Gabapentin misuse, abuse and diversion: a systematic review

Area of Science:

• Pharmacology
• Addiction Medicine
• Public Health

Background:

• Gabapentin, an anti-epileptic and analgesic drug, was initially presumed to have no abuse potential.
• Widespread off-label prescribing has occurred despite increasing reports of gabapentin misuse, abuse, and diversion.
• This review addresses the prevalence, effects, motivations, and risk factors for gabapentin misuse.

Purpose of the Study:

• To estimate and describe the prevalence of gabapentin misuse.
• To characterize the effects and motivations behind gabapentin misuse.
• To identify risk factors for gabapentin misuse, abuse, and diversion.

Main Methods:

• A systematic search of peer-reviewed papers was conducted.
• Included studies demonstrated gabapentin misuse (e.g., higher dosage, no prescription) or diversion.
• Thirty-three papers (23 case studies, 11 epidemiological reports) from multiple countries met inclusion criteria.

Main Results:

• Gabapentin misuse prevalence: 1% in the general population, 40-65% among those with prescriptions, 15-22% among opioid abusers.
• Reported effects mimic opioids, benzodiazepines, and psychedelics, even at prescribed doses.
• Misuse primarily for recreation, self-medication, or self-harm, often with other substances like opioids, benzodiazepines, and alcohol.

Conclusions:

• International evidence indicates significant misuse and abuse of gabapentin.
• Populations with a history of substance abuse are at particular risk.
• Gabapentin misuse poses a public health concern requiring further attention.