<i>Notes from the Field:</i> Trends in Gabapentin Detection and Involvement in Drug Overdose Deaths — 23 States and the District of Columbia, 2019–2020

Mattson, Christine L.; Chowdhury, Farnaz; Gilson, Thomas

doi:10.15585/mmwr.mm7119a3

Cited by 26 publications

(18 citation statements)

References 6 publications

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“…Of concern, a high proportion of participants with dementia seemed to be more at risk of inappropriate use of gabapentin with concurrent CNS‐active medications. Additionally, a recent post‐mortem toxicology report from the CDC detected that gabapentin‐involved overdose death doubled in the second quarter of 2020 compared to the first quarter of 2019 30 . Considering the vulnerability of older adults and the possibility of misuse of gabapentin, the results from this study call for other studies to fully evaluate the efficacy and risk of using off‐label gabapentin in older adults.…”

Section: Discussionmentioning

confidence: 78%

“…compared to the first quarter of 2019. 30 Considering the vulnerability of older adults and the possibility of misuse of gabapentin, the results from this study call for other studies to fully evaluate the efficacy and risk of using off-label gabapentin in older adults. Policymakers and the clinicians need to be aware of the risk of gabapentin use in older adults to prevent any health burden that may increase in the future.…”

Section: Discussionmentioning

confidence: 90%

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Gabapentin utilization among older adults with different cognitive statuses enrolled in the National Alzheimer's Coordinating Center (2006–2019)

Moga

Abner

2022

Brit J Clinical Pharma

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This study aimed to examine gabapentin utilization trends among older adults with different cognitive statuses and investigate concurrent medication use of potentially inappropriate medications. Data were extracted from the National Alzheimer's Coordinating Center Uniform Data Set (2006–2019). We estimated the yearly prevalence of gabapentin use, both overall and within subgroups defined by cognitive status (normal, mild cognitive impairment and dementia) and demographics (age and sex) for participants aged 65+. Additionally, we assessed the prevalence of concurrent use of gabapentin with opioids, combined opioids and benzodiazepine, antidepressant and antipsychotic. From 35 205 eligible older adults (mean age [SD]: 75.7 [7.0]; male: 43.1%), gabapentin use increased from 2006 to 2019 in both overall and every participant subgroup. About 10%–30% of gabapentin users reported to concurrently use opioids, and the concurrent use of gabapentin, opioid and benzodiazepine was up to 7.5% throughout the study period. The frequency of concurrent use with antipsychotics or antidepressants was higher in participants with dementia than those with normal cognition or those who were mildly cognitively impaired. Given increasing use among older adults, rigorous studies are needed to examine the safety of gabapentin in this population.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 90%

Gabapentin utilization among older adults with different cognitive statuses enrolled in the National Alzheimer's Coordinating Center (2006–2019)

Moga

Abner

2022

Brit J Clinical Pharma

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“…One decedent in this report combined gabapentin (a drug used to treat neuropathic pain) with a CNS stimulant. While a recent report found that less than 10% of drug overdose deaths detected gabapentin in combination with stimulants, gabapentin’s involvement in fatal opioid overdoses in increasing 51 …”

Section: Discussionmentioning

confidence: 99%

Fatalities Involving Substance Use Among US Oil and Gas Extraction Workers Identified Through an Industry Specific Surveillance System (2014–2019)

Ramirez-Cardenas

Wingate

Pompei

et al. 2023

J Occup Environ Med

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Objective: Characteristics of oil and gas extraction (OGE) work, including long hours, shiftwork, fatigue, physically demanding work, and job insecurity are risk factors for substance use among workers. Limited information exists examining worker fatalities involving substance use among OGE workers. Methods: The National Institute for Occupational Safety and Health's Fatalities in Oil and Gas Extraction database was screened for fatalities involving substance use from 2014 through 2019. Results: Twenty-six worker deaths were identified as involving substance use. Methamphetamine or amphetamine was the most common substances (61.5%) identified. Other contributing factors were lack of seatbelt use (85.7%), working in high temperatures (19.2%), and workers' first day with the company (11.5%). Conclusions: Employer recommendations to mitigate substance use-related risks in OGE workers include training, medical screening, drug testing, and workplace supported recovery programs.

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“…Of 58 362 drug related deaths in 23 U. S. states and the District of Columbia between 2019 and 2020, gabapentin was detected in 9.7% of cases and involved in the cause of death in 2975 cases (5.0%) [53]. If gabapentin was detected, opioids were also involved in the cause of death in 85-90% of the cases [53].…”

Section: Drd Following Simultaneous Use Of Opioids and Gabapentinoidsmentioning

confidence: 99%

Predictors and motives of polydrug use in opioid users. A narrative review

Amsterdam

Pierce

Brink

2023

Current Opinion in Psychiatry

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Purpose of reviewTo review the recent literature on predictors and personal motives of polydrug use in opioid users with a focus on combined use of opioids with stimulants, benzodiazepines and gabapentinoids.Recent findingsIn North America, methamphetamine is now the most prevalent co-drug in opioid users and is responsible for high mortality rates. In Europe, opioids are rather combined with either cocaine, benzodiazepines or gabapentionoids, but recent data are lacking.Main personal motives of opioid users to combine opioids with methamphetamine or cocaine is to boost the opioid high, inhibit the withdrawal effects of heroin and have a cheaper alternative to maintain the opioid high. Risk factors of polydrug use by opioid users included being male, younger age, homelessness, high-risk sexual behavior, needle sharing, incarceration, poor mental health and recent use of cocaine or prescription opioids. The motives for co-use of opioids and gabapentinoids also include seeking a better high, lower price and to self-medicate pain/physical symptoms, including those resulting from withdrawal.SummaryWhen treating opioid users with polydrug drug use, special attention should be paid to dosing when in opioid agonist methadone/buprenorphine treatment and to the presence of physical pain. The validity of part of the personal motives seems questionable which deserves attention when counselling opioid users with polydrug use.

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Notes from the Field: Trends in Gabapentin Detection and Involvement in Drug Overdose Deaths — 23 States and the District of Columbia, 2019–2020

Cited by 26 publications

References 6 publications

Gabapentin utilization among older adults with different cognitive statuses enrolled in the National Alzheimer's Coordinating Center (2006–2019)

Gabapentin utilization among older adults with different cognitive statuses enrolled in the National Alzheimer's Coordinating Center (2006–2019)

Fatalities Involving Substance Use Among US Oil and Gas Extraction Workers Identified Through an Industry Specific Surveillance System (2014–2019)

Predictors and motives of polydrug use in opioid users. A narrative review

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