A C2 prescription (also written as C-II or Schedule II) is a prescription for a controlled substance that the federal government classifies as having a high potential for abuse and the risk of severe physical or psychological dependence. These are legal, medically useful medications, but they come with the strictest prescribing rules of any drug you can get from a pharmacy. If your doctor handed you a C2 prescription or you saw “CII” on a pill bottle label, it means your medication falls into this tightly regulated category.
What Makes a Drug Schedule II
The Drug Enforcement Administration sorts all controlled substances into five schedules based on two factors: how likely the drug is to be abused and whether it has an accepted medical use. Schedule I is the most restricted (drugs with no approved medical use, like heroin), while Schedule V is the least restricted. Schedule II sits just below that top tier. These drugs are considered dangerous and carry serious dependence risk, but they also have legitimate medical purposes that keep them available by prescription.
Common C2 Medications
C2 prescriptions generally fall into two main groups: opioid painkillers and stimulants used for ADHD.
- Opioid pain medications: oxycodone (OxyContin, Percocet), hydrocodone (Vicodin), fentanyl (Duragesic patches), morphine, hydromorphone (Dilaudid), methadone, and codeine.
- Stimulants: amphetamine (Adderall, Dexedrine), methylphenidate (Ritalin), and methamphetamine (Desoxyn, rarely prescribed).
Cocaine also has a Schedule II classification because it has limited medical use as a local anesthetic, though it is rarely prescribed in practice.
No Refills Allowed
The single biggest difference you’ll notice with a C2 prescription compared to other medications is that refills are prohibited under federal law. Your pharmacy cannot simply refill it the way they would blood pressure medication or even a Schedule III drug. Every time you need more, your prescriber must write a new prescription.
To reduce the inconvenience, federal regulations do allow your doctor to write up to three separate prescriptions at one visit, covering a total of 90 days. Each prescription after the first must include a “do not fill before” date so they’re spaced out appropriately. Not every state permits this, and your doctor has to determine it won’t create a risk of misuse, so the practice varies. If your prescriber does use this approach, you’ll walk out of the appointment with multiple prescriptions, each with a different fill date written on it.
Partial Fills Are an Option
If you don’t need your full quantity right away, or if the pharmacy doesn’t have enough in stock, you can request a partial fill. A 2016 federal law (the Comprehensive Addiction and Recovery Act) made this available to any patient, not just those in long-term care. You, your caregiver, or your prescriber can request a partial fill as long as the total amount dispensed across all partial fills doesn’t exceed what the original prescription called for. Any remaining portions must be picked up within 30 days of the date the prescription was written.
Paper, Electronic, or Emergency
C2 prescriptions can be written on paper or sent electronically to your pharmacy. Electronic prescribing for controlled substances has been permitted since 2010, and many states now require it. When a paper prescription is used, it must include tamper-resistant features that prevent copying, erasing, or counterfeiting. You’ll sometimes notice special watermarks or background patterns on the prescription pad for this reason.
In emergencies, a prescriber can call in a C2 prescription by phone, but the pharmacy can only dispense enough to cover the emergency period. The prescriber must then follow up with a written prescription, typically within 72 hours.
Picking Up a C2 Prescription
Expect to show identification when you pick up a C2 medication. Many states require pharmacists to ask for a valid photo ID before handing over a Schedule II drug, even if you’re a regular customer. The specifics vary by state. Georgia, for instance, requires government-issued photo ID specifically for Schedule II pickups. Virginia mandates ID checks for Schedule II but makes it optional for lower schedules. Some states require ID for all controlled substance pickups regardless of schedule.
If someone else is picking up your medication for you, they will likely need to show their own ID as well. Some pharmacies also ask the person to sign a log.
No Federal Expiration on Filing
There is no federal time limit on when a C2 prescription must be filled after your prescriber signs it. However, state laws frequently impose their own deadlines, and many pharmacies have internal policies about how old a prescription can be before they’ll accept it. If you’re sitting on a C2 prescription for more than a few weeks, it’s worth calling your pharmacy to confirm they’ll still fill it under your state’s rules.
Disposing of Unused C2 Medications
Because these drugs carry high abuse potential, safe disposal matters. The DEA sponsors National Prescription Drug Take Back Days, and many pharmacies now have permanent drop-off boxes or kiosks where you can surrender unused medications year-round. Some pharmacies also offer prepaid mail-back envelopes.
Certain opioids, particularly fentanyl patches, are on the FDA’s “flush list,” meaning you should flush unused portions down the toilet rather than leave them in the trash where they could be found. Even a used fentanyl patch retains enough medication to be dangerous to someone it wasn’t prescribed for. For most other C2 medications not on the flush list, mixing them with coffee grounds or cat litter in a sealed bag and placing them in household trash is an acceptable backup if take-back options aren’t available.