Gabapentin Abuse and Controlled Substance Status

Introduction to Gabapentin Abuse

• Approximately 50% of patients prescribed gabapentinoids were treated continuously for at least 12 months, and sudden cessation can lead to physical and psychological withdrawal, as reported by The Lancet Psychiatry 1
• Long-term prescribing of gabapentin (>12 months) is common but often not recommended by clinical guidelines or of doubtful efficacy, according to The Lancet Psychiatry 1

Clinical Considerations

• The American College of Physicians and other medical societies recommend carefully evaluating patients for a history of drug abuse before prescribing gabapentin, although no specific guideline is cited in the article, the general principle is supported by various clinical guidelines 1
• Prescribers must confirm with their respective state licensure authorities regarding local laws and regulations, as gabapentin's legal status varies significantly by jurisdiction, as noted in Gastroenterology 2

Gabapentin Classification and Prescribing Guidelines

Introduction to Gabapentin Classification

• The American College of Emergency Physicians notes that gabapentin differs from other commonly prescribed medications like opioids and benzodiazepines, which have federal controlled substance designations, as it is not a scheduled drug at the federal level 3, 4

Clinical Implications and Prescribing Recommendations

• The American Academy of Emergency Medicine recommends that prescribers be aware of the potential for gabapentin to be abused, particularly among individuals with poly-substance abuse history, and to monitor for signs of misuse, as gabapentin is commonly abused to potentiate opioid effects, and when combined with opioids, significantly increases respiratory depression risk and opioid-related mortality 3, 4