Profile of Substance Misuse among Adolescent and Young Adult Gabapentinoid Users: A Register-Based Follow-up Study of Former Adolescent Psychiatric Inpatients

Abstract

Aims: Our study examined characteristics of adolescent and young adult study participants using gabapentinoids (gabapentin, pregabalin), with previous history of adolescent psychiatric inpatient hospitalization. Particular focus was on temporal association of age, at first prescription for gabapentinoids, to age at tobacco smoking initiation, regular alcohol use, diagnosis of substance dependence and prescriptions for benzodiazepines and opioids. Methods: The initial study population contained 508 adolescents (300 females, 208 males) admitted to psychiatric inpatient care in Oulu University hospital between the ages 13-17 years. Register-based follow-up information on prescriptions for gabapentinoids, benzodiazepines and opioids, as well as ICD-10 diagnosis for hospital-treated substance dependence, was obtained from the Finnish national health care registers. Results: The users of gabapentinoids accounted for 9.1% of the initial study population. Of adolescence-related characteristics, suicidal ideation, suicide attempts and non-suicidal self-injury was emphasized in females using gabapentinoids. The majority of participants using gabapentinoids had benzodiazepines (80.4%) and opioids (71.7%) as comorbid drugs. Initiation of tobacco smoking and alcohol use and first prescriptions for of benzodiazepines and opioids, and a diagnosis of substance dependence commonly predated first prescriptions for gabapentinoids. Conclusions: In clinical practice, the decision to prescribe gabapentinoids to adolescents or young adults must be made with caution, particularly for those with substance use problems and/or without a clinically approved indication.

Misuse of prescribed psychotropic medication and drug crime offending: A follow‐up case‐control study of former adolescent psychiatric inpatients

“…This is an interesting finding, considering that Peltokorpi et al. (2021) found that tobacco smoking and alcohol use, the first prescriptions of benzodiazepines and opioids, and a diagnosis of substance dependence predated the first prescriptions of gabapentinoids. Our finding indicates that gabapentinoids may challenge the field of prescribing medications, when the “opioid crisis” (Volkow & Blanco, 2021) and misuse of benzodiazepines (Votaw et al., 2019) have been one of the major concerns in worldwide public health in the past decades.…”

Deprescribing interventions for gabapentinoids in adults: A scoping review

“…6,21 Moreover, gabapentinoid use has also been associated with increased risks of suicidal ideation and behaviour, particularly among adolescents and young adults (15-24 years) and women. [22][23][24] Furthermore, physical dependence, tolerance and withdrawal from gabapentinoids have been well documented at both recommended dosages and supratherapeutic dosages. 6,22,25,26 In cases where a drug is no longer needed or is associated with more harm than benefits, the medicine should cease (or reduce in dose).…”

“…benzodiazepines) and opioid analgesics significantly increases adverse events, such as respiratory depression and mortality 6,21 . Moreover, gabapentinoid use has also been associated with increased risks of suicidal ideation and behaviour, particularly among adolescents and young adults (15–24 years) and women 22–24 . Furthermore, physical dependence, tolerance and withdrawal from gabapentinoids have been well documented at both recommended dosages and supratherapeutic dosages 6,22,25,26 …”