Need for international classification of gabapentin as a controlled substance

Peckham, Alyssa M.; Sclar, David A.

doi:10.1136/bmj.k4978

Cited by 2 publications

(1 citation statement)

References 15 publications

(19 reference statements)

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“…Drugs in this category require a physical prescriber signature for each prescription rather than authorization by electronic prescriptions. In addition, the prescriptions expire after 28 d (53). These provisions emphasize the need for programmatic pharmacovigilance to manage suspected PGB abuse in patients with a history of substance misuse (particularly opioids) and comorbid psychiatric conditions.…”

Section: Legal Status Of Pregabalinmentioning

confidence: 99%

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

et al. 2020

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Introduction: In recent years, there has been an increase in the non-medical use of psychoactive prescription drugs including pregabalin (PGB). Studies have shown that multiple drug users and patients in methadone treatment programs administered PGB at high dosages in order to achieve euphoria, reduce withdrawal symptoms, or potentiate the effects of methadone. For these reasons, accurate toxicological monitoring is required for these high-risk individuals. Materials and Methods:The present study investigated whether PGB could be detected in the hair samples of 250 patients with a history of opiate dependency, and under toxicological surveillance assess their compliance with methadone maintenance therapy.Results: Opiates were found in 54/250 of all hair samples, while cannabis was present in 74/250 patients, cocaine was detected in 21/250 patients, and benzodiazepines without prescription were identified in 49/250 patients. As expected, methadone was present in all 250 patients (100%). PGB without prescription was found in the hair samples of 35/250 patients (14%). Of these, 91.43% were male, 48.57% were <30 y old, and 45.71% were between ages 30 and 50 y. There were no apparent associations among PGB use, daily methadone dosage, and duration of methadone maintenance therapy. Psychiatric comorbidities were present in 25.71% of the patients abusing PGB. Anxiety (55.56%) and depression (33.33%) were the most prevalent psychiatric disorders.Discussion: Most of the patients taking PGB (57.14%) used other drugs (especially opiates) concurrently. The utility of hair analysis is explained by easy and rapid sample collection and the ability of the hair to reflect long-term drug use and incorporate drug metabolites. The findings of this study suggested that PGB has significant potential for abuse by high-risk populations such as opioid users and patients with dual diagnosis. These risks are particularly high in cases of poly-drug use and drug intake that are not in compliance with prescription guidelines.

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Section: Legal Status Of Pregabalinmentioning

confidence: 99%

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

et al. 2020

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Sociodemographic and clinical correlates of gabapentin receipt with and without opioids among a national cohort of patients with HIV

et al. 2021

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Gabapentin is commonly prescribed for chronic pain, including to patients with HIV (PWH). There is growing concern regarding gabapentin's potential for harm, particularly in combination with opioids. Among PWH, we examined factors associated with higher doses of gabapentin receipt and determined if receipt varied by opioid use. We examined data from the Veterans Aging Cohort Study, a national prospective cohort including PWH, from 2002 through 2017; data were analyzed in 2020. Gabapentin receipt was categorized as none, low dose (<1,469 mg/day), and high dose (1,469mg/day). Covariates included prescribed opioid dose, selfreported past year opioid use, and other sociodemographic and clinical variables. We used multinomial logistic regression to determine the independent association between gabapentin receipt and prescribed opioids and other sociodemographic and clinical characteristics. In secondary analyses, we replaced prescribed opioids with self-reported opioid use. Among 3,702 PWH, 902 (24%) received any gabapentin during the study period at a mean daily dose of 1,469 mg. There were no observed differences in gabapentin receipt over the study period. In the multinomial model, high-dose gabapentin receipt was associated with high-dose benzodiazepine receipt (adjusted odds ratio [aOR], 95% confidence interval [CI]= 1.53, [1.03-2.27]), pain interference (1.65 [1.39-1.95]), and hand or foot pain (1.81, [1.45-2.26]). High-dose gabapentin receipt was associated with prescribed high-dose opioids receipt (2.66 [1.95-3.62]) but not selfreported opioid use (1.03 [0.89-1.21]). PWH prescribed gabapentin at higher doses are more likely to receive high-dose opioids and high-dose benzodiazepines, raising safety concerns.

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Need for international classification of gabapentin as a controlled substance

Cited by 2 publications

References 15 publications

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

Sociodemographic and clinical correlates of gabapentin receipt with and without opioids among a national cohort of patients with HIV

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