State controlled substance scheduling can move faster than federal scheduling — and in some cases, states have classified substances differently than the DEA.
Tramadol
Tramadol became federally Schedule IV in 2014. Some states have tramadol in a more restrictive schedule than Schedule IV. Always verify the applicable state schedule when dispensing tramadol across state lines.
Kratom
Kratom (Mitragyna speciosa) remains unscheduled federally as of May 2026, but six states have banned or scheduled it: Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin. In these states, kratom products cannot be sold or dispensed legally.
Xylazine
Xylazine (tranq) is a veterinary sedative that has emerged as a significant adulterant in illicit opioid supplies. While federally unscheduled for human use, several states have taken action. Pennsylvania and Florida have taken regulatory steps. The landscape is evolving rapidly.
Why this matters for pharmacists
For compounding pharmacists, state scheduling variances affect what can be compounded and how. For telepharmacists supervising dispensing across state lines, the applicable state’s schedule — not the federal schedule — controls.
Staying current
State scheduling actions are tracked by NABP and individual state boards. Always verify current scheduling with your state board before dispensing or compounding.