Washington University in St. Louis, School of Medicine. Department of Psychiatry, St. Louis, MO, USA.
University of Arkansas, Department of Health, Human Performance & Recreation, Fayetteville, AR, USA.
Drug Alcohol Depend. 2022 May 1;234:109400. doi: 10.1016/j.drugalcdep.2022.109400. Epub 2022 Mar 9.
As prescriptions for gabapentin have increased in recent years, nonmedical use and risk of adverse outcomes (e.g., hospitalizations and overdose) have been identified, particularly in association with opioids, including opioid agonist medications (OAMs) buprenorphine and methadone. However, there is a lack of systematic, nationwide data assessing the relationship between the nonmedical use of gabapentin and OAMs.
Data were sourced from two nationwide opioid surveillance programs of treatment-seeking individuals with opioid use disorder (OUD). Both programs utilized an identical serial, cross sectional survey of 12,792 new entrants to one of 163 substance use treatment programs for OUD in 46 states and the District of Columbia from January 2019 to December 2020.
Past month nonmedical use of gabapentin was endorsed by 9.3% of the sample. Of those using gabapentin nonmedically, 64.1% also endorsed nonmedical use of an OAM, including concomitant use of methadone (35.3%), and buprenorphine (49.0%). Concomitant nonmedical use of gabapentin and OAMs was more prevalent (versus nonmedical use of gabapentin alone) in the Southern region, among those living in a street dwelling, those with chronic pain and healthcare professionals.
Nonmedical use of gabapentin in people with OUD appears to frequently coincide with nonmedical use of OAMs. As prescriptions and off-label use of gabapentin increase, provider education should include the risks of concomitant gabapentin and OAM use, particularly amongst buprenorphine prescribers. Future research should investigate motivations (e.g., OUD self-management) for nonmedical use of gabapentin and OAMs within the context of OUD treatment access and retention.
近年来，加巴喷丁处方量增加，其非医疗用途和不良后果（如住院和过量用药）风险已得到确认，尤其是与阿片类药物（包括阿片类激动剂药物，如丁丙诺啡和美沙酮）同时使用时。然而，目前缺乏系统的、全国性的数据来评估加巴喷丁的非医疗用途与阿片类药物之间的关系。
数据来源于两个全国性的阿片类药物监测项目，针对的是患有阿片类药物使用障碍（OUD）的寻求治疗的个体。这两个项目均利用相同的、连续的、横断性调查，于 2019 年 1 月至 2020 年 12 月期间，对来自 46 个州和哥伦比亚特区的 163 个治疗 OUD 的药物使用障碍治疗项目中的 12792 名新入组者进行了调查。
过去一个月，有 9.3%的样本报告了加巴喷丁的非医疗用途。在非医疗使用加巴喷丁的人群中，有 64.1%的人同时还报告了阿片类药物的非医疗用途，包括美沙酮（35.3%）和丁丙诺啡（49.0%）的同时使用。在南部地区、居住在街头的人群、患有慢性疼痛的人群和医疗保健专业人员中，同时非医疗使用加巴喷丁和阿片类药物的情况更为普遍（与单独非医疗使用加巴喷丁相比）。
在患有 OUD 的人群中，加巴喷丁的非医疗使用似乎经常与阿片类药物的非医疗使用同时发生。随着加巴喷丁处方量和非标签使用的增加，医生在提供教育时应包括同时使用加巴喷丁和阿片类药物的风险，尤其是在丁丙诺啡的开处方者中。未来的研究应调查在 OUD 治疗的获得和保留的背景下，加巴喷丁和阿片类药物的非医疗使用的动机（例如，OUD 自我管理）。
