Class IV Drugs

The Controlled Substances Act is a legal statute that was put into effect in 1970 under President Richard Nixon. The act organizes all prescription and illegal, non-prescription drugs into a hierarchy of tiered classes known as “schedules.” Generally, the lower the schedule number, the more dangerous the drug is when misused. Under this system, a Schedule II drug will have more risks of misuse, dependence and withdrawal than a Schedule IV drug.

Drugs that are classified as Schedule IV controlled substances are approved for medical use and are available only by prescription. They present a low potential for abuse compared to drugs in Schedules I-III. They considered to have a moderate to low risk of causing dependence or addiction in people who take them.

Tramadol, known under the brand name Ultram, is an opioid pain reliever that is used to treat all types of chronic or acute pain. Tramadol is taken orally in tablet form and it becomes active one hour after it is administered, providing up to six hours of moderate pain relief. The drug is often combined with acetaminophen. Like other Schedule IV drugs, it does carry some risk of dependence.

Dextropropoxyphene, sold under the brand name Darvon, is an opioid analgesic that is used to treat less severe pain. It can also be used in local anesthesia and in cough suppressants. In 2009, it was taken off the market in the United States after it was determined that its medicinal benefits were far fewer than its associated risks which included heart problems, addiction, and fatal overdoses.

Benzodiazepines are a class of depressants that are used to treat anxiety, seizures, insomnia and acute alcohol withdrawal symptoms. These drugs have had varying degrees of effectiveness in providing short-term relief for symptoms. They do have several side effects, both moderate and severe, which include nausea, vomiting, muscle aches, pain, rebound insomnia, headaches and amnesia.

Benzodiazepines have a long history of abuse. They are widely prescribed across the country and, as a result, have found their way onto the illicit drug market. They also have the potential to be abused by prescribed patients and members of their households. As recreational drugs, they are commonly referred to as “benzos.” Benzodiazepines are commonly abused in combination with alcohol or other drugs. Risks of misusing benzodiazepines include addiction, dependence, acute withdrawal symptoms, overdose and death.

Some examples of benzodiazepines are chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax) and clonazepam (Klonopin).

Other controlled substances under Schedule IV are fenfluramine, which is a banned appetite suppressant. Lorcaserin, sold under the brand name Belviq, is another appetite suppressant. Several stimulants that are also marketed for weight loss and appetite suppression, including fenproporex, mazindol, amfepramone and diethylpropion, are classified under Schedule IV.