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Controlled substances:

What is a controlled substance or controlled medication?

The federal government has categorized a class of medication as having a higher-than-average potential for abuse or addiction. Such medications, known as controlled substances, are divided into categories based on their potential for abuse or addiction. They range from illegal street drugs (Schedule 1, or C1) to medications with decreasing potential for abuse (C2 through C5). Prescriptions containing narcotics or amphetamines are often classified as C2, since they have a relatively high potential for abuse or addiction.

Do controlled substances have special prescribing and dispensing requirements?

Yes. Most prescriptions for controlled substances are subject to both federal and state regulations. These regulations define how a prescription can be written, how your doctor can communicate it to a pharmacist, and how many times it can be refilled, among other aspects. For example, many controlled substances can only be refilled up to 6 months from the date of the original prescription, and medications with a higher potential for abuse (C2) cannot be refilled at all. All pharmacies, whether retail or home delivery, are subject to these regulations.

If your plan allows you to send a prescription for a controlled substance to the Express Scripts Pharmacy, you must send it by mail. Some states have regulations that limit the number of days allowed for a C2 prescription to be received and filled by a pharmacy. To meet the intent of such regulations, the prescription must be postmarked within the specified number of days of the date the prescription was written. Express Scripts will fill prescriptions for controlled substances for up to a 90-day supply, if requested, subject to state regulations (for example, New York state law limits controlled substances to a one-month supply). Please note that certain plans may prohibit home delivery of C2 controlled substances. Even when a plan does allow for this, Express Scripts will not accept prescription requests for C2 controlled substances by phone or, as prohibited by federal law, by fax.

Please keep in mind that all regulations regarding controlled substances vary by state. For more information about controlled substances and your state's regulations regarding them, please contact Express Scripts Member Services.

Are controlled substances shipped differently than other medications?

Express Scripts ships controlled substances with a high potential for addiction or abuse (C2) via 2-day air and requires a signature upon receipt to ensure that the medications have been received. If you are not home, the carrier will leave a notice that delivery was attempted, along with instructions on how you can schedule redelivery or pick up your package. We ship controlled substances with a lower potential for abuse (C3 - C5) by regular mail through the U.S. Postal Service.

If I have a prescription for a controlled substance, will it arrive with the rest of my order?

Because special requirements for shipping controlled substances may apply, Express Scripts uses only certain home delivery pharmacies to dispense these medications. If you submit a prescription for a controlled substance along with other prescriptions, it may need to be filled through a different pharmacy than the other prescriptions in your order. As a result, you may receive your order in more than one package. Furthermore, prescriptions for controlled substances may be subject to state regulations regarding postmark date and limitations on the amount dispensed. (See above for more information about state regulations on dispensing.)

If you have questions about your medication, please contact Express Scripts Customer Service.

Can I return a controlled substance?

By law, we may not accept or request the return of controlled substances, except under very specific circumstances, such as damage. If the medication has been damaged, we will ask your doctor to send us a new prescription, and we will waive the copayment for the replacement supply. In most other cases, we may not accept such medications for destruction; you (or, if applicable, a caregiver) must dispose of the medication.

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