Federal policy on PCS aims to balance the need to limit abuse of prescription controlled substances (PCS) with the need to maintain access to PCS for legitimate medical use. Approaches to reducing prescription drug abuse include scheduling of PCS; safe storage and disposal; focusing law enforcement; using data to identify risk; awareness and education; and treatment. Coordination

Multiple federal agencies participate in the mission to reduce prescription drug abuse—the White House Office of National Drug Control Policy (ONDCP) coordinates and tracks these agencies' efforts and related federal funding. Regulation

The primary federal statutes governing the regulation of prescription drugs are the Federal Food, Drug, and Cosmetic Act (FFDCA) and the Comprehensive Drug Abuse Prevention and Control Act of 1970, commonly referred to as the Controlled Substances Act (CSA). Federal law enforcement, primarily DEA, aims to prevent, detect, and investigate the diversion of prescription drugs while regulating the supply for legitimate medical, commercial, and scientific purposes. Health

Federal agencies and programs that provide health care services may prescribe PCS for underlying conditions (e.g., pain, insomnia, or ADHD) and may treat patients for prescription drug abuse or related problems (e.g., overdose or withdrawal). Current Approaches Aimed at Reducing Prescription Drug Abuse

The federal government, state and local governments, and various private entities (e.g., pharmacies) are currently undertaking a range of approaches to reducing prescription drug abuse. Scheduling of PCS

The particular scheduling status of a PCS has several significant consequences: (1) it directly affects patient access to the medication (in terms of the number of allowable refills and whether prescriptions must be written or may be conveyed over the telephone by the physician to the pharmacist); (2) it affects the degree of regulatory requirements that controlled substance handlers (manufacturers, distributors, pharmacies, and physicians) must follow (such as security restrictions and recordkeeping obligations); and (3) it determines the degree of criminal punishment for illegal traffickers of the controlled substance. Focusing Law Enforcement Efforts

Federal law enforcement efforts to combat prescription drug abuse may focus on specific geographic regions or on specific types of drugs, depending on how priorities are established. ONDCP analyzes geographic patterns of drug trafficking in High Intensity Drug Trafficking Areas (HIDTA). Prescription Drug Monitoring Programs (PDMPs)

Prescription drug monitoring programs (PDMPs) maintain statewide electronic databases of prescriptions dispensed for PCS. Efforts to increase awareness and education about prescription drug abuse may focus on health care providers, patients, or the general public. Treatment

Prescription drug abuse may be prevented in some cases through choices in treatment of underlying conditions (e.g., pain), and it may be treated effectively through pharmacologic or non-pharmacologic interventions. New products may be developed for treating both underlying conditions and prescription drug abuse.
An estimated 6.5 million individuals currently abuse prescription drugs in the United States. Unlike policy on street drugs, federal policy on prescription drug abuse is complicated by the need to maintain access to prescription controlled substances (PCS) for legitimate medical use. The federal government has several roles in reducing prescription drug abuse.
Coordination. The Office of National Drug Control Policy (ONDCP) coordinates and tracks prescription drug abuse reduction efforts and funding of multiple federal agencies.
Regulation. The primary federal statutes governing prescription drug regulation are the Federal Food, Drug, and Cosmetic Act (FFDCA) and the Comprehensive Drug Abuse Prevention and Control Act of 1970, commonly called the Controlled Substances Act (CSA).
Law Enforcement. Federal law enforcement, primarily the Drug Enforcement Administration (DEA), aims to prevent, detect, and investigate the diversion of prescription drugs while regulating the supply for legitimate medical, commercial, and scientific purposes.
Health. Federal agencies and programs involved in health may address prescription drug abuse through service delivery (e.g., the Veterans Health Administration), financing (e.g., Medicare), and research (e.g., the National Institute on Drug Abuse).
The federal government, state and local governments, and various private entities (e.g., pharmacies) are currently undertaking a range of approaches to reducing prescription drug abuse.
Scheduling of PCS. The scheduling status of a PCS (1) affects patient access to PCS (e.g., by limiting refills); (2) affects the degree of regulatory requirements (e.g., supply chain recordkeeping); and (3) determines the degree of criminal punishment for illegal traffickers.
Safe Storage and Disposal. DEA regulates storage of PCS by registered entities (e.g., pharmacies); provides registered entities with options for proper disposal of PCS; and sponsors National Prescription Drug Take-Back Days to assist citizens in safe disposal of PCS.
Focusing Law Enforcement. Federal law enforcement efforts may focus on geographic areas with higher rates of prescription drug abuse or on High Intensity Drug Trafficking Areas (HIDTA) that experience a higher volume of illicit trafficking of PCS.
Using Data to Identify Risk. Most states operate prescription drug monitoring programs—databases of prescriptions filled for PCS. Other public and private entities also have data that may be analyzed to identify high-risk behavior among prescribers, dispensers, or patients.
Awareness and Education. Efforts to increase awareness and education about prescription drug abuse may focus on health care providers, patients, or the general public.
Treatment. Some prescription drug abuse may be avoided in treating underlying conditions (e.g., pain) or may be treated with pharmacologic or non-pharmacologic interventions. New products may improve treatment for both underlying conditions and prescription drug abuse.