State-level response to gabapentin misuse in the United States: Implications and future direction

Am J Health Syst Pharm. 2022 Apr 19;79(9):e143-e148. doi: 10.1093/ajhp/zxab486.

Abstract

Purpose: Gabapentin misuse is on the rise and has forced many US states to mobilize policies to address this public health concern. The purpose of this manuscript is to update state-level gabapentin misuse-related policies in the US through September 1, 2021, discuss the benefits and risks of current measures, and highlight gaps in national response.

Methods: Identification of state and federal district policy changes and deliberations related to gabapentin were searched via internet for all 50 states and 1 federal district (n = 51). Only results from state regulatory bodies, such as the board of pharmacy, or state legislative bodies, such as the senate, were considered for inclusion.

Results: Results showed that 22 states and federal districts (43.1%) tightened regulation, while another 2 (3.9%) are considering doing so. Of the 22 states and federal districts with policy changes, 15 (68.2%) enrolled gabapentin into their prescription drug monitoring program, while 7 (31.8%) reclassified gabapentin as a Schedule V controlled substance (C-V).

Conclusion: Absent of federal guidance surrounding gabapentin misuse, the onus has fallen on individual states; thus, approaches have ranged from no intervention to reclassification as a C-V. These measures aim to reduce medication supply but fall short of addressing patient outcomes and reducing harm. Therefore, harm reduction-informed public health policies must be implemented to positively impact patient outcomes and enhance safety.

Keywords: abuse; drug policy; gabapentin; gabapentinoid; misuse; public health.

MeSH terms

  • Gabapentin / therapeutic use
  • Humans
  • Prescription Drug Misuse* / prevention & control
  • Public Policy*
  • United States

Substances

  • Gabapentin