School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA.
Kroger Pharmacy, Decatur, Illinois, USA.
Subst Abus. 2021;42(4):454-459. doi: 10.1080/08897077.2021.1891602. Epub 2021 Mar 9.
Gabapentin is an anticonvulsant medication with potential misuse reported in case reports and population studies, highlighting the need to reexamine its abuse liability. The purpose of this study was to describe gabapentin dispensing patterns and assess potential misuse. We used data from Ohio's Prescription Drug Monitoring Program (PDMP) from December 1, 2016 to March 31, 2017 and restricted the population to adults who filled at least one gabapentin prescription ( = 379,372). Gabapentin dispensing patterns are described and multiple strategies were used to assess potential misuse, including Lorenz-1 curve analysis. Supratherapeutic dosing, number of prescribers and number of pharmacies used were compared for individuals who were co-dispensed medications for opioid use disorder (MOUD) and those who were not. More than one million gabapentin prescriptions were dispensed during the 4-month period, with a mean dose of 1103.8 mg. While few individuals received supratherapeutic dosing, exceptionally high doses were observed. Half of the individuals (50.9%) were co-dispensed gabapentin and opioids. The Lorenz-1 value for gabapentin (5.5%) did not exceed the threshold for misuse potential. Individuals co-dispensed MOUD were more likely to have supratherapeutic dosing; however, they had a lower Lorenz-1 value compared to individuals not co-dispensed MOUD. Among Ohio residents dispensed gabapentin, there was no evidence of misuse using PDMP data based on the Lorenz-1 value, yet supratherapeutic dosing of gabapentin was observed and was associated with OUD. New strategies may be needed to identify the non-medical use of gabapentin.
加巴喷丁是一种抗惊厥药物，已有病例报告和人群研究报告其潜在误用情况，这凸显了重新评估其滥用可能性的必要性。本研究旨在描述加巴喷丁的配药模式并评估潜在的误用情况。我们使用了俄亥俄州处方药物监测计划（PDMP）的数据，时间范围为 2016 年 12 月 1 日至 2017 年 3 月 31 日，并将研究人群限制为至少开具过一种加巴喷丁处方的成年人（ = 379,372）。描述了加巴喷丁的配药模式，并使用多种策略评估潜在的误用情况，包括 Lorenz-1 曲线分析。比较了同时开具阿片类药物使用障碍（MOUD）治疗药物和未同时开具这些药物的个体的超治疗剂量、开方医生数量和使用的药房数量。在 4 个月的时间内共开出了超过 100 万份加巴喷丁处方，平均剂量为 1103.8mg。虽然很少有个体接受超治疗剂量，但观察到了极高的剂量。一半的个体（50.9%）同时开具了加巴喷丁和阿片类药物。加巴喷丁的 Lorenz-1 值（5.5%）未超过潜在误用的阈值。同时开具 MOUD 的个体更有可能接受超治疗剂量；然而，与未同时开具 MOUD 的个体相比，他们的 Lorenz-1 值较低。在俄亥俄州开具加巴喷丁的居民中，基于 Lorenz-1 值，没有证据表明存在 PDMP 数据中的误用情况，但观察到了加巴喷丁的超治疗剂量，且与 OUD 相关。可能需要新的策略来识别加巴喷丁的非医疗用途。
