Researchers from the University of Texas at Austin report that gabapentinoids carry the risk of abuse potential —especially in patients with a history of opioid abuse — and that documented reports of abuse are on the rise. Findings from the study are published in Drugs.

With increasing reports of gabapentinoids (eg, pregabalin, gabapentin) abuse, study authors aimed to assess the extent of abuse, characteristics of typical abusers, patterns of abuse, and potential harms. They conducted a systematic review of various databases indexed through July 28, 2016. Twenty-four epidemiological studies, three clinical abuse liability studies, 16 abuse/misuse/dependence case reports/series, and 17 acute overdose case reports/series were included in the review.  

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The analysis showed a growing number of patients were self-administering higher than recommended doses to achieve euphoric highs. Gabapentinoid abuse was noted in 1.6% of the general population; among opioid abusers, prevalence ranged from 3%–68%. In addition, 11,940 reports of gabapentinoid abuse were identified from 2004–2015 with >75% reported since 2012. 

Substance abuse (especially opioids) and psychiatric comorbidities were identified as risk factors. “While effects of excessively high doses are generally non-lethal, gabapentinoids are increasingly being identified in post-mortem toxicology analyses,” noted study authors Kirk E. Evoy. Clinicians should be aware of high-risk populations and monitor for signs of abuse. 

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