![]() We dental professionals must be aware of gabapentin’s rise as a drug of abuse, both alone and in combination with other substances. Why should dental professionals take notice? However, we all know that we live in a world in which not every patient takes medications as prescribed. ![]() Like almost all FDA-approved medications, when prescribed responsibly and taken as prescribed, gabapentin can offer great relief to those with these conditions. It’s also prescribed for multiple psychiatric conditions, such as anxiety disorder, bipolar disorder, attention deficit disorder, and is even prescribed, somewhat ironically, in addiction treatment to reduce cravings and withdrawal symptoms. It’s been prescribed to treat multiple physical conditions with neurological origins, from restless leg syndrome to nerve pain to acute and post-herpetic pain associated with shingles. However, in the quarter century since its initial approval, off-label uses have exploded. ![]() Since its introduction, gabapentin has been very popular and widely used as an adjuvant, an add-on drug that boosts the effects of other drugs, especially to help control partial seizures in adults. Was this just social and broadcast media hysteria or is this based on a real abuse phenomenon? As it turns out, after my initial scratch of the surface, there was a lot for me to uncover about the truth behind these gabapentin warnings. “So, what’s really going on here?” I pondered. Vaping: the new gateway drug and what dental professionals can do However, these two reports hardly constituted thousands. Further review of the literature revealed yet another report of fatality by overdose, which was published the International Journal of Legal Medicine in 2015. Well, many prescription and non-prescription drugs taken in excessive amounts may cause death, even such innocuous drugs as aspirin and acetaminophen. Indeed, my quick review of the literature indicated that the first peer-reviewed report of any gabapentin-linked death was published in 2011 in the Journal of Forensic Sciences, and that was an intentional suicide by overdose. I was unaware of any widespread reports concerning any safety issues with it. It has been available in the US since 1993. ![]() Gabapentin is an anti-seizure drug that is also prescribed for nerve pain. “Gabapentin?!” I said to myself incredulously. I must admit that initially these warnings struck me as a bit alarmist. The new menace was the prescription drug gabapentin, commonly known by its most popular brand-name, Neurontin. Nevertheless, the notifications and warnings went viral and I watched them quickly spread from the web to broadcast media. Second, after such major strides had recently been made in combatting the opioid epidemic in America, how was it possible that another prescription drug had slipped in so easily to replace opioids as the next “menace"? Watch the video First, as a pharmacist, pharmacology educator, speaker, and author for more than 30 years, surely I would have heard of an issue with the illicit use of yet another prescription drug. It was early on a Sunday morning when I first received several notifications on Facebook about a “new” prescription drug abuse menace in America that was “killing thousands."
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