Schedule 4 Narcotics List

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The Drug Enforcement Administration (DEA) classifies chemicals and drugs according to the Controlled Substance Act. Officials consider several factors when scheduling substances, including the potential for diversion, misuse, and dependence, as well as if it has medical use in treatment. The five schedules start with the most dangerous substances, which have no accepted medical use, and work their way down to the drugs with the lowest risk.1 Schedule 4 narcotics have a mild to moderate risk for misuse, dependence, and addiction.

In this article:

What Are Schedule IV Drugs?

Compared to Schedule 3, the list of Schedule 4 narcotics has less potential for misuse yet can still be of use in medical treatments. Misusing any drug on the list of Schedule 4 narcotics may lead to physical or psychological dependence but at a much lower potential than Schedules 1, 2, or 3. Schedule 4 narcotics meet the following:1

  • It has a low potential for misuse compared to the drugs in a higher schedule.
  • It can be of use in medical treatment in America.
  • It has a lower potential for dependence compared to the drugs in a higher schedule.

The original definition of a narcotic included any drug that alters mood, senses, and perceptions and causes you to feel sleepy, tired, pain relief, and may put you into a stupor. Over the years, the official definition has evolved to represent mainly opioids, illegal, and prescription.5

As such, the list of Schedule 4 narcotics below includes both opioids and other substances that fall under this schedule.

List of Schedule 4 Narcotics

Many different drugs are categorized as Schedule 4 narcotics by the DEA.

Xanax

According to a recent national survey, 5.4 million people over the age of 12 admitted to misusing Xanax in the year before the survey. Nearly 400,000 are adolescents. Xanax falls into the drug category, benzodiazepines, prescription medicine to alleviate muscle spasms and prevent seizures. However, doctors prescribe them the most for aiding in sleep and in reducing anxiety.2

Xanax, a long-lasting Schedule 4 drug, is misused by teens and adults. Xanax comes in the form of a pill. Misuse involves crushing the pill and snorting the powder. They are often taken with other drugs to increase the effects, which include the following:6

  • Amnesia
  • Mood is irritable or hostile
  • Vivid dreams, often nightmares
  • Central nervous system slows
  • Sleepiness
  • Relaxation
  • Drowsiness
  • Confusion
  • Impaired or slow coordination
  • Digestive problems
  • Headaches
  • Weight changes
  • Low libido
  • Muscle strength loss

Misusing Xanax can lead to overdose, so it’s essential to know the effects so you can call for help immediately. Overdose effects of Xanax include:6

  • Breaths slow or stop
  • Heart rate slows or stops
  • Skin changes colors
  • Skin becomes clammy and cold
  • Unresponsiveness

Darvocet

Darvocet was withdrawn from the U.S. market in 2010 after being on the list of Schedule 4 narcotics for many years. One reason is that it is very addictive. Also known as propoxyphene, Darvocet is sometimes combined with acetaminophen to create more of an analgesic effect. It was previously used to manage moderate to severe pain.7

Darvocet is a drug many people misuse. Some take more than their prescription advises, crush it, snort it, and mix it with alcohol and other drugs. During the discontinuation of Darvocet, a research study found that 90% of those who misuse it switched to a different opioid rather than quit taking the drug.7

Side effects of Darvocet include:8

  • Sleepiness
  • Confusion
  • Digestive issues
  • Slow breathing
  • Slow heart rate

Misusing Darvocet can lead to addiction, dependence, or both. It can also lead to a coma, overdose, and death. More than 16,000 prescription opioid overdoses were reported in a 2020 study. Today, numerous prescription opioids similar to Darvocet are still on the market.8

Valium

Valium is often given to treat withdrawal symptoms from alcohol. It can also relieve symptoms of anxiety. The benefit of Valium is that it calms the neurotransmitters or activity in the brain, easing anxiety and muscle spasms. Valium, also known as diazepam, is on the list of Schedule 4 narcotics and belongs to the class of drugs known as benzodiazepines. Side effects of Valium include the following:9

  • Drowsiness
  • Dizziness
  • Sex drive changes
  • Confusion
  • Constipation
  • Irregular urination
  • Headache
  • Dry mouth

Valium misuse can lead to overdose. The symptoms of a Valium overdose include:9

  • Loss of control of body functions
  • Shaking in different parts of the body
  • Slurred speech
  • Loss of consciousness
  • Stopped heart rate or breathing

Ativan

Ativan, also known as lorazepam, is in the class of benzodiazepines on the list of Schedule 4 narcotics. As a sedative-hypnotic, this anti-anxiety medication works quickly to calm brain activity. Ativan can also treat insomnia, seizures, and for some, alcohol withdrawal. Ativan is typically given in oral doses, but some may misuse it by crushing and snorting it. Side effects vary due to the amount someone consumes, especially when misusing the drug.

