Alcohol Isn’t a Controlled Substance, but It Is Regulated — Here’s Why

Healthline
Medically reviewed by Megan Soliman, MD — By Adrienne Santos-Longhurst
May 3, 2023

Alcohol isn’t a controlled substance in the United States, but its production, distribution, and sale are federally regulated.

Alcohol is a psychoactive substance with the potential for dependence.

Alcohol production, distribution, and sale are regulated by the federal government through the Alcohol and Tobacco Tax and Trade Bureau and the Bureau of Alcohol, Tobacco, Firearms, and Explosives because of the health risks associated with alcohol consumption.

In the United States, there are about 261 alcohol-related deaths each day, and more than 47,000 people per year die as a result of long-term health failure from drinking.

Globally, harmful alcohol use contributes to 3 million deathsTrusted Sourceeach year.

Consumption guidelines are meant to help prevent harmful use.

What are the current consumption guidelines?

According to the current alcohol consumption guidelinesTrusted Source for Americans, people of legal drinking age should limit alcohol consumption to two drinks or less per day.

Cisgender women and others assigned female at birth should consume no more than one drink per day, and cisgender men and others assigned male at birth should consume no more than two drinks per day.

The guidelines also recommend avoiding alcohol entirely if you:

• are under the minimum legal drinking age in the United States, which is 21
• are pregnant or think you might be
• are taking medications known to interact with alcohol
• have a medical condition that can be made worse by alcohol
• are recovering from alcohol use disorder or are unable to control how much you drink
• are planning to drive a vehicle or operate machinery

How does short-term alcohol use affect your body?

You might notice the following effects while drinking alcohol or shortly afterward:

• a relaxed or drowsy feeling
• a giddy or euphoric feeling
• lowered inhibitions
• impulsive behavior
• mood changes
• dizziness
• slurred speech
• changes in perception or vision
• loss of coordination
• trouble focusing or making decisions
• nausea and vomiting
• headache
• diarrhea
• blackouts

When these effects kick in depends on how long the alcohol takes to work its way through your body. It’s different for everyone and depends on factors such as your age, sex, and metabolism; the amount of alcohol you consume; and how quickly you consume it.

These effects may only be temporary but can lead to consequences that last much longer than a hangover. Impaired judgment, mood swings, and loss of coordination significantly increase the risk of violence, accidents, and injuries.

Are complications possible with long-term or excessive alcohol use?

Excessive alcohol use can have lasting effects on you and those around you.

The long-term effects of drinking alcohol, particularly in excess, include:

• poor mental health
• impaired memory or concentration
• erectile dysfunction
• premature ejaculation
• weakened immune system
• pancreatitis
• liver disease
• high blood pressure
• heart disease
• stroke
• certain types of cancer, including breast, colon, liver, mouth, throat, esophageal, and stomach cancer

What’s the difference between controlled and uncontrolled substances?

Controlled substances are pharmaceutical and non-pharmaceutical drugs and other substances that the federal government regulates based on their known risk for misuse and dependence and danger to the public.

Under the Controlled Substances Act (CSA), controlled substances with a medical use, such as valium and morphine, are available only by prescription from a licensed medical professional.

Those without a known medical use, such as heroin, are illegal in the United States.

Uncontrolled substances such as alcohol can be used by anyone. Individual states determine whether and how it’s imported, distributed, and sold, as well as who can possess it.

Some states allow local governments control over alcohol policyTrusted Source and its enforcement.

What is the Controlled Substances Act?

The CSA is a federal policy for regulating all drugs. This includes legal drugs, such as over-the-counter and prescription medications, and illegal drugs.

The CSA uses a classification system that places each drug into one of five categories, known as schedules, based on accepted medical use, potential for misuse and dependency, and safety liability.

The lower the schedule, the higher the risk associated with use:

• Schedule 1: These substances have a high potential for misuse and no accepted medical use. This category includes heroin, LSD, and MDMA.
• Schedule 2: These substances have a high potential for misuse and dependence but do have some accepted medical uses. This category includes oxycodone and fentanyl.
• Schedule 3: These drugs have a lower potential for misuse than Schedules 1 and 2 and have accepted medical uses. This category includes ketamine, anabolic steroids, and Tylenol with codeine.
• Schedule 4: These drugs have accepted medical uses and a lower potential for misuse than Schedule 3 substances. This category includes Xanax, Valium, and Ambien.
• Schedule 5: These substances have the lowest potential for misuse and have known medical uses. This category includes cough medicines with codeine and Food and Drug Administration-approved drugs containing cannabidiol (CBD), such as Epidiolex.

The bottom line

Alcohol isn’t a controlled substance in the United States, but it is federally regulated because of its many known health risks and potential for harmful use.

If you’re wondering about the legal implications of drinking alcohol, check your state’s laws and regulationsTrusted Source.