A repeated cross-sectional study of factors associated with pregabalin-positive poisoning deaths in Ireland

Lynn, Ena; Cousins, Gráinne; Lyons, Suzi; Bennett, Kathleen

doi:10.1016/j.drugalcdep.2019.107741

Cited by 19 publications

(28 citation statements)

References 32 publications

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“…Most of these studies were based on post-mortem data but some were generated by data from suspected DUID cases. An Irish study found an increase in pregabalin-positive poisoning deaths from 5% of all cases in 2013 to 26% in 2016 [51]. The odds of being pregabalin positive increased with female sex, opioid misuse, recent treatment for problem drug use, and the year of death.…”

Section: Forensic Toxicologymentioning

confidence: 99%

“…Using this method for ranking the safety of 70 pharmaceuticals, pregabalin and gabapentin were ranked in the middle. An Irish study found an increase in the pregabalin poisoning deaths from 2013 to 2016 [51]. For gabapentin, it is still somewhat controversial whether a substantial overdose of gabapentin used alone is enough to induce life-threatening respiratory or cardiac insufficiency.…”

Section: Risks With Abuse Of Gabapentinoidsmentioning

confidence: 99%

“…Correlations between an increased prescription of gabapentinoids and an increased frequency of abuse/misuse [45], and between the numbers of dispensings of pregabalin and pregabalin-positive poisoning deaths [51] have been reported. In the USA, the increased pregabalin use has also been related to 'off-label' use as an alternative to opioids for various pain management [108].…”

Section: Recommendations To Authoritiesmentioning

confidence: 99%

“…The medical profession supported this change despite an extra burden for prescribers, pharmacists, and patients [111]. National e-prescription systems have also been proposed to prevent altered prescriptions or overlapping multiple prescriptions [112][113][114], especially prescription of central nervous system anti-depressant drugs from different prescribers [51].…”

Section: Recommendations To Authoritiesmentioning

confidence: 99%

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Current Evidence on Abuse and Misuse of Gabapentinoids

2020

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This review summarizes current evidence on the abuse and misuse of the gabapentinoids pregabalin and gabapentin. Pharmacovigilance studies, register-based studies, surveys, clinical toxicology studies, and forensic toxicology studies were identified and scrutinized with the goal to define the problem, identify risk factors, and discuss possible methods to reduce the potential for abuse and misuse. Studies found that gabapentinoids are abused and misused and that individuals with a history of psychiatric disorders or substance use disorder seem to be at high risk. Moreover, some evidence supports the notion that patients with opioid use disorders may be at an increased risk of abusing gabapentinoids. Available evidence also suggests that abuse and misuse are more frequent in users of pregabalin compared with users of gabapentin. Health professionals and prescribers should be aware of the risk for misuse of pregabalin and gabapentin, which eventually could lead to abuse, substance dependence, and intoxications. Prescribing to patients belonging to risk populations such as those with psychiatric disorders or substance use disorder should be avoided if possible and, if prescribed, signs of misuse and abuse should be monitored.

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Section: Forensic Toxicologymentioning

confidence: 99%

Section: Risks With Abuse Of Gabapentinoidsmentioning

confidence: 99%

Section: Recommendations To Authoritiesmentioning

confidence: 99%

Section: Recommendations To Authoritiesmentioning

confidence: 99%

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Current Evidence on Abuse and Misuse of Gabapentinoids

2020

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“…54 A study conducted in Ireland explored the association between opioid use and treatment for problem drug use and pregabalin-positive poisoning death. 55 Therefore, it is likely that the co-prescribing of opioids or substance misuse and abuse is also a major risk factor to the increased drug-related death in gabapentinoid users in the UK. Nevertheless, the association between gabapentinoid utilisation patterns (e.g.…”

Section: Discussionmentioning

confidence: 99%

Investigating the prescribing trajectory and geographical drug utilisation patterns of gabapentinoids in primary care in England: An ecological study

Chen

et al. 2021

Brit J Clinical Pharma

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Opioid and analgesic utilization in Ireland in 2000 and 2015: A repeated cross‐sectional study

Moriarty¹,

Bennett²,

Fahey³

2021

Pharmacology Res & Perspec

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In recent decades, opioid use has increased internationally and is a major public health concern. This study aims to characterize changes in opioid and other analgesic prescribing in Ireland over a 15‐year period (2000–2015). This is a repeated cross‐sectional study of administrative pharmacy claims data in 2000 and 2015. Individuals of all ages in Ireland's Eastern Health Board region who were eligible for the General Medical Services (GMS) scheme were included. This scheme covers 40% of the population, mostly those on lower incomes and older people. The primary outcome was dispensing of opioids, both prevalence of any use and rate per 1000 GMS eligible population (standardized to the 2015 population). Logistic regression was used to assess odds of opioid dispensing in 2015 versus 2000, controlling for demographic differences. The eligible study population was 364 436 in 2000 and 523 653 in 2015. In 2000, 19.4% of the eligible population had at least one opioid dispensing compared to 20.8% in 2015. The rate increased from 671 to 1098 dispensings per 1000 population. The increase was highest in the dispensing rates of codeine, tramadol, oxycodone, buprenorphine, and fentanyl. Compared to 2000, there was higher odds in 2015 of being dispensed a strong opioid (adjusted odds ratio 2.0, 95%CI 1.97–2.04) or long‐acting formulation (3.75, 95%CI 3.58–3.92). Increased prescribing of opioids, particularly strong opioids, between 2000 and 2015 is evident in Ireland. This is concerning due to the potential for misuse, and opioid‐related morbidity/mortality.

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A repeated cross-sectional study of factors associated with pregabalin-positive poisoning deaths in Ireland

Cited by 19 publications

References 32 publications

Current Evidence on Abuse and Misuse of Gabapentinoids

Current Evidence on Abuse and Misuse of Gabapentinoids

Investigating the prescribing trajectory and geographical drug utilisation patterns of gabapentinoids in primary care in England: An ecological study

Opioid and analgesic utilization in Ireland in 2000 and 2015: A repeated cross‐sectional study

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