Combined Gabapentinoid and Opioid Use: The Consequences of Shifting Prescribing Trends
Authors: Douglas C. Throckmorton, Janet Woodcock
Journal: Annals of Internal Medicine (2018)

Editorials20 November 2018Combined Gabapentinoid and Opioid Use: The Consequences of Shifting Prescribing TrendsDouglas C. Throckmorton, MD and Janet Woodcock, MDDouglas C. Throckmorton, MDU.S. Food and Drug Administration, Silver Spring, Maryland (D.C.T., J.W.) and Janet Woodcock, MDU.S. Food and Drug Administration, Silver Spring, Maryland (D.C.T., J.W.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2175 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Health care professionals face immense challenges in reining in the diversion and improper use of opioid analgesics while at the same time ensuring that patients in pain are appropriately managed. Encouraging the development of alternatives to opioids is an important component of the U.S. Food and Drug Administration's approach to the opioid crisis (1). However, as health care practitioners begin to explore new pain management paradigms, it is crucial to monitor for negative and unintended consequences of changes in prescribing that may manifest as new patterns of abuse or adverse events (2).Gomes and colleagues' report (3) and previous work ...References1. Woodcock J, Throckmorton DC. The FDA's approach to the prescription opioid problem. Clin Pharmacol Ther. 2018;103:954-5. [PMID: 29570773] doi:10.1002/cpt.1055 CrossrefMedlineGoogle Scholar2. Throckmorton DC, Gottlieb S, Woodcock J. The FDA and the next wave of drug abuse—proactive pharmacovigilance. N Engl J Med. 2018;379:205-7. [PMID: 29847203] doi:10.1056/NEJMp1806486 CrossrefMedlineGoogle Scholar3. Gomes T, Greaves S, van den Brink W, Antoniou T, Mamdani MM, Paterson JM, et al. Pregabalin and the risk for opioid-related death: a nested case–control study. Ann Intern Med. 2018;169:732-4. doi:10.7326/M18-1136 LinkGoogle Scholar4. Gomes T, Juurlink DN, Antoniou T, Mamdani MM, Paterson JM, van den Brink W. Gabapentin, opioids, and the risk of opioid-related death: a population-based nested case-control study. PLoS Med. 2017;14:e1002396. [PMID: 28972983] doi:10.1371/journal.pmed.1002396 CrossrefMedlineGoogle Scholar5. Goodman CW, Brett AS. Gabapentin and pregabalin for pain—is increased prescribing a cause for concern? N Engl J Med. 2017;377:411-4. [PMID: 28767350] doi:10.1056/NEJMp1704633 CrossrefMedlineGoogle Scholar6. Johansen ME. Gabapentinoid use in the United States 2002 through 2015. JAMA Intern Med. 2018;178:292-4. [PMID: 29297045] doi:10.1001/jamainternmed.2017.7856 CrossrefMedlineGoogle Scholar7. Evoy KE, Covvey JR, Peckham AM, Ochs L, Hultgren KE. Reports of gabapentin and pregabalin abuse, misuse, dependence, or overdose: an analysis of the Food and Drug Administration Adverse Events Reporting System (FAERS). Res Social Adm Pharm. 2018. doi:10.1016/j.sapharm.2018.06.018 CrossrefMedlineGoogle Scholar8. Abrahamsson T, Berge J, Öjehagen A, Håkansson A. Benzodiazepine, z-drug and pregabalin prescriptions and mortality among patients in opioid maintenance treatment—a nation-wide register-based open cohort study. Drug Alcohol Depend. 2017;174:58-64. [PMID: 28315808] doi:10.1016/j.drugalcdep.2017.01.013 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: U.S. Food and Drug Administration, Silver Spring, Maryland (D.C.T., J.W.)Note: The authors are full-time employees of the U.S. government.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2175.Corresponding Author: Douglas C. Throckmorton, MD, U.S. Food and Drug Administration, Building 51, Room 6132, 10903 New Hampshire Avenue, Silver Spring, MD 20993; e-mail, Douglas.[email protected]hhs.gov.Current Author Addresses: Dr. Throckmorton: U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Building 51, Room 6132, Silver Spring, MD 20993.Dr. Woodcock: U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Building 51, Room 6133, Silver Spring, MD 20993.This article was published at Annals.org on 21 August 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPregabalin and the Risk for Opioid-Related Death: A Nested Case–Control Study Tara Gomes , Simon Greaves , Wim van den Brink , Tony Antoniou , Muhammad M. Mamdani , J. Michael Paterson , Diana Martins , and David N. Juurlink Combined Gabapentinoid and Opioid Use Alyssa M. Peckham and David A. 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Sclar, BPharm, PhDPregabalin increases risk of opioid-related death 20 November 2018Volume 169, Issue 10Page: 727-728KeywordsAnalgesicsCentral nervous systemDrug abuseDrug interactionsDrugsFood and Drug AdministrationHealth careNervous systemOpioidsPain management ePublished: 21 August 2018 Issue Published: 20 November 2018 PDF downloadLoading ...