Could gabapentin be America's next drug of abuse?

Based in Denver, USA, Cordant Health Solutions, a provider of innovative tools for monitoring behavioral health, chronic pain and criminal justice cases, has released 2018 workers' compensation drug testing data around patients who were prescribed gabapentin and enrolled in Cordant's program, raising questions on gabapentinoids.

As providers try to find non-addictive alternatives to opioids to treat pain, prescriptions for off-label use of gabapentin have been climbing. Perhaps best known for treating pain associated with shingles, gabapentin does not show an affinity for the same types of receptor sites in the brain that are associated with drugs of abuse. But public health researchers are starting to sound an alarm, citing mounting evidence that gabapentin may not be as benign as once thought. Scientists point out that gabapentin does share some characteristics of drugs of abuse, such as psychoactive effects and withdrawal syndrome, and reports of gabapentin misuse are rising.

"Originally approved in 1993, gabapentin and its relative, pregabalin, are approved to treat epilepsy as well as specific types of nerve pain," said Pete Zaharas, the pharmacist in charge at Cordant. "Between 2002 and 2015, prescription rates for gabapentin tripled, perhaps because it is not classified as a scheduled drug by the federal government, meaning that it is thought to have little potential for abuse."