing ketamine can lead to harmful effects.8
Long-term consequences of ketamine misuse include:8
- Recurrent hallucinations
- Depression
- Memory problems
- Kidney malfunction
- Stomach ulcers and other pains
- Bladder pain
- Potential for psychological dependence
- Possible overdose when mixed with alcohol
Anabolic Steroids and Testosterone
The human body produces testosterone, the primary hormone in men that helps maintain their male characteristics. For example, it’s why facial hair, deep voice, and muscles exist at greater levels in men and not women. Although women do have some testosterone, levels are much lower in comparison. Because anabolic steroids cause withdrawal symptoms when you try to quit, they are considered addictive. Anabolic steroids are prescribed to males to help with delayed puberty or build strength in weak muscles due to conditions like cancer. Some men and women misuse anabolic steroids to improve athletic performance and increase muscle mass and strength.9
Misuse of anabolic steroids can lead to life-altering damages, including:7,8
- Kidney and liver damage or failure
- Stroke
- Heart disease
- Mood swings
- Paranoia
- Anger outbursts
- Low sperm count
- Shrinking of testicles
- Baldness
- Cancer
Misusing testosterone can produce other adverse effects, including memory problems, anxiety, torn muscles, neurodegeneration, cognitive impairment, arrhythmias, oxidative stress, and sexual dysfunction. One of the most concerning factors related to testosterone misuse is that it is often purchased online from a company without regulations and safety measures. You may not be getting what you paid for, and instead are setting yourself up for detrimental health consequences.10
Tylenol with Codeine
Tylenol is the brand name for acetaminophen, an over-the-counter fever reducer and pain reliever. Codeine is a narcotic used to relieve pain and ease coughing. Combined, they are a Schedule III narcotic that someone can misuse and become addicted to. Someone using Tylenol with codeine for a prolonged period will likely experience withdrawal symptoms when they try to quit. Misusing Tylenol with codeine can cause uncomfortable and sometimes dangerous reactions, including overdose.11
Separately, each drug produces physical and sometimes irreversible problems when misused. Long-term use of acetaminophen can damage the liver. Reports state acetaminophen toxicity is the leading cause of liver transplants in the United States. Other than liver failure, it can also cause painful skin reactions.12
Codeine slows the respiratory system and heart rate. It produces euphoria, which is part of the reason it has potential for misuse. Tolerance quickly builds, and someone may need to take more to feel the same effects as they did when they first used it. As a narcotic, codeine can lead to dependence and withdrawal symptoms. It can also lead to addiction, which may be difficult to overcome without professional addiction treatment.
Other harmful effects of codeine misuse include the following:13
- Sleep disturbances
- Liver damage
- Fertility issues
- Seizures
- Coma
- Overdose
Buprenorphine
Buprenorphine, which is often combined with naloxone to form Suboxone, is a drug used to treat someone withdrawing from opioids to ease cravings, urges, and uncomfortable symptoms. It has been very successful in helping many people stop using opioids in the long term. However, because buprenorphine is a partial opioid agonist, it has potential for diversion and misuse.
