Gabapentin Increasingly Implicated in Overdose Deaths

Data from the State Unintentional Drug Overdose Reporting System suggest that gabapentin’s role in US overdose deaths may be growing. Overall, toxicology tests detected gabapentin in 10% of all cases with test results available. Overdose deaths in which gabapentin was detected doubled from 449 in the first quarter of 2019 to 959 in the second quarter of 2020. James W. Mold, MD, MPH

Free full text

View

Gabapentin Increasingly Implicated
in Overdose Deaths
Postmortem toxicology tests detected gabapentin in almost 1 in 10 US overdose deaths
between 2019 and 2020.In about half of the
cases, a medical examiner or coroner ruled
the drug was a cause of the death, according to a report from the CDC’s Division of
Overdose Prevention.
The US Food and Drug Administration
(FDA) approved gabapentin for treating seizures and pain associated with shingles. But
growing off-label prescribing of gabapentin for nerve pain and other conditions contributed to its prescription rate doubling
from about 13 to 27 per 1000 insurance beneficiaries between 2009 and 2016. In fact,
by 2019, gabapentin had become the
seventh most prescribed drug in the US.
Gabapentin is sometimes used to amplify the effects of illicit opioids. In late 2019,
the FDA warned that gabapentin might
cause serious breathing difficulties when
usedwith drugs that depress the central nervous system, such as opioids, antianxiety
medications, and antidepressants.
Now, data from the State Unintentional
Drug Overdose Reporting System from 23
states and the District of Columbia suggest
that gabapentin’s role inUS overdose deaths
may be growing.Overall, toxicology tests detected gabapentin in 5687 overdose deaths
between 2019 and 2020—about 10% of all
cases with test results available. Overdose
deaths in which gabapentin was detected
doubled from 449 in the first quarter of 2019
to 959 in the second quarter of 2020.
The proportion of these cases thatmedical examiners ruled were caused by the drug
increased from 50% in early 2019 to 55% by
late 2020. About 90% of these cases also involved opioids, primarily illicitly manufactured fentanyl. About 83% of deaths caused
by gabapentin occurred amongWhite adults
aged 35 to 54 years.
“Personswho use illicit opioidswith gabapentinshouldbeeducatedabouttheincreased
risk for respiratorydepressionanddeath,” the
authors wrote. − Bridget M. Kuehn, MSJ

Author/s:

Kuehn, B. M.

Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the District of Columbia, 2017

John Bayhi — Sat, 14 Mar 2020 20:31:53 +0000

Date Added:

March 14, 2020

Journal/Publication:

MMWR Morbidity and Mortality Weekly Report

Publisher:

Centers for Disease Control and Prevention

Publication Date:

March 13, 2020

Issue:

Volume:

Pages:

265-270

URL:

Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the District of Columbia, 2017

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.15585/mmwr.mm6910a3

Keywords

alcohol use

screening and brief intervention

alcohol SBI

binge drinking

PMID (1):

32163383

MeSH

Behavioral Risk Factor Surveillance System

Fetal Alcohol Spectrum Disorders

Public Health Practice

health personnel

Evidence-Based Medicine

insurance coverage

Telephone

Centers for Disease Control and Prevention

U.S.

Longitudinal Studies

The CDC recommends screening all adults for binge drinking with a single question and recommending reduction to those who screen positive. James W. Mold, MD, MPH

Free full text

View

What is already known about this topic?

Binge drinking increases the risk for adverse health conditions and death. Alcohol screening and brief intervention (SBI), recommended by the U.S. Preventive Services Task Force (USPSTF) for all adults in primary care, is effective in reducing binge drinking.

What is added by this report?

In 2017, 81% of survey respondents were asked by their health care provider about alcohol consumption and 38% about binge drinking at a checkup in the past 2 years. Among those asked about alcohol use and who reported current binge drinking, 80% received no advice to reduce their drinking.

What are the implications for public health practice?

Implementation of alcohol SBI as recommended by USPSTF, coupled with population-level evidence-based interventions, can reduce binge drinking among U.S. adults.

Author/s:

McKnight-Eily, LR, Okoro, CA, Turay, K, Acero, C, Hungerford, D