Side effects can range from mild to severe and include the following:10

  • Respiratory slowing or stopping
  • Aggression
  • Blood pressure changes
  • Dizziness
  • Amnesia
  • Sex drive changes
  • Appetite changes
  • Constipation
  • Blurred vision
  • Slurred speech
  • Physical weakness
  • Coordination issues
  • Jaundice

Ambien

Ambien, also known as zolpidem, treats insomnia by slowing down brain activity so that you can fall asleep. Ambien is usually given in pill form, but oral sprays and sublingual tablets are available. Misuse of Ambien occurs when you take medicine in any other way than prescribed, like splitting or crushing the tablet or injecting the liquid. Taking more than the prescription for these Schedule 4 narcotics can lead to overdose. Short-term harmful effects of Ambien include:11

  • Sleepiness or extreme fatigue
  • Dizziness
  • Grogginess
  • Digestive problems
  • Balance and coordination problems
  • Uncomfortable sensations in the hands, feet, and extremities
  • Ear ringing
  • Dry mouth
  • Swelling of the throat or tongue
  • Aggression
  • Shakiness
  • Chest pain

Tramadol

Tramadol, an opioid now on the list of Schedule 4 narcotics, was added in 2014 because of its potential for misuse. Tramadol comes in extended-release and quick-release forms. Doctors prescribe this drug for pain relief because it alters how the brain and central nervous system respond to pain. Tramadol comes in tablet, liquid, and capsule forms.

Side effects of Tramadol can be mild, moderate, or severe:12

  • Dry mouth
  • Heartburn
  • Anxiety
  • Muscle tension, spasms, cramps
  • Rashes
  • Nausea or vomiting
  • Constipation
  • Seizures
  • Agitation
  • Rapid heartbeat
  • Shakiness
  • Swelling in various parts of the body
  • Excessive sweating
  • Hallucinations

Klonopin

Klonopin, also known as clonaezpam, is another benzodiazepine listed as Schedule 4 drug. Much like other benzodiazepines on this list, it is prescribed to treat panic disorder and seizures as well as alcohol withdrawal.13

People may misuse Klonopin to self-medicate anxiety, get high, or to amplify the effects of other drugs like opioids or alcohol, which is why it’s considered a Schedule 4 narcotic. Klonopin misuse can lead to physiological dependence, which means you need to keep using the drug to stave off withdrawal symptoms. Klonopin can also be addictive, leading to a pattern of compulsive use despite negative consequences.

Schedule IV Narcotics Addiction

Chronic drug misuse can lead to addiction. If you are misusing any drugs on the list of Schedule 4 narcotics, it’s possible to develop dependence and addiction.

There are many different signs of drug addiction, and this condition can manifest in different ways for different people. However, if you develop a tolerance to a Schedule 4 narcotic drug, meaning you need higher doses to feel high, this could be an indication that you have an addiction. Another indicator is that of dependence—if you experience withdrawal symptoms when you suddenly quit or reduce use, you could have an addiction. But this only applies to people who are misusing Schedule 4 narcotics, not those taking their medication as prescribed.

Additionally, you may participate in risky behaviors, such as selling your Schedule 4 narcotics for money. You may obtain narcotics in dangerous ways, such as doctor shopping, buying other people’s prescriptions, or stealing. Other signs of a Schedule 4 narcotics addiction include the following:14

  • Misusing substances for longer than intended and more than intended
  • Cravings or a strong desire to use
  • Being unable to fulfill personal, professional, and social obligations due to drug misuse
  • Continuing to misuse substances even though you know it will worsen physical or psychological conditions
  • Continuing to misuse substances even though doing so creates problems at work, home, and socially

Whether you have a prescription or are obtaining Schedule 4 narcotics illegally, addiction is treatable. The first step is to contact a treatment provider for a substance abuse evaluation. They will assess the extent and nature of your addiction and make appropriate treatment recommendations, such as inpatient or outpatient rehab.

If you’d rather look for a treatment facility right now, you can call our confidential helpline at 800-407-7195(Who Answers?) to speak to a treatment support specialist. We are available 24//7 to help you find the right program for you.

Resources

  1. U.S. Department of Justice (2022). Diversion Control Division: Controlled Substances Schedules.
  2. Preuss CV, Kalava A, King KC. (2021). Prescription of Controlled Substances: Benefits and Risks. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
  3. U.S. Food and Drug Administration. (2018). Controlled Substance Staff Functional Roles.
  4. U.S. Government Information. (2020). Title 21: Food and Drugs.
  5. Center for Behavioral Health and Quality. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health Substance Abuse and Mental Health Services Administration. (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  6. George TT, Tripp J. (2021). Alprazolam. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
  7. Jeffery, M. M., Morden, N. E., Larochelle, M., Shah, N. D., Hooten, W. M., & Meara, E. (2020). Response to Propoxyphene Market Withdrawal: Analgesic Substitutes, Doses, and Adverse Events. Medical Care, 58(1), 4-12.
  8. National Institute on Drug Abuse. (2021). Prescription Pain Medications (Opioids).
  9. U.S. National Library of Medicine. (2022). Diazepam. MedlinePlus.
  10. Ghiasi N, Bhansali RK, Marwaha R. (2022). Lorazepam. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
  11. U.S. National Library of Medicine. (2021). Ativan-Lorazepam. DailyMed.
  12. U.S. National Library of Medicine. (2022). Tramadol. MedlinePlus.
  13. U.S. National Library of Medicine. (2021). Clonazepam. MedlinePlus.
  14. National Institute on Drug Abuse. (2018). Media Guide.

the Take-Away

The Schedule 4 narcotics list contains drugs with a mild abuse potential. Organizing drugs into schedules allows for rules and regulations to be appropriately created with specific drugs in mind.