Managing chronic pain: are gabapentinoids being misused?

Gabapentinoid prescriptions for neuropathic and musculoskeletal pain in Lebanon

Aim: The purpose of this study is to analyze the different characteristics of gabapentinoids prescription by Lebanese orthopedics surgeons. Methods: This is an observational, cross-sectional study using a survey which was carried out in collaboration with the Lebanese Orthopedic Society over a 3-month period. Results: Forty-two orthopedic surgeons responded, most of them prescribing gabapentinoids in their daily practice with only half of the patients feeling relief after taking them. Furthermore, most of the surgeons prescribed these drugs for patients above 18 years old and for both acute and chronic pain. Conclusion: Even though almost half of the patients do not experience relief after taking gabapentinoids, these drugs are becoming more and more prescribed.

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

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.