Mostly, it’s in the dosage and purity. Controlled substances are controlled for a reason. Doctors can totally prescribe actual meth and cocaine etc, but they have people overseeing them and holding them accountable so they don’t abuse that, and the doctors oversee the patients to make sure patients don’t abuse the medication, etc. On top of that, the medically prescribed versions of drugs, especially ones like meth, cocaine, etc would be regulated by the FDA in production, so they’re a lot purer, and thus safer, than illegal versions of those same drugs (a lot of the danger of drugs like this–besides the risk of addiction–is that they may be mixed with something like fentanyl, which is lethal in even extremely tiny dose).
All this oversight and regulation is why it’s safer.
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