Misuse includes trading Suboxone for another drug, selling it to purchase opioids, taking more than prescribed, and ingesting it in a way not prescribed. For example, some people may inject buprenorphine or Suboxone rather than take it orally. Harmful effects of Suboxone misuse may include the following:14
- Anxiety
- Depression
- Sleep disturbances
- Respiratory suppression
- Central nervous system suppression
- Hepatitis
- Adrenal failure
- Sleep apnea
- Dependence
- Addiction
When mixed with other drugs, especially sedatives, respiratory failure and overdose are a risk. Some people who are sensitive to Suboxone can have an allergic reaction, fatal and nonfatal. The misuse of Suboxone can lead to negative mental health symptoms.14
How to Get Schedule 3 Narcotics
You can only get Schedule 3 narcotics from a prescribing medical professional, including:4
- Doctors
- Nurse practitioners
- Surgeons
- Dentists
- Mid-level providers
- Podiatrists
- Veterinarians
If the prescriber has authorization from the Drug Enforcement Administration and has a license to practice, they are eligible. The pharmacist must also have DEA authorization to fill a Schedule III prescription. However, they cannot fill the prescription unless all of the following are present:4
- Date the doctor wrote the prescription
- Patient information: name, address, date of birth
- Doctor’s name and address
- Doctor’s DEA number
- Drug name, strength, and form
- Quantity
- Clear directions on how to use the medicine
- Number of refills, even if no refills are allowed
- Doctor’s signature
For all drugs on the list of Schedule III narcotics, a person is allowed a maximum of five refills, and the quantity cannot exceed 90 for each one.4
Drug Class vs. Drug Schedule
There are five drug classes and five drug schedules. These are not the same. However, many people get confused because they are both ways of organizing drugs according to their ingredients. The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), lists nine different drug classes, including:5
- Alcohol
- Caffeine
- Tobacco
- Stimulants
- Cannabis
- Inhalants
- Sedatives, Hypnotics, Anxiolytics
- Opioids
- Hallucinogens
They also have an “other” substance classification that covers drugs not included in the nine classes. The DSM-5 lists a few, such as nitrous oxide, antiparkinsonian medications, anithistamines, kava, and cathinones.5
The Controlled Substance Act regulates a set of drug classes separate from the five drug schedules. The five classes are:6
- Narcotics
- Depressants
- Stimulants
- Hallucinogens
- Anabolic Steroids
The Controlled Substance Act provides guidelines on selecting drugs for the list of Schedule III narcotics. It reviews the scientific evidence of the drug’s effects, history of misuse, current data on misuse, and risk to the public.6
Avoiding Outcomes of Misuse
There is a long list of Schedule 3 narcotics that are misused by teens, college students, and adults today. Misuse can lead to dependence, which is noticeable by the withdrawal symptoms you experience when you stop taking them. They can all lead to potentially life-threatening outcomes if consuming too much or interaction occurs when mixing with alcohol or other substances.
One way to avoid these outcomes is by choosing to get help. Numerous treatment options are available for someone with an addiction to a Schedule 3 narcotic or any other substance. Whether you are just beginning to misuse drugs or have been struggling with a long-term substance use disorder, there is a treatment program to meet your needs.
Call 800-934-1582(Who Answers?) to find help today.
Resources
- U.S. Department of Justice Drug Enforcement Agency. (2021). Controlled Substance Schedules.
- Ortiz NR, Preuss CV. (2021). Controlled Substance Act. StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing.
- Preuss CV, Kalava A, King KC. (2021). Prescription of Controlled Substances: Benefits and Risks. StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing.
- Kenny BJ, Preuss CV. (2021). Pharmacy Prescription Requirements. StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing.
- Alozai Uu, Sharma S. Drug and Alcohol Use. StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing.
- U.S. Department of Justice Drug Enforcement Agency. (2017). Drugs of Abuse.
- Rosenbaum SB, Gupta V, Palacios JL. (2021). StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing.
- U.S. Department of Health and Human Services. (2016). Appendix D, Important Facts About Alcohol and Drugs. Substance Abuse and Mental Health Services Administration (U.S.); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. Washington (D.C.).
- National Institute on Drug Abuse. (2018). Anabolic Steroids Drug Facts.
- Albano, G. D., Amico, F., Cocimano, G., Liberto, A., Maglietta, F., Esposito, M., Rosi, G. L., Di Nunno, N., Salerno, M., & Montana, A. (2021). Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review. Healthcare, 9(1), 97.
- U.S. National Library of Medicine. (2021). Acetaminophen.
- Agrawal S, Khazaeni B. (2021). Acetaminophen Toxicity. StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing.
- U.S. Food and Drug Administration. (2019). Codeine Medication Guide and Instructions for Use.
- U.S. National Library of Medicine. (2021). Label: Suboxone.
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