Gabapentin misuse, abuse and diversion: a systematic review.
Since its market release, gabapentin has been presumed to have no abuse potential and subsequently has been prescribed widely off-label, despite increasing reports of gabapentin misuse. This review estimates and describes the prevalence and effects of, motivations behind and risk factors for gabapentin misuse, abuse and diversion.



Databases were searched for peer-reviewed papers demonstrating gabapentin misuse, characterized by taking a larger dosage than prescribed or taking gabapentin without a prescription, and diversion. All types of studies were considered; grey literature was excluded. Thirty-three papers met inclusion criteria, consisting of 23 case studies and 11 epidemiological reports. Published reports came from the United States, the United Kingdom, Germany, Finland, India, South Africa and France, and two analyzed websites not specific to a particular country.



Prevalence of gabapentin misuse in the general population was reported to be 1%, 40-65% among individuals with prescriptions and between 15 and 22% within populations of people who abuse opioids. An array of subjective experiences reminiscent of opioids, benzodiazepines and psychedelics were reported over a range of doses, including those within clinical recommendations. Gabapentin was misused primarily for recreational purposes, self-medication or intentional self-harm and was misused alone or in combination with other substances, especially opioids, benzodiazepines and/or alcohol. Individuals with histories of drug abuse were most often involved in its misuse.



Epidemiological and case report evidence suggests that the anti-epileptic and analgesic medication gabapentin is being misused internationally, with substance abuse populations at special risk for misuse/abuse.
Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA.|Department of Epidemiology, University of Kentucky College of Public Health, Lexington, KY, USA.|Department of Biostatistics, University of Kentucky College of Public Health, Lexington, KY, USA.
Rachel V
RV
Smith
Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA.|Department of Epidemiology, University of Kentucky College of Public Health, Lexington, KY, USA.
Jennifer R
JR
Havens
Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA.|Department of Pharmacology, University of Kentucky College of Medicine, Lexington, KY, USA.|Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, KY, USA.
Sharon L
SL
Walsh
D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D000077206:Gabapentin; D006801:Humans; D064226:Prescription Drug Diversion / Q000706:statistics & numerical data*; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology*; D005680:gamma-Aminobutyric Acid
D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin
Diversion; gabapentin; prescription drug misuse; substance abuse; systematic review