A recent study has found that gabapentin is being used nonmedically in conjunction with nonmedical methadone or buprenorphine to reduce withdrawal symptoms. For the study, based on two nationwide opioid surveillance programs of treatment-seeking individuals with opioid use disorder (OUD), the researchers wanted to systematically assess the relationship between the nonmedical use of gabapentin and agonist medications used to treat OUD. For the study, 9.3% of the OUD sample reported past month nonmedical use of gabapentin. Of those, 64.1% were using either buprenorphine (49.0%) or methadone (35.3%) nonmedically. The use of gabapentin and the other two drugs was higher in chronic pain, homeless, and healthcare professionals. Nonmedical use of gabapentin in people with OUD appears to frequently coincide with nonmedical use of buprenorphine and methadone, the researchers concluded. They also urge that treatment providers be educated about the risks of gabapentin, stressing that this should particularly be known by buprenorphine prescribers. They suggested that within the context of OUD treatment access and retention, motivations for nonmedical use, including efforts to avoid withdrawal. Methadone is Schedule II on the Controlled Substances Act, the most restrictive category of legal medications; buprenorphine is Schedule III; gabapentin is currently unscheduled by the federal government, but some states do consider it a controlled substance so they can track prescriptions on the PDMP. Ellis MS, Buttram ME, Kasper ZA: Nonmedical use of gabapentin and opioid agonist medications in treatment-seeking individuals with opioid use disorder. Drug Alcohol Depend. 2022 May 1;234:109400.
