ARSH: Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 7255 NE 4th Ave., Suite 112, Miami, FL 33138, USA.
ARSH: Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 7255 NE 4th Ave., Suite 112, Miami, FL 33138, USA.
Drug Alcohol Depend. 2019 Nov 1;204:107554. doi: 10.1016/j.drugalcdep.2019.107554. Epub 2019 Sep 13.
Gabapentin is used in the treatment of seizures and neuralgia, and it is prescribed off-label to treat substance use disorders and withdrawal symptoms. Recent research documents misuse of gabapentin, especially among prescription opioid misusers. The present study contributes to this literature by examining the initiation of gabapentin misuse.
Qualitative interviews were conducted with prescription and/or illicit opioid (mis)users who reported a history of gabapentin misuse (N = 62) and who did not (N = 29). During semi-structured interviews, respondents provided descriptions of the first time they misused gabapentin. An ethnographic decision model was constructed to illustrate the factors that influence the initiation decision.
Multiple individual, social, and environmental factors influence the decision to initiate gabapentin misuse. Respondents described the initiation decision related to: a) wanting to feel a psychoactive high during times of limited access to one's preferred drug because of institutional barriers (e.g., substance abuse treatment; jail; transitional living facility; N = 18); b) the desire to use multiple drugs, including for experimentation or to potentiate another substance (N = 18); and c) the need to self-treat withdrawal symptoms during periods of opioid nonuse or when opioids were unavailable (N = 16). Respondents also initiated gabapentin misuse to self-treat physical pain (N = 10).
Multiple approaches are needed to mitigate gabapentin misuse, including limiting availability in institutional settings and informal channels as well as addressing the needs of drug users who experience physical pain and withdrawal symptoms. Continued research is needed to examine therapeutic uses of gabapentin and behaviors related to misuse.
加巴喷丁用于治疗癫痫和神经痛，也被开处方用于治疗物质使用障碍和戒断症状。最近的研究记录了加巴喷丁的滥用，尤其是在处方类阿片类药物滥用者中。本研究通过检查加巴喷丁滥用的起始情况，为这一文献做出了贡献。
对报告有过加巴喷丁滥用史（N=62）和没有滥用史（N=29）的处方和/或非法阿片类药物（滥用）者进行了定性访谈。在半结构化访谈中，受访者提供了他们第一次滥用加巴喷丁的描述。构建了一个民族志决策模型来说明影响起始决策的因素。
多个个体、社会和环境因素影响了开始滥用加巴喷丁的决定。受访者描述了与以下因素有关的起始决策：a）由于机构障碍（例如，药物滥用治疗；监狱；过渡生活设施），在有限的获取个人首选药物的情况下，想要体验到致幻的快感（N=18）；b）想要使用多种药物，包括实验或增强另一种物质的效果（N=18）；c）在非使用阿片类药物期间或阿片类药物不可用时，需要自我治疗戒断症状（N=16）。受访者还为了治疗身体疼痛而开始滥用加巴喷丁（N=10）。
需要采取多种方法来减少加巴喷丁的滥用，包括在机构环境和非正式渠道中限制其可获得性，以及满足经历身体疼痛和戒断症状的药物使用者的需求。需要进一步研究来检查加巴喷丁的治疗用途和与滥用相关的行为。
