Gabapentin and US Overdose Deaths: 10 Questions
Gabapentin prescribing has escalated steadily in recent years, with 69 million prescriptions for the anticonvulsant dispensed in 2019, according to the Centers for Disease Control and Prevention (CDC).
There is concern that many of those prescriptions are for off-label purposes and, beyond that, that large amounts of the drug are being abused, most often in combination with opioids, both prescribed and illicit.
With the rise in apparent use have come a disturbing number of reports of gabapentin-involved overdose deaths, a number that doubled in the second quarter of 2020 compared to the first quarter of 2019, the CDC reports.
Try the 10 questions in this quiz, based on a recent MMWR Notes from the Field report, to find out what you know about the trend and, equally important, what you may not know.
1. Gabapentin is FDA-approved for which of the indications above?
Answer: D. Gabapentin is only FDA-approved for the treatment of postherpetic neuralgia pain and asadjunctive therapy for partial seizures.
2. In the US in 2021, where did gabapentin rank among the most frequently prescribed medications?
Answer: A. Gabapentin was the 6th most frequently prescribed medication in the US in 2021.
3. True or False. When taken alone, gabapentin appears to be safe with a low risk for overdose resulting in death.
Answer: A. True. When taken by itself, gabapentin appears to be a relatively safe medication with minimal risk of fatality from overdose.
4. Which of the statements above about gabapentin are true?
Answer: D. All the statements about gabapentin are true. Gabapentin potentiates the effects of illicit opioids and may increase risk of death from respiratory despression when used with opioid.
5. Gabapentin is detected on postmortem toxicology in approximately what percentage of overdose deaths?
Answer: B. 10%. Gabapentin is detected in approximately 10% of overdose-death postmortem toxicology assessement.
6. True or False. The CDC believes that gabapentin-involved deaths are most likely underreported.
Answer: A. True. Gabapentin is likely involved in more overdose deaths than reported because often it is not tested for in toxicology and so is not included on death certifactes.
7. In approximately what percentage of overdose deaths involving gabapentin are opioids also involved?
Answer: D. ~90% of overdose deaths that involve gabapentin also involve opioids.
8. True or false. The percentage of overdose deaths involving gabapentin and illicit opioids appears to be decreasing.
Answer: B. False. The percentage of overdose deaths involving gabapentin and illicit opioids appears to be increasing, a trend the CDC attributes to the growing number of overdose deaths involving gabapentin and illicit opioids, primarily illicit fentanyl.
9. Which demographic groups above are most likely to experience overdose deaths involving gabapentin?
Answer: E. The CDC reports that most gabapentin-involved overdose deaths are occurring among non-Hispanic White persons (83.2%) and persons aged 35–54 years (52.2%).
10. True or False. The Drug Enforcement Administration classifies gabapentin as a controlled substance indicating a potential for abuse.
